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Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29562
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I was in an automobile accident in May. I was told that I ...

Customer Question

I was in an automobile accident in May. I was told that I had a contusion to the Ulnar nerve. However everything I have read said that it should only take 2-6 weeks to heal. I am approaching 2 months. I have been to Physical Therapy and they haven''t been able to do much because of the pain and tenderness in the elbow, down the arm and into the hand which has affected the last two fingers. From the top of the pinkie finger I have boarderline dangerous loss of sensation, the ring finger is not as bad but still have numbness. My question is this normal for a simple contusion or is it a more moderate contusion-I''m confused
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.

Greetings.

What were the investigations done for diagnosing ulnar contusion?

Dr. Arun

Customer: replied 6 years ago.
Reply to Dr. Arun Phophalia's Post: They took Xrays in the mergency room to see if the elbow was broken-negative. The ER doc pushed on the inside back portion of the elbow which created more pain down through the arm and into the wrist and went into the ring and little fingers.
I was then sent to an Orthopedic doctor who examined the elbow and did range of motion with the arm, wrist and hand. H e also tested the nerves with a sharp and blunt object.
I was sent to PHysical Therapy and after today I have one more visit.
I cannot put any pressure on the elbow or arm-such as laying it on a table as this increases pain, tingling sensation down through the arm and into those two fingers. In PT they again tested the nerves with different items for sensation and found the top part of the baby finger is borderline dangerous-meaning I could get burned and not feel it-the ring finger is somewhat numb but not to the extent of the baby finger.
Last week, the Physical Therapist had me try to hold a one pound weight in my hand and raise the hand upward and the weight almost fell right out of my hand and it caused more pain in the wrist and up the arm into the elbow. I have no gripping or pulling abilities at the moment.
The Orthopedic doctor has released me back into my family doctors care-I only saw the Ortho doc 2 times.
I have had nerves cut before and I have been fortunate that they have healed in a relatively short period of time, so I don't understand why this should take 16 months just to see if the nerve damage is permanent and then to proceed with a nerve test etc etc. To me this doesn't sound like a typical contusion-maybe I'm wrong but I need someone to give me their opinion so that I can understand what is going on.
Thanks
Jennifer
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Jennifer,

It is high time that you need to get the electrodiagnostic studies like EMG & NCV. Electromyograph is usually performed at around 4 weeks following nerve injury and it will give a fair idea about the denervation. Nerve conduction studies is particularly useful in determining secondary compression sites and type of injury to the nerve. If there is a persistent compression of the nerve, a surgery may be needed.

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 6 years ago.
Reply to Dr. Arun Phophalia's Post: Hello,
So are you thinking that because of my symptoms that the injury to the elbow is something more than just a contusion and that is why after almost a month of PT that my symptoms are still the same and not much progress made. I am concerned because I am right handed and it is my right elbow, arm and hand that has been affected.
Thanks for your help
Jennifer
Expert:  Dr. Arun Phophalia replied 6 years ago.

Yes, Jennifer,

These investigations would show the exact status of the nerve.

After these investigations, if they don't diagnose, I would get an MRI of the elbow. I am also thinking of a whiplash which has caused problem and getting an MRI of the cervical spine would also be prudent as the next step.

Dr. Arun

Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29562
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 2 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Reply to Dr. Arun Phophalia's Post: Thank you very much Dr., you have been so helpful with this issue as I know my body and how fast it heals and for this to continue on like this was driving me crazy because there is a reason why the inflamation hasn't gone down,the finger to be the way they are and the amount of pain that I am having. Once again thank you very much.
Jennifer
Expert:  Dr. Arun Phophalia replied 6 years ago.

You are welcome.

Best wishes and kindest regards.

Dr. Arun

Customer: replied 6 years ago.
Thank you and I will request you as an expert in the future.
Have a great weekend
Jennifer

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