PMC7656046_01
Dorsal view of left hand. Note interosseous muscles atrophy, specially seen between I and II metacarpal bones (white arrow).
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F1
Physical examination showed marked weakness and atrophy of all ulnar supplied intrinsic left hand muscles, except for the hypothenar muscles [Figure 1].
Surgical view showing the pisohamate hiatus. The fibrous arch (white arrow) must be divided to release the deep branch of ulnar nerve. Note the deep branch of ulnar nerve (red arrow) passing posterior to the fibrous arch and the superficial branch of ulnar nerve (black arrow) passing anterior to the arch.
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F2
The procedure revealed a mild compression of the deep ulnar branch under the origin of the flexor digiti quinti brevis and opponens digiti quinti muscles [Figure 2].
PMC7656046_02
Physical examination of hands. (a) Ventral view of hands, atrophy of ulnar innerved intrinsic hand muscles. (b) Close aspect of hypothenar region. Note left hypothenar region atrophy (white arrow).
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F3
Physical examination revealed mild weakness (Grade IV) and atrophy of all ulnar supplied intrinsic left hand muscles, including the hypothenar muscles, and hypoesthesia in the V finger [Figure 3].