A qualitative study of common functional problems experienced by people with complete ulnar nerve paralysis.

OBJECTIVES To identify the most common functional problems caused by ulnar nerve palsy. This study is the first phase in the process of developing a patient-centred hand function questionnaire specific for ulnar palsy. DESIGN Twenty-five participants with complete irreversible ulnar nerve palsy were asked to record the five main problems they had because of their hand deformity in the week before they came to hospital. They ranked these problems in order of priority. The participants had all been referred to LEPRA-HOINA Leprosy Reconstructive Surgery Hospital, Muniguda, Orissa, India for tendon transfer surgery. RESULTS Thirty-nine problems were experienced by the participants; 37 of these were functional problems. Five problems had a prevalence of > or =40%, these were holding soap (68%), eating (56%), buttoning (48%), holding a glass (44%) and lifting small objects (44%). Further analysis according to whether the left or right hand was affected was performed; 92% of participants with right ulnar nerve palsy had a problem eating compared to only 20% of those with left ulnar palsy. Eating was ranked as the most important problem by 28% of participants, holding a glass by 12% and holding soap by 8%. CONCLUSIONS Ulnar nerve palsy had an important impact on basic activities of daily living--eating, washing, and drinking. Not only are these activities themselves affected but the person with a hand deformity avoids social situations where it will be noticed. This study indicates that there is a need to identify and treat people who have ulnar nerve palsy in order that they can be integrated into society, become independent with activities of daily living and earn an income.