A 40-year old male after binge drinking slept on a chair. On the next day, he presented with weakness of the right arm and was not able to move his hand. Examination showed ulnar nerve palsy. What would be the management?
**Core Concept**
Ulnar nerve palsy, also known as "Saturday night palsy," typically results from prolonged compression of the ulnar nerve, often due to sleeping in an awkward position with the arm in an extended, adducted, and internally rotated position, which can occur after excessive alcohol consumption.
**Why the Correct Answer is Right**
The management of ulnar nerve palsy primarily involves conservative measures, as the nerve usually recovers spontaneously within a few days to weeks. Initially, the patient should avoid any activity that exacerbates the symptoms, and physical therapy may be recommended to improve range of motion and strength. In some cases, a wrist splint or a sling may be used to support the affected limb. However, surgical intervention might be necessary if there is a significant delay in recovery or if the patient experiences persistent symptoms.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because surgical intervention is usually not the first line of treatment for ulnar nerve palsy.
**Option B:** This option is incorrect because physical therapy alone may not be sufficient for recovery, and the patient may need additional conservative measures such as a wrist splint or sling.
**Option C:** This option is incorrect because steroid injections are not typically used as a treatment for ulnar nerve palsy.
**Clinical Pearl / High-Yield Fact**
It is essential to note that "Saturday night palsy" can also occur due to other factors such as compression from a tight tourniquet, a tight cuff, or even a sleeping bag.
**Correct Answer: C. Physical therapy and conservative management.**