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Dorsal Cutaneous Branch of Ulnar Nerve (DCU)

OVERVIEW
Key Points:
• This nerve can be injured in ulnar-sided wrist lacerations and surgical procedures within the area that include treatment of ulnar styloid fractures.
Sensory Innervation:
• Provides sensation to the dorsal medial/ulnar aspect of the hand.
• Originates from roots C8 and branches from the ulnar nerve.
Nerve Transfers: This nerve can be a useful donor nerve for sensory nerve transfers involving the hand.

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EXAMINATION
Sensory examination includes testing the dorsal medial/ulnar aspect of the hand innervated by the dorsal cutaneous branch of the ulnar nerve.
 
Sensory Examination:
• Ask patients to draw area of diminished sensation/numbness on a body diagram.
• Testing the skin along the dorsal ulnar aspect of the wrist and hand for reduced/absent sensation by use of light touch or other sensory examination modalities.
Clinical Relevance:
• Provides sensation to the dorsal medial/ulnar aspect of the wrist and hand.
Adjacent Sensory Distribution:
PROXIMAL/MEDIAL – Medial antebrachial cutaneous nerve.
PROXIMAL/LATERAL – Lateral antebrachial cutaneous nerve.
 
LATERAL – Superficial branch of the radial nerve.
 
VOLAR – Palmar cutaneous branch and digital cutaneous branches of the ulnar nerve.
Relevant Anatomy:
Innervation
• Roots: C8.
• Nerve: Ulnar nerve.
• Sensory Territory: Dorsal ulnar aspect of the hand.
• Innervation Route: C8 → ulnar nerve → dorsal cutaneous branch of ulnar nerve.
Course: The dorsal cutaneous branch of the ulnar nerve branches from the ulnar nerve within the ulnar aspect of the volar mid-forearm. It separates from the main trunk of the ulnar nerve about 5-12 cm proximal to the level of the wrist crease.  It then curves dorsally to innervate the dorsal ulnar aspect of the hand.