Ulnar nerve entrapment across the elbow (UNEAE) and across wrist (UNEAW) is the second most common entrapment of the hand after carpal tunnel syndrome. There are few gradings available for UNEAE and lesser in UNEAW.The aim of this research is;1. To create a clinically appropriate ulnar nerve entrapment grading tool to covers both area of entrapment in one research paper.2. To see the relation of sensory nerve involvement across wrist with the entrapment across elbow and to evaluate its effectiveness in terms of compatibility with previous research, without any invasive tests like needle EMG examination. 3. To identify the lesion below and across wrist as well as across elbow in order to support the clinical Physiologist (CP) to grade them properly and also help the consultant in deciding to treat with conservative or surgical treatment.4. To compare the recording from the first dorsal interosseous (FDI) muscles with the abductor digiti minimi (ADM) muscle to see which muscle is more sensitive and shows early changes in ulnar nerve entrapment. The proposed revised grading system is based on more nuanced, descriptive categories, ranging from "normal”, "early”, "mild”, "moderate” and "severe”. To create full grading system of UNEAW and UNEAE some additional category of clinical grading is therefore proposed.What will audience learn from your Presentation: My presentation will be of interest for those who are involved in recording the neurophysiology of the ulnar nerve as well to the surgeons who are involved in hand surgery.  This will give them the information that they need to decide on a conservative or surgical approach to treatment. My presentation will also help those that are new or are considering joining the neurophysiological or surgical field.  My proposed grading will give them precise information of nerve entrapment in a simple and easy to use method. 

Salim Hirani has worked in Neurophysiology for more than 30 years. He completed his Neurophysiology course in the United Kingdom. Over his career, he has worked in several different countries and can speak 4-5 languages. He has authored three research papers: "Refined Grading of Carpal Tunnel Syndrome" published in the BMC journal in 2019, "Neurophysiological Grading Tools of Ulnar Nerve Entrapment Across Elbow" in the Journal of Neurology, Neurological Science and Disorders in 2023, and "Neurophysiological Study for Ulnar Entrapment at Wrist" in the Journal of Psychiatry and Behavioural Sciences in June 2023, accessible at meddocsonline.org.