The dorsal cutaneous branch of the ulnar nerve divides from the main ulnar nerve proximal to the wrist and passes subcutaneously around the ulnar aspect of the wrist to supply the dorsal hand and fingers. Because it divides proximal to Guyon canal, its sensation is preserved in wrist-level ulnar nerve compression — the presence of dorsal ulnar sensory loss indicates an ulnar nerve lesion proximal to the wrist (cubital tunnel level).
| Origin | Ulnar nerve 5 to 6 cm proximal to the wrist, posterior to the FCU |
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Testing dorsal ulnar sensation allows localisation of ulnar nerve lesions — intact dorsal sensation with palmar numbness localises to Guyon canal, while both palmar and dorsal numbness localises to the elbow or proximal. The dorsal cutaneous branch is at risk in ulnar styloid fractures and during dorsal wrist procedures.
Preserved dorsal ulnar sensation with palmar numbness localises ulnar neuropathy to Guyon canal rather than the cubital tunnel at the elbow.
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