Cubital Tunnel Syndrome is a condition characterized by compression of the ulnar nerve in an area of the elbow called the cubital tunnel.
The ulnar nerve travels down the back of the elbow behind the bony bump called the medial epicondyle, and through a passageway called the cubital tunnel. The cubital tunnel is a narrow passageway on the inside of the elbow formed by bone, muscle, and ligaments with the ulnar nerve passing through its center. The roof of the cubital tunnel is covered with a soft tissue called fascia.
When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump. When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed leading to a variety of symptoms, called cubital tunnel syndrome.
In general, signs and symptoms of Cubital Tunnel Syndrome arise gradually, progressing to the point where the patient seeks medical attention. Left untreated, Cubital Tunnel Syndrome can lead to permanent nerve damage in the hand. Commonly reported symptoms associated with Cubital Tunnel Syndrome include:
The common causes responsible for cubital tunnel syndrome, include:
Your physician will perform the following:
Your physician may order X-ray and electrodiagnostic tests such as electromyography and nerve conduction studies. These tests can assist your doctor in determining how well the nerve is functioning and locate areas of muscle wasting and nerve compression.
Your physician will recommend conservative treatment options initially to treat the symptoms unless muscle wasting or nerve damage is present.
Conservative treatment options may include:
If conservative treatment options fail to resolve the condition or if muscle wasting or severe nerve compression is present, your surgeon may recommend a surgical procedure to treat your condition.
The goal of Cubital Tunnel surgery is to reduce the pressure on the ulnar nerve by providing more space for the nerve to move freely and to increase blood flow to promote healing of the ulnar nerve. There are different surgeries that can be performed to treat your condition, such as:
Medial Epicondylectomy: This surgery involves removing the medial epicondyle, the bony bump on the inside of the elbow, enabling the ulnar nerve to glide smoothly when the elbow is flexed and straightened.
Ulnar Nerve Transposition: This surgery involves creating a new tunnel in front of the medial epicondyle and transposing (moving) the ulnar nerve to the new tunnel.
Your surgeon will decide which options are best for you depending on your specific circumstances.
After surgery, your surgeon will give you guidelines to follow depending on the type of repair performed and the surgeon’s preference. Common post-operative guidelines include:
The majority of patients suffer no complications following Cubital Tunnel surgery, however, complications can occur following elbow surgery and include: