Tag Archive: transposition

Cubital Tunnel Syndrome Treatment Opions

Cubital tunnel syndrome occurs when the ulnar nerve is pinched as it passes behind the elbow. If you have ever hit your funny bone, you understand what cubital tunnel syndrome is like.

Is cubital tunnel syndrome common?

According to experts, cubital tunnel syndrome is a common nerve entrapment condition with an incidence of 25 cases per 100,000 persons per canstockphoto4094506year. The condition is caused by injury or irritation to the inside aspect of the elbow. This syndrome is most common among persons who have jobs where their elbow is bent most of the day, where they could suffer repetitive injury to the elbow, or where they lean on the elbow much of the time. Also, persons who play golf, tennis, or guitar are at increased risk for ulnar nerve injury.

What are the symptoms of cubital tunnel syndrome?

Like other nerve compression syndromes, cubital tunnel syndrome causes numbness, pain, and weakness. Nerves become pinched for many reasons. The ulnar nerve is one of the nerves that supply the upper extremity. Irritation to this nerve produces elbow pain and arm weakness. When the elbow is struck, it causes a shooting sensation into the ring and small fingers. Weakness of the hand muscles is also common with this condition.

How is cubital tunnel syndrome diagnosed?

The diagnosis of cubital tunnel syndrome is made by a thorough history and physical examination. If there is a concern about structural injury or damage, x-rays and nerve conduction tests may be ordered.

What is the treatment for cubital tunnel syndrome?

Cubital tunnel syndrome treatment starts with simple steps. Most cases of cubital tunnel syndrome resolve after a short time. Treatment options are:

  • Avoidance of leaning on the elbow
  • Taking anti-inflammatory medicines (naproxen and ibuprofen)
  • Padding the elbow for leisure and work activities
  • Splinting the elbow at night

Will I need surgery?

When conservative treatment fails, the orthopedic specialist may recommend surgery. Because the nerve may be pinched at several locations behind the elbow, to release pressure from all areas of pressure, surgery is done. For many patients, treatment consists of moving the nerve to the front aspect of the elbow, so the nerve is under much less tension when the elbow is bent (called ulnar nerve transposition).

What types of surgeries are there for ulnar nerve syndrome?

Several approaches can be considered to treat cubital nerve syndrome. These include:

  • Local decompression of the nerve – This is achieved by simple decompression without medial epicondylectomy. It involves the release of canstockphoto25790214deep tissue that overlies the nerve. This procedure is recommended with symptoms are mild or intermittent, there is little or no pain, there is no instability of the ulnar nerve, and/or the osseous structure of the elbow is normal.
  • Medial epicondylectomy – This involves making a large incision over the elbow, and decompressing the cutaneous nerves. The flexor pronator is detached from the elbow bone, and the medial epicondyle, or a portion of it, is removed.
  • Anterior transposition – This involves decompression of the ulnar nerve, excision of the proximal end of the medial epicondyle, and transposition of the nerve into the subcutaneous tissue.
  • Endoscopic release – This procedure uses a tiny scope with camera to allow for local decompression of the nerve. The advantages of this procedure include reduced complication rates, faster rehabilitation, and limited invasiveness. In a recent study, 87% of patients reported good or excellent results with endoscopic release surgery.

Orthopedic and Sports Performance Institute offers both conservative and surgical options for cubital tunnel syndrome in Gilbert Arizona. The includes injections, bracing, medications and various options for surgery. Most insurance is accepted, call us today!