Cubital Tunnel Syndrome

What is it?

Cubital Tunnel Syndrome is a condition that is caused by pressure on a large nerve (ulnar nerve) located behind your elbow. This nerve controls feeling in your little and ring fingers. It also controls most of the muscles in your hand.

Pressure on the ulnar nerve behind the elbow is called Cubital Tunnel Syndrome because the nerve runs through a tunnel behind the elbow, which is called the Cubital Tunnel. Bone, muscles and ligaments form this tunnel. Sometimes the space in the tunnel becomes narrowed leading to pressure on the nerve. This then causes the symptoms of Cubital Tunnel Syndrome.

Who gets it?

Cubital Tunnel Syndrome is the second most common nerve entrapment syndrome after Carpal Tunnel Syndrome. There are a variety of possible causes but in most cases no obvious cause is found.

What are the symptoms?

The symptoms of Cubital Tunnel Syndrome are usually tingling in the little and ring fingers of the hand. This is often made worse when the elbow is bent or when the elbow is resting on a firm surface. Some patients are woken from their sleep with the tingling. Occasionally, patients experience a dull ache down the inside of the forearm. In more severe cases, there may be loss of feeling in the little and ring fingers together with weakness and clumsiness of the hand.

How is it diagnosed?

I can sometimes suspect Cubital Tunnel Syndrome after a simple physical examination. However, there are a number of other conditions, which can cause tingling in the fingers, and the diagnosis is rarely certain after a simple physical examination. Other tests, which may be required, include an x-ray and nerve conduction studies.

What are nerve conduction studies?

A nerve conduction study is a test to measure the ability of a nerve to transmit messages (electrical impulses) to and from the brain. If a nerve is compressed it will not be able to transmit the impulse normally.

As well as the ulnar nerve, other nerves may be tested at the same time to be certain that the abnormality is in the ulnar nerve and that your symptoms are not the result of some other cause.

How is it treated?

Some cases settle down without treatment. For the majority of patients the treatment is surgical. This involves releasing the pressure on the ulnar nerve as it passes through the Cubital Tunnel, hence the name Cubital Tunnel release. The roof of the Tunnel is divided to remove the pressure on the nerve. The surgery is normally performed under a general anaesthetic or a regional anaesthetic (block). Whatever type of anaesthetic you have, the surgery can be performed as a day case procedure.

What happens after surgery?

You will have a bandage around your elbow when you leave hospital. This will be removed normally between 10 and14 days later. It is important that you try to use your arm for light activities even whilst the bandage is on.

What are the risks of surgery?

The risk of surgery is very small but includes bleeding, infection, stiffness, nerve injury and increased sensitivity of the skin. This is discussed with you before your surgery.

How successful is the surgery?

This depends on how severe the nerve is compressed. For mild compression, excellent results are achieved in close to 100% of patients. For severe compression, excellent results are achieved in less than 50% and the recurrence rate (chance of the symptoms reoccurring) is close to 70%.

Do I have to have an operation?

No. If your symptoms are mild I may not recommend surgery.










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