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CUBITAL TUNNEL SYNDROME


The ulnar nerve supplies most of the small muscles of the hand that make small fine movements of the fingers possible. It supplies the sensation of the skin of the little finger and half of the ring finger. Therefore, when this nerve is compressed (at any place) the hand gets weaker (the hand muscles become wasted) and pins and needles are experienced in the little and ring fingers.

In Cubital Tunnel Syndrome, the ulnar nerve is compressed at the elbow. The ulnar nerve runs in a tunnel and passes structures that can create potential fibrous bands or pressure points on the nerve as it continues along it’s normal course. It is important to understand that in flexion (bending) of the elbow, the ulnar nerve is at maximum stretch. The pressure in this nerve is raised by 50% when the elbow is flexed beyond ninety degrees. The nerve runs just behind the medial epicondyle (the funny bone) and may create a snapping or electric-shock type feeling when it subluxes to the front of the medial epicondyle.

Sometimes the ulnar nerve is compressed at the level of the wrist in Guyon’s canal or just beyond it. The expression of symptoms has some variations to Cubital tunnel syndrome.

The principle of treatment is to relieve pressure on the ulnar nerve. In conservative non-surgical treatment, adjustment of lifestyle and splints are all based on the principle of preventing elbow flexion, which decreases the pressure on the nerve. There are two surgical procedures that are combined in advanced cases. The nerve is decompressed and freed around the elbow with or without transposing it to the front of the elbow, which “shortens” it’s route and it is then embedded in muscle or the fascia in the front of the elbow. This procedure reduces pressure on the nerve, and may provide immediate relief. Symptoms, however, may take 3-12 months to resolve, particularly if the cubital tunnel syndrome was chronic.


icon-5

CUBITAL TUNNEL SYNDROME


The ulnar nerve supplies most of the small muscles of the hand that make small fine movements of the fingers possible. It supplies the sensation of the skin of the little finger and half of the ring finger. Therefore, when this nerve is compressed (at any place) the hand gets weaker (the hand muscles become wasted) and pins and needles are experienced in the little and ring fingers.

In Cubital Tunnel Syndrome, the ulnar nerve is compressed at the elbow. The ulnar nerve runs in a tunnel and passes structures that can create potential fibrous bands or pressure points on the nerve as it continues along it’s normal course. It is important to understand that in flexion (bending) of the elbow, the ulnar nerve is at maximum stretch. The pressure in this nerve is raised by 50% when the elbow is flexed beyond ninety degrees. The nerve runs just behind the medial epicondyle (the funny bone) and may create a snapping or electric-shock type feeling when it subluxes to the front of the medial epicondyle.

Sometimes the ulnar nerve is compressed at the level of the wrist in Guyon’s canal or just beyond it. The expression of symptoms has some variations to Cubital tunnel syndrome.

The principle of treatment is to relieve pressure on the ulnar nerve. In conservative non-surgical treatment, adjustment of lifestyle and splints are all based on the principle of preventing elbow flexion, which decreases the pressure on the nerve. There are two surgical procedures that are combined in advanced cases. The nerve is decompressed and freed around the elbow with or without transposing it to the front of the elbow, which “shortens” it’s route and it is then embedded in muscle or the fascia in the front of the elbow. This procedure reduces pressure on the nerve, and may provide immediate relief. Symptoms, however, may take 3-12 months to resolve, particularly if the cubital tunnel syndrome was chronic.

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