Cubital tunnel syndrome Discussion
Cubital tunnel syndrome results from a combination of local pressure and
stretching the ulnar nerve at the elbow as it passes behind the medial
epicondyle. The problem may arise following local trauma, but most often is
spontaneous, with elbow position during sleep the largest contributing
factor. Problems include pain, numbness, altered sensation and weakness,
and may be permanent if nerve damage has occurred. Electrical nerve testing
may be helpful in assessing nerve damage, but may be normal even in
patients with symptomatic nerve compression. Nerve irritation at the neck
may produce similar symptoms and may coexist with this problem. Most mild
cases can be treated with a splint or elbow pad and avoidance of flexion
and direct pressure on the nerve. More advanced cases require surgery to
decompress and transpose the nerve out of the cubital tunnel. Problems
specific to this surgery include tenderness of the nerve in its new
location, as well as possible persistence of symptoms. An average of one
out of five patients are not improved by surgery. Many patients have some
degree of numbness or altered sensation in the elbow and forearm as a
direct result of surgery.
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