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Cubital tunnel release

What is cubital tunnel syndrome?

Cubital tunnel syndrome – also known as ulnar nerve entrapment – is a condition characterised by excessive pressure on, or stretching of the so-called ulnar nerve, causing numbness, tingling and weakness in the ring and small fingers.

The ulnar nerve is one of the three main nerves in the arm. It travels from the neck down to the hand and can be pinched in several places along its way. In the inner aspect of the elbow, it runs along a small passageway called the cubital tunnel. This is where the nerve usually gets compressed, causing the typical neurological symptoms associated with cubital tunnel syndrome.

What causes cubital tunnel syndrome?

Cubital tunnel syndrome can be associated with many conditions involving pressure on the ulnar nerve. This pressure is usually caused by inflammation and swelling which is most often caused by the following conditions:

Systemic diseases such as thyroid dysfunction, rheumatoid arthritis or diabetes can sometimes be accompanied by cubital tunnel syndrome.

The condition is most common in young adults and middle-aged people. It occurs in both man and women. It is often seen in physical workers and athletes.

What are the symptoms of cubital tunnel syndrome?

The symptoms of cubital tunnel syndrome can be divided into two major groups. As the ulnar nerve contains both sensory and motor neurons, some of the symptoms are sensory in nature (numbness, loss of sensation, pain in the ring and small finger, tingling), while others can be described as motor deficits: weakening of the grip and difficulty with finger coordination. At more advanced stages muscle wasting (atrophy) can occur occur.

Cubital tunnel syndrome - symptoms and diagnosis

The main symptoms of cubital tunnel syndrome are swelling around the elbow and sensitivity to pressure, especially along the ulnar nerve. In patients suffering from the condition the range of motion of the elbow tends to be limited.

The symptoms are usually worse during the night, but at later stages they can also interfere with daytime activities. especially when the elbow is bent for long periods of time, such as while holding a phone.

Electroneurogram - Medicover Hospital Hungary
Electroneurogram examination

How is cubital tunnel syndrome diagnosed?

Cubital tunnel syndrome is most often diagnosed by orthopedists. A combination of your medical history, a physical examination in and electrodiagnostic testing will be used to confirm the root cause of your complaints.

As disk herniation and certain disorders of the circulatory system can mimic the symptoms of carpal tunnel syndrome, a special test called electroneurogram (ENG) is recommended to confirm the diagnosis.

ENG is a type of nerve conduction study, designed to measure the conduction speed of your nerve impulses. If the nerve impulse is slower than normal as the nerve passes into the hand, you may have carpal tunnel syndrome. ENG is usually used to confirm a suspected the diagnosis.

X-ray is sometimes recommended to exclude the possibility of bone fractures and and some other types of injuries An articular ultrasound can help ascertain the cause of the excessive pressure or irritation.

What treatment options are available to patients suffering from cubital tunnel syndrome?

The symptoms of cubital tunnel syndrome can often be relieved with conservative treatment alone.. Wearing a splint at night can keep the elbow from bending and help reduce swelling, making more space for the nerve in the tunnel. In more severe cases, non-steroidal anti-inflammatory medications (NSAIDs) and injections to the cubital tunnel could help reduce swelling. If these treatments prove to be unsuccessful, surgical release of the cubital tunnel is the safest, fastest and most effective way to deal with the condition.

When is cubital tunnel release recommended?

If conservative treatment doesn’t alleviate the symptoms, the patient is in severe pain, or there is a risk of nerve damage, surgical treatment is recommended.

What happens during the surgery?

During your first appointment your orthopedic specialist will provide you with detailed information regarding the preoperative tests you need to undergo, the surgery itself (techniques, potential risks and recovery), and aftercare.

At our hospital carpal tunnel release is performed as outpatient surgery.

This type of surgery is performed under general or regional anesthesia. The aim of cubital tunnel release is to relieve the compression of the ulnar nerve by dividing the fascia.

Cubital tunnel release - Medicover Hospital Hungary
Cubital tunnel release

The surrounding tissues affected by the inflammation are removed, and finally the surgeon closes the wound with a few stitches.

Are there any risks associated with this type of surgery?

Cubital tunnel release is a very safe procedure. However, as with any surgical intervention, there are some risks and possible complications to take into account before making a treatment decision. On rare occasions the surgical site may become infected and the resulting inflammation can spread to the surrounding tissue, potentially affecting tendons, muscles, blood vessels, nerves and bones. In most cases pharmaceutical treatment is sufficient to control the infection, but in severe cases further operation may become necessary.

What to expect after surgery?

After a few hours of monitoring, you will be ready to leave the hospital, the bandage has to be changed on the next day. In the first few days light physical exercises of the hand, wrist, and fingers are recommended. Stitches removal takes place 10 days after surgery. Until then your hand should not come into contact with water. The wound may remain swollen for a couple of days after surgery. You may also experience numbness and pain which can be managed with OTC pain medication.It may take a few months until your hand is fully functional, physiotherapy can speed up your recovery.