The cubital tunnel is where the ulnar nerve passes at the elbow. The tunnel passes between the olecranon and the medial epicondyle. The tunnel can sometimes be tight thus causing compression on the ulnar nerve. The ulnar nerve supplies the small muscles of the hand and provides sensation to the ulnar one and half fingers.

Why does Cubital Tunnel Syndrome Occur?

The tunnel can be compressed at different sites, symptoms can be mild resulting in occasional pins and needles. More severe cases can result in loss of sensation and wasting of hand muscles. In long standing cases surgery cannot reverse these symptoms but simply reduce the chances of deterioration.

Non Surgical Treatment

In some cases night time splinting of the elbow; keeping it straight improves symptoms. I often trial this for 4 - 6 weeks.

Occupational therapy can also offer guidance on how to rest your elbows and limit activities that can aggravate symptoms.

Do I need Nerve Conduction Studies (NCS)?

I generally perform NCS in all cubital tunnel patients. This gives baseline information on the status of nerve function.

Surgical Treatment

The operation is usually performed under general anaesthetic or regional anaesthetic. It can also be performed under Local anaesthetic with adrenaline, for simple decompression of the nerve. Correction of nerve compression involves cutting the roof of the cubital tunnel to relieve the pressure . Occasionally, when there is arthritis or scarring in the area, some bone needs to be resected and/or the nerve has to be transposed forwards.

What are the complications?

Infection

Scar

Neuroma/Nerve Injury

Complex Regional Pain Syndrome

Failure to improve symptoms - particularly in those patients with more severe compression. Muscles that have atrophied may never recover and in those patients with poor sensation pre operatively recovery may be incomplete.

Cubital Tunnel Release Procedure

Anaesthetic : General Anaesthetic/Regional Anaesthetic/Local Anaesthetic

Operative time : 45 - 90 minutes

Hospital Stay : Day Case

Time off work : 2 - 4 weeks ( Longer period off in Heavy Manual workers)

Recovery Time : 4 - 6 weeks ( If the nerve is transposed recovery will be longer)