What Is Cubital Tunnel Syndrome?

Compression of the ulnar nerve due to traumatic arthritis of the elbow. There is a thickened fibrous band between the two sides of the flexor muscles of the ulnar wrist, which compresses the ulnar nerve. This is called the cubital tunnel syndrome. There is a curved narrow and deep sulcus between the epicondyle of the humerus and the ulna. The deep fascia traverses the upper side to form a bony fiber sheath, the ulnar nerve sulcus, also known as the elbow ulnar tube. Inside the tube are the ulnar nerve and the superior ulnar arteries and veins.

Basic Information

English name

cubital tunnel syndrome

Visiting department

orthopedics

Common locations

Elbow

Common causes

Fracture of elbow joint Elbow valgus deformity, ulnar nerve is stretched or fracture reduction is not good, bone in the elbow is uneven, ulnar nerve is worn, etc.

Common symptoms

The little finger is numb and uncomfortable. Sometimes writing and using chopsticks are not flexible. The ulnar carpi flexor and the ring finger and the little finger deep flexion are weak, and the intrinsic muscle atrophy of the hand, etc.

Causes of cubital tunnel syndrome

Fracture of elbow joint Elbow valgus deformity, ulnar nerve is stretched or fracture is poorly reset, bone in the elbow canal is uneven, ulnar nerve is worn out; occupying lesions such as hemangiomas, tendon sheath cysts in the elbow canal; osteoarthritis, rheumatoid Arthritis, systemic conditions such as diabetes, leprosy, etc. can produce complications of elbow tunnel syndrome.

Clinical manifestations of cubital tunnel syndrome

Patients with early symptoms often feel numbness and discomfort in the little fingers. Sometimes writing and using chopsticks are not flexible. When the symptoms worsen, the ulnar carpi flexor and the deep finger flexors of the ring finger and the little finger are weak, the internal muscles of the hand atrophy, and mild claw finger deformities appear. Froment X.

Treatment of cubital tunnel syndrome

Conservative treatment is suitable for those with early symptoms and mild symptoms. Adjust the posture of the arms, prevent excessive flexion of the elbow joint for a long time, avoid pillow and elbow sleep, and wear elbow support. Non-steroidal anti-inflammatory analgesics occasionally relieve pain and numbness, but do not promote steroid closure in the elbow.

Surgical treatment is suitable for those with intrinsic hand muscle atrophy and poor conservative treatment. The following surgical procedures are commonly used:

The ulnar nerve was released from the ulnar nerve groove and moved to the subcutaneous area of the anterior elbow. When the ulnar nerve is moved forward, the distal and proximal ends must be fully freed, and the joint branches and 1 or 2 muscle branches of the nerve must be cut to facilitate the displacement to the front of the elbow to prevent intramuscular compression after the displacement. A deep fascia is lifted at the beginning of the flexor muscle, and the displaced ulnar nerve is controlled at the front of the elbow to prevent the displaced nerve from slipping back when the elbow is stretched. The flipped deep fascia must have a certain width and length to prevent new entrapment of the ulnar nerve. Internerve bundle release is generally not recommended, otherwise symptoms will be aggravated. Postoperatively, the elbow was flexed with a plaster cast, and exercise was started 3 weeks later. Although other surgical methods have clinical applications, they are not very popular.

Prognosis of cubital tunnel syndrome

Patients with significant intrinsic muscle atrophy before surgery had poor results. The effect of ESP on the elbow before operation was good, but the effect without ESP was poor. Intraoperative neurofibrosis was seen during surgery, with poor postoperative results. Long duration of symptoms is also a sign of poor prognosis.