Cubital Tunnel Syndrome

The ulna nerve, also known as the “funny bone” nerve, passes through the cubital tunnel in the elbow. It starts from the medial cord of the brachial plexus in the neck area to the medial epicondyle in the elbow and extends to the fingertips. Being a very long nerve, it’s prone to having some complications, and it often gets entrapped at the joints.

The cubital tunnel syndrome is a common type of nerve entrapment condition where tightness in the cubital tunnel causes compression and irritation in the ulna nerve at the elbow. This leads to a tingling sensation, numbness in the ring and little fingers, a weakened grip, pain in the wrist and elbow and sometimes towards the shoulder.

When left without treatment, it may cause an ulnar claw and paralysis in the two fingers, as the nerve is also responsible for fine mortar dexterity in the hand. If you’ve been experiencing the symptoms above, it is high time you visit our plastic surgery clinic, London, for more consultation.

What Can Cause Cubital Tunnel Syndrome?

Currently, the primary causes for the cubital tunnel syndrome are unknown. However, in most cases, the condition is usually a result of tension to the nerve caused by elbow dislocation, and day to day hand movement activities highlighted below:

  • Repetitive bending of the elbow as the person reaches for
  • Pulls and lifts objects (like when smoking or using the phone)
  • Resting the elbow on a hard tabletop while typing, sports,
  • Bone fractures.

Additionally, inflammation in the elbow joint in patients with arthritis may also lead to cubital tunnel syndrome. Whichever the cause, it is best to have the condition checked as soon as possible by our plastic surgery UK veterans to prevent any further pain or damage.

Diagnosis and Non-invasive Treatments

Our orthopaedic surgeon will first conduct a clinical examination when diagnosing cubital tunnel syndrome at our plastic surgery clinic. In some cases, EMG or nerve conduction velocity tests will also be carried out to see how severe the condition is.

The tests are meant to measure the speed of nerve impulses to assess any nerve damage and perhaps the cause of the damage. Another diagnosis method is via X-Rays, where the doctor will rule out any signs of arthritis, cysts in the elbow, fluid buildup after an injury, or bone spurs from previous fractures.

Once there’s confirmation that the patient has cubital tunnel syndrome, the doctor may recommend some conservative treatment options before resorting to surgery. These treatment options include:

  • Advising the patient to rest and avoid strenuous activities that will irritate the nerve further
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Steroid injections to manage the pain
  • A night splint or pil-o brace to the elbow to restrict bending
  • Avoid resting the elbow on hard surfaces

Surgery and Recovery

If the non-invasive treatments fail to work, and the pain persists, or the condition worsens, the doctor will propose a surgical procedure. Such a procedure will be performed under general or local anaesthesia as agreed with the patient.

If cubital tunnel decompression is being performed along with the surgery, some adrenaline may also be used along with the local anaesthesia. Here, the roof of the cubital tunnel is opened and divided, which relieves the pressure on the ulnar nerve. If there is scar tissue in the elbow, the nerve may need to be transposed and the bone resected.

Downtime depends on the nature of work the patient is involved in and may take anywhere between 2 to 4 weeks. Recovery may take up to 6 weeks, although nerve transposition takes much longer to heal.

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