Cubital Tunnel Release at the Elbow

Cubital Tunnel Release at the Elbow

While most people know about carpal tunnel syndrome, a similar condition exists in the arm known as cubital tunnel syndrome. This is also known as ulnar nerve entrapment, and cubital tunnel release at the elbow is a procedure designed to reverse this condition. This is a necessary surgery if a patient has severe cubital tunnel syndrome. It is usually the last treatment that a doctor will recommend if other less invasive treatments have not been successful. 

 

Cubital Tunnel Syndrome

Like carpal tunnel, cubital tunnel syndrome compresses a nerve. This nerve is the ulnar nerve, which runs down the neck, through the shoulder, and down the arm. It also connects to the ring and pinky fingers of the hand.  It passes over the elbow on the side of the ulna. The ulnar nerve is actually what feels “funny” when you hit your “funny bone” if you bump your elbow. The cubital tunnel is the pathway for the nerve which is made of muscle and ligaments and surrounds the nerve itself. Sometimes this tunnel can be torn, crushed, or injured, which leads to swelling and inflammation. This causes the nerve to become compressed. Sometimes simple things like sleeping a certain way or resting your elbow in the same spot can irritate the nerve. 

 

Symptoms of Cubital Tunnel Syndrome

Similar to other nerve conditions, cubital tunnel syndrome causes neuropathy or a loss of sensation. This also can lead to or include the feeling of pins and needles in the arm and hand. The patient may or may not feel pain in the arm and hand, or on the inside of the elbow. In more severe cases, the patient may lose the ability to move or flex the ring or pinky finger, or may not be able to grip and grab things with their hand. This can be distressing for the patient and they may feel these symptoms very suddenly, or they may worsen over a period of time. 

 

Determining Treatment

There are a series of tests that a doctor may perform to find out if a patient needs less invasive treatment vs. cubital tunnel release at the elbow to treat cubital tunnel syndrome. One such test is a nerve conduction test which measures nerves to see if the electrical pathway is working quickly. A similar test called an Electromyogram or EMG tests the muscles to see if they work properly. A doctor may take an x-ray as well to check for broken bones or bone spurs that may interfere with the nerve. Some less invasive treatment options include physical therapy, anti-inflammatory medications, and splinting the elbow to avoid irritation and allow the nerve to heal. A doctor may also recommend steroid injections in the area of the nerve pain to help reduce inflammation quickly. However, cubital tunnel release at the elbow may be the only option for some patients. 

 

Cubital Tunnel Release at the Elbow

This procedure is relatively simple but needs to be performed carefully in order to keep the nerve undamaged and intact. The surgery usually takes about an hour to perform. First, the patient is placed under general anesthetic, or local anesthetic is applied to the area. The surgeon will make an incision over the interior of the elbow and access the ulnar nerve. Depending on the cause of the compression, they will inspect the cubital tunnel and remove anything compressing it, or cut the arcuate ligament. This ligament holds the nerve and releasing it will give the nerve space for any swelling or inflammation so that it will not compress. The surgeon may also release the nerve at a higher point above the elbow where it could also be compressed. They may also reconstruct the cubital tunnel. Then, the incision is closed and the patient can usually return home if there are no other complications. 

 

Cubital Tunnel Release

If you have cubital tunnel syndrome, cubital tunnel release at the elbow may be an option for you. Please contact us at Orthopaedic Associates of Riverside for an appointment. We can help you make a treatment plan and connect you with a team of support and care!