Cubital tunnel syndrome Discussion

Cubital tunnel syndrome results from a combination of local pressure and stretching the ulnar nerve at the elbow as it passes behind the medial epicondyle. The problem may arise following local trauma, but most often is spontaneous, with elbow position during sleep the largest contributing factor. Problems include pain, numbness, altered sensation and weakness, and may be permanent if nerve damage has occurred. Electrical nerve testing may be helpful in assessing nerve damage, but may be normal even in patients with symptomatic nerve compression. Nerve irritation at the neck may produce similar symptoms and may coexist with this problem. Most mild cases can be treated with a splint or elbow pad and avoidance of flexion and direct pressure on the nerve. More advanced cases require surgery to decompress and transpose the nerve out of the cubital tunnel. Problems specific to this surgery include tenderness of the nerve in its new location, as well as possible persistence of symptoms. An average of one out of five patients are not improved by surgery. Many patients have some degree of numbness or altered sensation in the elbow and forearm as a direct result of surgery.

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