Compression of the
Ulnar Nerve in the Cubital Tunnel, which is formed by the two heads of the
flexor carpi ulnaris muscle, humeral-ulnar
aponeurosis, and medial ligaments of the elbow, is known as Cubital Tunnel Syndrome. This condition may follow trauma or occur in association with processes which produce nerve enlargement or narrowing of the canal.
Compression of the Ulnar Nerve in the Cubital Tunnel, which is formed by the two heads of the flexor carpi ulnaris muscle, humeral-ulnar aponeurosis, and medial ligaments of the elbow, is known as Cubital Tunnel Syndrome. This condition may follow trauma or occur in association with processes which produce nerve enlargement or narrowing of the canal. Affected patients often experience numbness and tingling along the little finger and the ulnar half of the ring finger. This discomfort is often accompanied by weakness of grip and, rarely, by intrinsic wasting. It is the second most common compressive neuropathy. It also often results in elbow pain on the side of the arm next to the chest.
Symptoms and Signs
- Numbness in the hand and/or ring and little finger
- Pain in affected hand
- Hand and thumb clumsiness due to muscle weakness
Possible Causes
Most important causes which may lead to the Cubital Tunnel Syndrome can be listed as follows -
- Fascial bands
- Subluxation of the ulnar nerve over the medial epicondyle
- Cubitus valgus
- Bony spurs may cause compression of ulnar nerve
- Hypertrophied synovium
- Compression due to tumors can cause this syndrome
- Direct compression
Diagnosis and Investigations
Besides a careful physical examination following investigations may be of some help depending on case to case basis
- Nerve conduction velocity test (NCV) – conduction velocity will be decreased along the affected part
- Electromyography (EMG) – is based on the fact that innervations of the muscles might be affected due to pinched nerve
Treatment
- Avoiding aggravating factors like pressure on elbow
- Avoiding full flexion
- avoidance of pressure with elbow pads
- Night splints to prevent elbow flexion
- Avoidance of repetitive movements
- nonsteroidal anti-inflammatory drugs for pain relief
- Surgery