Cubital Tunnel Syndrome

This is a common condition: patients usually report episodic tingling or numbness in the small and ring fingers. The resting posture of the hand can change, due to a loss of strength and tone in the small muscles within the hand.

The condition is caused by interference with the normal working of the ulnar nerve (which supplies sensation to the skin of the small finger, and half of the ring finger, and motor nerve supply to the muscles within the hand.). The most common cause is compression or stretching of the ulnar nerve as it passes behind the inner aspect of the elbow. The nerve runs in a tunnel referred to as the cubital tunnel. With elbow flexion the nerve is stretched and the dimensions of the tunnel change.

Treatments

Most patients will have some improvement by keeping the affected arm straight during sleep, and by avoiding prolonged elbow flexion during work or sport. I will offer surgery to patients who have developed continuous numbness, weakness, or a change in the posture of the fingers in the hand.

Investigations

I would recommend that patients have nerve conduction studies before surgery. This investigation can be done as an out-patient. Nerve conduction studies are funded by most insurance companies and can be carried out at the Spire Lea Hospital (01223 266900) either before or after our consultation.

Conditions that can contribute to cubital tunnel syndrome

Symptoms can be exacerbated by prolonged elbow flexion, diabetes, elbow arthritis, old healed fractures, thyroid disease, pregnancy, and obesity.

Sport and cubital tunnel syndrome

Cubital tunnel syndrome is reported to be common in pitching or throwing athletes (bowlers, javelin throwers) and in weight lifters.

Cubital tunnel release surgery

The objective for cubital tunnel release surgery is to safely open up the cubital tunnel and relieve pressure on the ulnar nerve. This should potentially allow symptoms to improve. Surgery is performed under general anaesthetic as a day case procedure. I do not routinely move the ulnar nerve from its normal anatomical location, nor do I remove a bone from the inner elbow (medial epicondylectomy). The operation takes about thirty minutes. The arm is supported in a padded bandage around the elbow at the end of the operation. Most patients can drive between two and three weeks after surgery.

To make an appointment
please call 01223 550 881 or email: sam.lilley@cam-med.co.uk