Cubital tunnel syndrome (plastic surgery)

What is cubital tunnel syndrome?

Several nerves run through the hand and wrist and are responsible for movement and sensation. Any of these nerves can become compressed and cause symptoms. Common examples include carpal tunnel syndrome, cubital tunnel syndrome and ulnar tunnel syndrome. 

In cubital tunnel syndrome, the ulnar nerve is compressed in the cubital tunnel. This tunnel is located at the level of the elbow and consists of a bony channel through which the nerve runs. Various muscles and ligaments surround this tunnel and can put pressure on the nerve. When excessive pressure is applied to the nerve for a prolonged period, symptoms may develop.

Symptoms

The following symptoms may occur:

• Tingling in the little finger and half of the ring finger
• Loss of strength in the hand
• A so-called 'claw hand'

How is the diagnosis made? 

If, after a thorough clinical examination, there is a suspicion that the nerve is compressed, nerve tests (EMG and/or nerve conduction studies) may be performed to confirm the diagnosis. These tests also provide information about the severity of the condition. 

How is the treatment carried out?

There are several ways to treat cubital tunnel syndrome, depending on the stage of the condition.

It may help to rest the arm for a preiod of time and to avoid bending the elbow. This reduces the stretching of the nerve. A (night-time) splint that prevents the elbow from bending fully is often the first step in treatment. 

If these measures do not provide sufficient relief, surgery may be necessary. In most cases, releasing the 'roof' of the cubital tunnel is enough to give the nerve more space. Sometimes the nerve also needs to be moved to the front of the elbow, so that it is no longer under tension when the elbow is bent. 

Recovery and aftercare

Tingling and night-time pain usually improve within the first two weeks after surgery. If you had loss of strength and long-standing symptoms, recovery may take longer.