Cubital tunnel syndrome is a compression of the ulnar nerve at the elbow joint. The ulnar nerve passes through the elbow joint and is responsible for a portion of the sensation and movement of the hand. Because the ulnar nerve is compressed at the elbow, cubital tunnel syndrome is characterized by numbness and tingling in the small finger and part of the ring finger. Additionally, there may be an associated "electric shock" like pain when the elbow is tapped. The symptoms are worse when the elbow is flexed (bent) for a long period of time. Patients may also notice weakness and clumbsiness in their hands. They may have difficulty with fine motor tasks, such as buttoning their shirt. Physicians will typically diagnose cubital tunnel syndrome by taking patient history and a thorough physical exam. Typically, patients presenting with cubital tunnel syndrome will show decreased sensation in the small finger and motor tests will show that the patient holds the hand in a particular way to compensate for weak muscles. Additionally, physicians may require an EMG to confirm the diagnosis. An EMG is a diagnostic study that examines how well the nerves are conducting electrical signals.
The initial treatment of cubital tunnel syndrome is activity modification. The patient is encouraged to avoid activities involving prolonged elbow flexion (bending). In addition a splint may be worn at night that keeps the elbow extended (straightened out). If these measures do not work or the patient has significant weakness in their hand, then surgical intervention may be required. Surgical treatment of cubital tunnel syndrome would involve dissecting the ulnar nerve from behind the elbow and transposing, or moving it to a position in front of the elbow to reduce compression and pain. This places the nerve in a "relaxed" position where it will not be stretched every time the elbow is bent. After surgery the patient is placed in a splint for about 10 days to allow for full recovery.