Cubital Tunnel Release

Cubital tunnel release surgery can reduce the pain, numbness, and tingling sensations that are common symptoms of ulnar nerve entrapment, or cubital tunnel syndrome.

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Cubital Tunnel Release Benefits:

  • Reduction in achiness and pain on the inside of the elbow

  • Improved grip strength and coordination in the affected hand and wrist

  • Relief from numbness and tingling sensations

Composed of bones, muscles, and ligaments inside the elbow, the cubital tunnel is a passageway for the ulnar nerve. The ulnar nerve extends from the side of the neck down the shoulder and elbow to the fingertips. When this tunnel becomes compressed, it can cause nerve entrapment. Many patients report that cubital tunnel syndrome pain feels like they’ve hit their “funny bone” causing an aching sensation in the elbow, along with tingling, pins and needles, and weakness in the hand. Tingling and numbness associated with cubital tunnel syndrome are felt in the ring and little finger – the two digits innervated by the ulnar nerve. These symptoms are usually worse at night.

Treatment options for cubital tunnel syndrome include resting, wearing a splint or elbow brace, taking anti-inflammatory medications, completing physical therapy, and opting for cubital tunnel release surgery.

Diagnosing Carpal Tunnel Syndrome

It’s important to see a physician for a proper diagnosis, because other conditions – such as medial epicondylitis, or golfer’s elbow – may cause related symptoms.

Patients with ulnar nerve entrapment can present with a range of symptoms based on the severity of the condition. When you meet your hand surgeon for your cubital tunnel syndrome consultation, they will complete a physical exam to test sensation and weakness in the affected fingers and look for other signs of inflammation and ulnar neuropathy.

Your surgeon will conduct a physical examination of the elbow, wrist, and hand to look for signs of paresthesias in the ring and small finger and/or intrinsic muscle atrophy. They will perform an elbow flexion test and will tap areas above the cubital tunnel and elbow to see if you get tingling sensations in your ring and little finger. This is a positive indication that your cubital tunnel is inflamed and causing impingement of the ulnar nerve. Your doctor will also look for signs of ulnar-innervated intrinsic muscle atrophy.

Nerve conduction velocity and electromyography studies can also help detect prognosis severity. Your surgeon may also ultrasound your elbow to assess ulnar nerve compression.

Cubital Tunnel Release: What to Expect

Our qualified hand surgeons may recommend cubital tunnel release surgery if you are experiencing:

  • Persistent pain or weakness in the hand or fingers
  • Numbness or tingling in the ring and little fingers
  • Muscle wasting or atrophy in the hand or fingers
  • Loss of grip strength or fine motor skills
  • Difficulty with daily activities such as holding objects, typing, or playing an instrument

Cubital tunnel release is a highly effective procedure that provides significant relief for many patients. The surgery is typically performed under regional anesthesia on an outpatient basis at our ambulatory surgery center in Flagstaff. The entire surgery takes about 15-30 minutes. During the procedure, your surgeon will release common sites of ulnar nerve compression in the cubital tunnel. Some practitioners offer endoscopic carpal tunnel surgery, but as this has a lower success rate and higher complication rate it is not commonly performed.

Ulnar Nerve Anterior Transposition

If the nerve is significantly compressed and unstable, your surgeon may relocate the ulnar nerve anteriorly to the front of the medial epicondyle, the bony ridge on the inner side of the elbow. This procedure is commonly performed in patients with an unstable ulnar nerve that subluxates anteriorly during flexion. By moving the nerve to a more protected and stable position, patients gain relief from ulnar nerve irritation.

Medical Review: This procedural information has been medically reviewed by plastic and reconstructive surgeon, Brian A. Cripe, M.D.

Cubital Tunnel Release Recovery and Aftercare

Patients who have undergone cubital tunnel release surgery may resume their normal everyday activities as long as the pain is tolerable. Your surgeon will tell you which movements you should avoid and may prescribe physical therapy exercises to help build strength and mobility.

To alleviate pain and swelling, patients can elevate the operative elbow, apply cold compresses, and take Tylenol and Advil. Most patients can return to work within a week or two following endoscopic cubital tunnel surgery.

After two days, patients can remove surgical dressings and resume showering. Most cubital tunnel surgery patients do not need a splint or cast after cubital tunnel release surgery. Patients should avoid soaking in bathtubs until cleared by their doctor, and swimming should be avoided for six weeks to minimize the risk of infection. During the first few days after surgery, some drainage from the incision sites is normal. To prevent clothing from getting soiled, patients may find placing clean gauze or an absorbent dressing over the incisions helpful.

For most patients, cubital tunnel release surgery provides long-term relief from ulnar nerve entrapment symptoms. In some cases, the symptoms may return over time, but repeat surgery is typically successful in relieving symptoms again.

Cubital Tunnel Release FAQs

Cubital tunnel syndrome is a condition that is caused by pressure or compression on the ulnar nerve as it passes through the cubital tunnel, which is a narrow passage in the elbow. This compression can occur for a variety of reasons, including:

  • Repetitive or prolonged elbow flexion: Keeping the elbow bent for long periods of time, such as during sleep, can put pressure on the ulnar nerve.
  • Direct trauma: A blow to the elbow or a fracture can cause the nerve to be compressed.
  • Anatomical abnormalities: Some people may be born with a smaller cubital tunnel or a bone spur that puts pressure on the nerve.
  • Inflammation or swelling: Conditions such as arthritis or bursitis can cause inflammation or swelling around the nerve, leading to compression.
  • Ganglion cysts: These fluid-filled sacs can form near the elbow and put pressure on the nerve.
  • Occupational factors: Jobs that require repetitive or prolonged elbow flexion or pressure on the elbow, such as using a jackhammer or working at a computer, can increase the risk of developing cubital tunnel syndrome.

Treatment for cubital tunnel syndrome may include avoiding activities that worsen symptoms, using splints or braces to keep the elbow straight, taking nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation, and, in severe cases, surgery to relieve pressure on the nerve.

Cubital tunnel release surgery is typically covered by most health insurance plans, including private insurance and Medicare, as long as it is deemed medically necessary by a qualified healthcare provider. 

Cubital tunnel release surgery is typically deemed medically necessary when non-surgical treatments have been unsuccessful in relieving symptoms, or when the compression on the ulnar nerve is severe and causing significant pain, weakness, or numbness in the hand and fingers. 

The extent of medical coverage may vary depending on the specific insurance plan and your policy. Remember to check with your insurance provider to understand your coverage and any out-of-pocket expenses that may be incurred. Make sure to verify that the surgeon performing your cubital tunnel release surgery is within your insurance network, as out-of-network providers may result in higher costs.

You May Also Be Interested In:

  • Carpal Tunnel Syndrome

  • Cubital Tunnel Syndrome

  • De Quervain’s Tenosynovitis

  • Dupuytren’s Contracture

  • Golfer’s Elbow

  • Hand Arthritis

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