Cubital Tunnel-Cubital Tunnel Syn (Calfee

Cubital Tunnel Syn (Calfee - JAAOS 2017)

Pdf Summary

Cubital tunnel syndrome is the second most common upper extremity compressive neuropathy, with an incidence of 25 cases per 100,000 person-years in men and 19 cases per 100,000 person-years in women. Nonsurgical treatment is successful in most patients with mild nerve dysfunction, aiming to decrease compression and traction on the ulnar nerve about the elbow. Surgical treatment rates for cubital tunnel syndrome have increased in recent years, with in situ decompression growing in popularity. However, recent randomized controlled trials have failed to identify a preferred surgical procedure for cubital tunnel syndrome. Revision cubital tunnel surgery, often consisting of submuscular transposition, may improve symptoms, although ulnar nerve recovery after revision surgery is less consistent than after primary surgery. The ulnar nerve can be compressed at multiple sites in the cubital tunnel, including the arcade of Struthers and the cubital tunnel proper. Diagnosis of cubital tunnel syndrome is made clinically based on patient history and physical examination findings. Differential diagnosis includes other conditions that cause ulnar hand paresthesia, such as C8/T1 radicular compression, thoracic outlet syndrome, or ulnar nerve compression at the wrist. Nerve conduction studies can be useful in confirming the diagnosis. Treatment for cubital tunnel syndrome involves nonsurgical management for mild cases and surgical interventions for persistent or severe symptoms. Surgical options include in situ decompression, medial epicondylectomy, and submuscular, intramuscular, or subcutaneous transposition of the ulnar nerve. Revision and salvage procedures may be necessary for patients with unsuccessful surgical outcomes or persisting symptoms. Overall, the choice of surgical procedure should be based on individual patient factors and surgeon preference.

Keywords

Cubital tunnel syndrome

upper extremity compressive neuropathy

nerve dysfunction

ulnar nerve

elbow

surgical treatment

in situ decompression

revision cubital tunnel surgery

diagnosis

surgical options