Cubital Tunnel Syndrome:Part 1
Cubital Tunnel Syndrome: Part 1
Wojewnik B, Bindra R. Cubital tunnel syndrome — Review of current literature on causes, diagnosis and treatment. Journal of Hand and Microsurgery. 2009;1(2):76-81. doi:10.1007/s12593-009-0020-9.
- Most don’t need surgery, unless traumatic injury to elbow structure
- SOL: bone spur, ganglions, callus,
- Froment sign: weakness of adductor pollicus muscle, pt given a piece of paper and holds it together between the thumb and index finger (key pinch) with flexion of the thumb IP joint (because weakness of add poll muscle.
-Positive flexion sign at the elbow with supination and wrist extension reproducing the symptoms up to 60 seconds and ulnar nerve subluxation with elbow flexion can also be seen.
- Treatment: braces, to limit flexion
Cutts S. Cubital tunnel syndrome. Postgraduate Medical Journal. 2007;83(975):28-31. doi:10.1136/pgmj.2006.047456.
- 2nd most common peripheral nerve entrapment
- The cubital tunnel is formed by the cubital tunnel retinaculum which straddles a gap of about 4 mm between the medial epicondyle and the olecranon
- intraneural pressure associated with elbow flexion are believed to be key issues
-shape of the tunnel changes from an oval to an ellipse with elbow flexion. narrows the canal by 55%. , this compression can hinder blood flow;
-Elbow flexion, wrist extension and shoulder abduction increases intraneural pressure by six times.
- persons at risk_ holding prolonged flexion, prolonged position (tools, phones), pitchers at late cocking phase stresses nerve and tend to have mild boney changes at the elbow;
- 4th and 5th fingers parasthesia, or motor changes (clawing or abduction of little fingers
- elbow flexion test, tinnel, ULTT ulnar
-treatments: avoid prolonged flexion, nerve mobility,
-Cent Eur Neurosurg. 2011 May;72(2):90-8. doi: 10.1055/s-0031-1271800. Epub 2011 May 4.
Cubital tunnel syndrome - a review and management guidelines.
-J Hand Ther. 2014 Jul-Sep;27(3):192-9; quiz 200. doi: 10.1016/j.jht.2014.02.003. Epub 2014 Feb 27.
Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain.
- J Manipulative Physiol Ther. 2010 Feb;33(2):156-63. doi: 10.1016/j.jmpt.2009.12.001.
Neurodynamic mobilization in the conservative treatment of cubital tunnel syndrome: long-term follow-up of 7 cases.