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Praxis für Neurochirurgie
Dr. Elmar Patz
Dr. Patz with CT scan

Nerve compression syndrome of the ulnar nerve at the elbow (cubital tunnel syndrome)

After carpal tunnel syndrome cubital tunnel syndrome is the second most common compression syndrome affecting the peripheral nerves. The ulnar nerve passes through the so-called cubital canal, running along the inside of the elbow between the tip of the elbow and the projection of the upper arm bone (humerus). This bottleneck is covered by a hard sheet of tendonlike material (aponeurosis), extending between the two edges of bone.

Possible causes for compression of the nerve at this point are damage from chronic application of pressure (resting the elbow on a hard surface for a long time), changes in the bone or local overgrowth of nervous tissue.

Symptoms:

Patients report numbness (hypaesthesia) affecting the 4th and 5th fingers, as well as inside of the forearm and the edge of the hand. Later on they may experience a dragging pain in the elbow, radiating out into the forearm and edge of the hand. This may be followed by palsy of the hand muscles after some time. This problem is generally noticed by patients when they have difficulty in making pinch grip movements (writing, opening a bottle). They frequently also complain of an electric tingling sensation with pressure on the nerve in the elbow.

Diagnosis:

As with carpal tunnel syndrome, diagnosis of this condition also involves measuring nerve transmission speed to obtain an accurate picture of the location and extent of the damage.

Treatment:

If there is no improvement in symptoms or nerve transmission speed after 6-8 weeks, surgery should be carried out to avoid lasting delayed damage.

Surgery involves cutting the hard ligament covering the nerve and the constricting muscle under local anaesthetic, so releasing the nerve. The use of a splint and immobilisation of the elbow joint is not necessary here.

Also see:

» Slipped disc
» Nerve compression syndrome of the hand
» Bony narrowing of the spinal canal
» Chronic backache

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Praxis für Neurochirurgie · Dr. Elmar Patz · Boxgraben 95 · 52064 Aachen