Cubital tunnel syndrome is a condition that occurs when the ulnar nerve, one of the three main nerves in the hand, becomes compressed or exposed to pressure at the elbow region. The nerve travels between two bony protrusions on the inner side of our elbow and passes through a structure called the cubital tunnel, located between the two points of origin of the muscle in this area. The nerve is vulnerable to pressure and trauma because of it is very superficial in this region.
When we bend our elbow, the nerve stretches and the diameter of the tunnel decreases. Prolonged bending position of the elbow, for example using computer, holding a phone, driving, writing, or sleeping with the hand under the head, can facilitate compression of the nerve in the tunnel. Additionally, previous elbow fractures, masses in the elbow, arthritis and rheumatic diseases can also cause nerve compression.
Patients typically complain of tingling and numbness in the inner aspect of their forearms and hands, specifically in the ring finger and little finger. There may also be pain radiating from the elbow towards the hand. If the nerve is compressed for a long time, muscle wasting and weakness in the muscles of the little finger begin.
The diagnosis is made based on the patient's history and physical examination findings, along with electrophysiological tests. Rarely, advanced investigations such as ultrasound, elbow MRI, or MR neurography of the ulnar nerve may be required.
In patients whose complaints have just begun and are diagnosed at an early stage, behavioral therapy that limits elbow movements, physiotherapy applications, the use of splints to keep the elbow in a straight position, and the use of anti-inflammatory drugs may be beneficial. Surgical treatment is applied to patients who do not benefit from non-surgical treatment options, or those with advanced stage disease. The aim of surgical treatment is to release the nerve which is compressed. Full recovery can be achieved in the majority of patients with appropriate treatment methods.
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