Our Summary

Cubital tunnel syndrome is the second most common issue involving nerve compression in the upper arm. This syndrome typically presents as a tingling sensation or weakness in the hand. If it’s not treated, the nerve can undergo irreversible damage, which can result in loss of function in the forearm and hand. Recognizing the symptoms of cubital tunnel syndrome early can prevent nerve damage. The initial treatment usually involves using a splint to support the elbow. If this doesn’t work and the symptoms persist, surgery is the next step. There are three main surgical methods to reduce the pressure on the nerve: simple decompression, anterior transposition, and medial epicondylectomy. Studies have shown that each method has its own advantages, but the chosen method depends on the specific circumstances of the case and the surgeon’s judgement. After the surgery, symptoms can often return because of a variety of issues, and a second surgery is usually required. This article is a comprehensive review of cubital tunnel syndrome.

FAQs

  1. What is cubital tunnel syndrome and how is it typically presented?
  2. What are the three main surgical methods used to treat cubital tunnel syndrome?
  3. Why might symptoms of cubital tunnel syndrome return after surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand surgery for cubital tunnel syndrome is to follow post-operative instructions carefully, including keeping the incision clean and dry, performing prescribed exercises to regain strength and flexibility, and attending follow-up appointments with the surgeon. It’s important to communicate any new or worsening symptoms to the doctor promptly to ensure proper healing and recovery. Additionally, maintaining good overall hand and arm health through stretching, proper ergonomics, and avoiding repetitive movements that can aggravate the nerve can help prevent future issues.

Suitable For

Patients who are typically recommended for hand surgery include those with:

  1. Cubital tunnel syndrome: This condition involves nerve compression in the upper arm, leading to symptoms such as tingling, weakness, and loss of function in the hand. Surgery may be recommended if initial treatments such as splinting do not provide relief.

  2. Carpal tunnel syndrome: This condition involves compression of the median nerve in the wrist, leading to symptoms such as numbness, tingling, and weakness in the hand. Surgery may be recommended if conservative treatments do not provide relief.

  3. Trigger finger: This condition involves the finger getting stuck in a bent position, leading to pain and difficulty straightening the finger. Surgery may be recommended if conservative treatments such as splinting and steroid injections do not provide relief.

  4. Dupuytren’s contracture: This condition involves the formation of thickened, tight cords in the palm, leading to difficulty straightening the fingers. Surgery may be recommended to release the cords and improve hand function.

  5. Rheumatoid arthritis: This autoimmune condition can lead to joint damage in the hands, causing pain, swelling, and deformity. Surgery may be recommended to repair or replace damaged joints and improve hand function.

  6. Traumatic injuries: Patients who have experienced traumatic injuries to the hand, such as fractures, dislocations, or tendon injuries, may require surgery to repair the damage and restore hand function.

Overall, patients who are experiencing persistent symptoms in the hand, such as pain, weakness, numbness, or loss of function, despite conservative treatments, may be recommended for hand surgery to improve their quality of life and restore hand function.

Timeline

  • Patient experiences tingling sensation or weakness in the hand
  • Patient seeks medical attention and is diagnosed with cubital tunnel syndrome
  • Initial treatment with splinting is attempted
  • If symptoms persist, patient undergoes hand surgery (simple decompression, anterior transposition, or medial epicondylectomy)
  • Patient experiences relief from symptoms post-surgery
  • Follow-up appointments are scheduled to monitor progress and address any issues that may arise
  • In some cases, a second surgery may be required if symptoms return or new issues develop

What to Ask Your Doctor

  1. What are the risks and potential complications associated with hand surgery for cubital tunnel syndrome?
  2. How long is the recovery process after hand surgery for cubital tunnel syndrome?
  3. What type of anesthesia will be used during the surgery?
  4. What can I expect in terms of pain management after the surgery?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How successful is hand surgery for cubital tunnel syndrome in relieving symptoms and preventing further nerve damage?
  7. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  8. How many surgeries have you performed for cubital tunnel syndrome, and what is your success rate?
  9. What is the expected outcome in terms of hand function and symptom relief after the surgery?
  10. Are there any lifestyle changes or modifications I should make after the surgery to prevent recurrence of symptoms?

Reference

Authors: Thakker A, Gupta VK, Gupta KK. Journal: J Hand Surg Asian Pac Vol. 2020 Dec;25(4):393-401. doi: 10.1142/S2424835520400032. PMID: 33115358