What is Cubital Tunnel Surgery?

Cubital tunnel surgery is surgery to treat a pinched nerve in the elbow. The ulnar nerve, which controls movement and sensation in the hand, begins in the neck and runs across the shoulder and down the arm. At the inside of the elbow, the ulnar nerve must go through a tiny passage called the cubital tunnel. The space is small, and in some people the ulnar nerve snaps over the bony ridge of the elbow as it moves. If the ulnar nerve becomes irritated, it causes pain, tingling, numbness, weakness, or sensations like electric shocks in the arm and hand. This is known as cubital tunnel syndrome. It can be triggered by an injury, repetitive bending of the arm, or even something as simple as sleeping with your elbow bent or taking a long trip with your elbow propped on an armrest. Cubital tunnel syndrome is a very common condition.

Typically, non-surgical treatments, such as rest, splinting, or anti-inflammatory medications are tried before surgery is considered. If surgery is necessary, there are three main techniques used to decompress the ulnar nerve and treat cubital tunnel syndrome.

  • Cubital tunnel release is perhaps the most common cubital tunnel surgery. During this procedure, the surgeon makes a tiny cut in the ligaments surrounding the cubital tunnel. This opens up the space, making a larger tunnel. It frees the ulnar nerve to move and work without pressure.
  • Ulnar nerve transposition is surgery done to move the ulnar nerve to a place where it can't get caught on the edge of bone as the elbow bends. The surgeon moves the ulnar nerve from the cubital tunnel to a new space in the elbow.
  • Medial epicondylectomy is performed when patients have a genetic tendency for their ulnar nerve to snap across the bony part of their elbow, known as the medial epicondyle. In this case a small bit of the medial epicondyle is shaved away, giving the ulnar nerve a smoother, freer surface to move.

Depending on the type of surgery performed, you may have a splint or brace for some weeks. After surgery it is important to follow instructions for stretching and physical therapy, which can help your arm and hand work better and heal faster. Within a few weeks, you should be able to perform most daily activities without pain or numbness.

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