cubital tunnel syndrome

Question 1

what is it?

Answer 1

ulnar nephropathy
compression of ulnar nerve at the elbow behind the medial epicondyle

Question 2

what are the causes?

Answer 2

tight band of fascia forming the roof of tunnel
due to tightness at the intermuscular septum as the nerve passes through or between the two heads at the origin of flexor carpi ulnaris

Question 3

what are the symptoms?

Answer 3

pins and needles in ulnar 1 1/2 fingers
night symptoms - caused by sleeping with arm in flexion
ring and little finger involvement

Question 4

what are the signs?

Answer 4

tinel’s test over cubital tunnel usually positive
weakness of ulnar nerve innervated muscles may be present including 1st dorsal interosseous and adductor pollicis
ulnar clawing

Question 5

what investigations are used?

Answer 5

nerve conduction studies
wartenberg’s sign - abducted small finger
tinnel’s test - tapping
modified palen’s test - elbow flexion test
froment’s test - thumb flexion during key grip

Question 6

what is the management?

Answer 6

NSAIDs, night time elbow extension
surgery - ulnar nerve decompression