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Cubital Tunnel: Nonsurgical Management

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Cubital Tunnel Syndrome
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Abstract

Cubital tunnel syndrome is the second most common compressive neuropathy in the upper extremity. Non-operative treatments that have been studied include activity modification, splinting, and corticosteroid injections. In mild cases, activity modification and nighttime splinting have shown some efficacy in studies. Corticosteroid injection has not been demonstrated to be efficacious for cubital tunnel syndrome.

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References

  1. Dy CJ, Mackinnon SE. Ulnar neuropathy: evaluation and management. Curr Rev Musculoskelet Med. 2016;9(2):178–84. https://doi.org/10.1007/s12178-016-9327-x.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Apfelberg DB, Larson SJ. Dynamic anatomy of the ulnar nerve at the elbow. Plast Reconstr Surg. 1973;51(1):79–81.

    Article  CAS  PubMed  Google Scholar 

  3. Feindel W, Stratford J. The role of the cubital tunnel in tardy ulnar palsy. Can J Surg. 1958;1(4):287–300.

    CAS  PubMed  Google Scholar 

  4. Vanderpool DW, Chalmers J, Lamb DW, et al. Peripheral compression lesions of the ulnar nerve. J Bone Joint Surg Br. 1968;50(4):792–803.

    Article  CAS  PubMed  Google Scholar 

  5. Pechan J, Julis I. The pressure measurement in the ulnar nerve: a contribution to the pathophysiology of the cubital tunnel syndrome. J Biomech. 1975;8(1):75–9.

    Article  CAS  PubMed  Google Scholar 

  6. Gelberman RH, Yamaguchi K, Hollstien SB, et al. Changes in interstitial pressure and cross-sectional area of the cubital tunnel and of the ulnar nerve with flexion of the elbow: an experimental study in human cadavera. J Bone Joint Surg Am. 1998;80(4):492–501.

    Article  CAS  PubMed  Google Scholar 

  7. Kern RZ. The electrodiagnosis of ulnar nerve entrapment at the elbow. Can J Neurol Sci. 2003;30(4):314–9.

    Article  PubMed  Google Scholar 

  8. Aziz W, Firrell JC, Ogden L, et al. Blood flow in a chronic entrapment neuropathy model in the rabbit sciatic nerve. J Reconstr Microsurg. 1999;15(1):47–53.

    Article  CAS  PubMed  Google Scholar 

  9. Dahlin LB, Rydevik B, McLean WG, et al. Changes in fast axonal transport during experimental nerve compression at low pressures. Exp Neurol. 1984;84(1):29–36.

    Article  CAS  PubMed  Google Scholar 

  10. Miller RG, Camp PE. Postoperative ulnar neuropathy. JAMA. 1979;242(15):1636–9.

    Article  CAS  PubMed  Google Scholar 

  11. Bozentka DJ. Cubital tunnel syndrome pathophysiology. Clin Orthop Relat Res. 1998;351:90–4.

    Article  Google Scholar 

  12. Green JR Jr, Rayan GM. The cubital tunnel: anatomic, histologic, and biomechanical study. J Shoulder Elb Surg. 1999;8(5):466–70.

    Article  Google Scholar 

  13. Dellon AL. Review of treatment results for ulnar nerve entrapment at the elbow. J Hand Surg Am. 1989;14(4):688–700.

    Article  CAS  PubMed  Google Scholar 

  14. Dellon AL, Hament W, Gittelshon A. Nonoperative management of cubital tunnel syndrome: an 8-year prospective study. Neurology. 1993;43(9):1673–7.

    Article  CAS  PubMed  Google Scholar 

  15. Iba K, Wada T, Aoki M, et al. Intraoperative measurement of pressure adjacent to the ulnar nerve in patients with cubital tunnel syndrome. J Hand Surg Am. 2006;31(4):553–8.

    Article  PubMed  Google Scholar 

  16. Boone S, Gelberman RH, Calfee RP. The management of cubital tunnel syndrome. J Hand Surg Am. 2015;40(9):1897–904; quiz 1904. https://doi.org/10.1016/j.jhsa.2015.03.011. Epub 2015 Aug 1.

    Article  PubMed  Google Scholar 

  17. Szabo RM, Kwak C. Natural history and conservative management of cubital tunnel syndrome. Hand Clin. 2007;23(3):311–8, v–vi.

    Article  PubMed  Google Scholar 

  18. Blackmore S. Therapist’s management of ulnar nerve neuropathy at the elbow. In: Mackin E, editor. Rehabilitation of the hand and upper extremity. St Louis: Mosby; 2002. p. 679–89.

    Google Scholar 

  19. Lund AT, Amadio PC. Treatment of cubital tunnel syndrome: perspectives for the therapist. J Hand Ther. 2006;19(2):170–8.

    Article  PubMed  Google Scholar 

  20. Blair W. Cubital tunnel syndrome in the work environment. In: Gordon S, Blair S, Fine L, editors. Repetitive motion disorders of the upper extremity. Rosemont: American Academy of Orthopaedic Surgery; 1995. p. 455–65.

    Google Scholar 

  21. Beekman R, Wokke JH, Schoemaker MC, et al. Ulnar neuropathy at the elbow: follow-up and prognostic factors determining outcome. Neurology. 2004;63(9):1675–80.

    Article  CAS  PubMed  Google Scholar 

  22. Dimond M, Lister G. Cubital tunnel syndrome treated by long-term splintage. Proceedings of the 1985 American Society for Surgery of the Hand Annual Meeting. J Hand Surg Am. 1985;10:430.

    Google Scholar 

  23. Seror P. Treatment of ulnar nerve palsy at the elbow with a night splint. J Bone Joint Surg Br. 1993;75(2):322–7.

    Article  CAS  PubMed  Google Scholar 

  24. Apfel E, Sigafoos GT. Comparison of range-of-motion constraints provided by splints used in the treatment of cubital tunnel syndrome—a pilot study. J Hand Ther. 2006;19(4):384e391; quiz 392.

    Article  Google Scholar 

  25. Shah CM, Calfee RP, Gelberman RH, Goldfarb CA. Outcomes of rigid night splinting and activity modification in the treatment of cubital tunnel syndrome. J Hand Surg Am. 2013;38(6):1125–30.e1. https://doi.org/10.1016/j.jhsa.2013.02.039. Epub 2013 May 3.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Svernlöv B, Larsson M, Rehn K, Adolfsson L. Conservative treatment of the cubital tunnel syndrome. J Hand Surg Eur Vol. 2009;34(2):201e207.

    Article  Google Scholar 

  27. McPherson SA, Meals RA. Cubital tunnel syndrome. Orthop Clin North Am. 1992;23(1):111–23.

    CAS  PubMed  Google Scholar 

  28. Hong CZ, Long HA, Kanakamedala RV, et al. Splinting and local steroid injection for the treatment of ulnar neuropathy at the elbow: clinical and electrophysiological evaluation. Arch Phys Med Rehabil. 1996;77(6):573–7.

    Article  CAS  PubMed  Google Scholar 

  29. vanVeen KE, Alblas KC, Alons IM, Kerklaan JP, Siegersma MC, Wesstein M, Visser LH, Vankasteel V, Jellema K. Corticosteroid injection in patients with ulnar neuropathy at the elbow: a randomized, double blind, placebo-controlled trial. Muscle Nerve 2015;52(3):380–5. https://doi.org/10.1002/mus.24551. Epub 2015 Jun 18.

    Article  CAS  Google Scholar 

  30. Hamscha UM, Tinhofer I, Heber S, Grisold W, Weninger WJ, Meng S. A reliable technique for ultrasound-guided perineural injection in ulnar neuropathy at the elbow. Muscle Nerve. 2017;56(2):237–41. https://doi.org/10.1002/mus.25490. Epub 2017 Feb 20.

    Article  CAS  Google Scholar 

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Correspondence to Nicole J. Jarrett .

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Jarrett, N.J., Kahan, D.M. (2019). Cubital Tunnel: Nonsurgical Management. In: Fowler, J. (eds) Cubital Tunnel Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-14171-4_5

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  • DOI: https://doi.org/10.1007/978-3-030-14171-4_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14170-7

  • Online ISBN: 978-3-030-14171-4

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