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Cubital Tunnel Syndrome: Current Concepts

Abstract

Purpose of Review

Compressive neuropathy of the ulnar nerve across the elbow is a common diagnosis encountered frequently within a hand and upper extremity clinical practice. Appropriate and timely evaluation, diagnosis, objective testing, and evidence-based decisions regarding treatment options are paramount in the optimal care of the patient with this pathology. An understanding of current literature is critical in determining and understanding best practices.

Recent Findings

A thorough review of the recent literature regarding physical examination, diagnostic testing, and nonoperative versus operative results was performed. Regarding physical examination, the glenohumeral internal rotation test and scratch collapse test are more effective and sensitive than traditional maneuvers such as Tinel’s testing and the elbow flexion test. Electrodiagnostic testing, magnetic resonance imaging, and ultrasound evaluation have all been shown to be effective in diagnosing cubital tunnel syndrome. However, no single test has proven itself to be superior. Nonoperative treatment can be successful for mild cases of cubital tunnel syndrome. Surgical release techniques comparing open with endoscopic release are equivocal, and in situ release versus transposition techniques show that transposition should not be performed routinely.

Summary

The diagnosis and treatment of cubital tunnel syndrome do not have a well-defined algorithm based on current literature. The treating physician must therefore utilize the available information to determine a diagnostic and treatment plan individualized to the patient. More rigorous scientific studies are needed to determine the most effective surgical approaches for cubital tunnel syndrome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to Michael N. Nakashian.

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Michael N. Nakashian declares that he has no conflict of interest. Danielle Ireland declares that she has no conflict of interest. Patrick Kane declares that he has no conflict of interest.

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This article is part of the Topical Collection on Compressive Neuropathies in the Upper Extremity

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Nakashian, M.N., Ireland, D. & Kane, P.M. Cubital Tunnel Syndrome: Current Concepts. Curr Rev Musculoskelet Med 13, 520–524 (2020). https://doi.org/10.1007/s12178-020-09650-y

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  • DOI: https://doi.org/10.1007/s12178-020-09650-y

Keywords

  • Cubital tunnel syndrome
  • Ulnar neuropathy
  • Ulnar nerve compression
  • Ulnar nerve transposition
  • Cubital tunnel release
  • In situ decompression