Cubital Tunnel Syndrome

The notes on this page are written as a source of information to both patients and health professionals. It is a general overview and its content should not be seen as direct medical advice. Further information regarding diagnosis and treatment specific to your condition can be made via a consultation with Dr Amaranath.

Anatomy of the Elbow & Cubital Tunnel

The cubital tunnel is a space at the level of the elbow which surrounds the ulna nerve. It is bordered by the medial epicondyle, olecranon, medial collateral ligament, Osbourne’s ligament and flexor carpi ulnaris heads.

What is cubital tunnel syndrome?

Cubital Tunnel Syndrome (CTS) is a condition which involves compression of the ulna nerve at the level of the elbow. It can lead to symptoms of tingling, numbness and progressive motor weakness commonly affecting the little and ring fingers of the hand.

What are the common causes?

CTS is commonly caused by compression of the ulna nerve at one of the following sites:

  1. Arcade of Struthers

  2. Medial intermuscular septum

  3. Osbourne’s ligament

  4. The heads of Flexor Capri Ulnaris (FCU) Tendon

What are the preferred Investigations/Imaging?

  1. Elbow X-Ray - This should include an Anterior/Posterior and Lateral. It can rule out any bony causes for the compression.

  2. Nerve Conduction Studies – This helps to confirm the diagnosis of ulna neuropathy (CTS) and can help differentiate when there may be crossover of symptoms between median and ulna nerve.

  3. MRI Elbow – This is useful to rule out any space occupying lesions that may cause compression of the ulna nerve.

What are the treatment options?

  1. Non-operative – Once a diagnosis has been obtained treatment can include non-operative measures such as analgesia, activity modifications, nerve gliding exercises and night time splinting in extension.

  2. Ulna nerve neurolysis/transposition – In patients who fail non-operative management, then an open ulna nerve release would be recommended. This involves an incision over the medial aspect of the elbow and releasing the nerve from the level of the arcade of struthers to the two heads of FCU. In some patients the nerve will be moved in front of the tunnel (transposition) to stop any chance of future compression.

What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after elbow surgery please see our Rehabilitation Protocols here.