Cubital Tunnel Syndrome

  • Most common nerve compression at elbow

Causes

  • Idiopathic
  • Activities requiring repetitive elbow movements
  • Osteoarthritis
  • Rheumatoid arthritis
  • Fractures / Dislocations
  • Cubitus valgus
  • Instability of ulnar nerve
  • Anconeus epitrochlearus muscle

Symptoms

  • Pain to medial forearm
  • Paraesthesias to ulnar nerve distribution of hand

Signs

  • Benediction Hand
    • Little finger & ring finger are clawed
      • Flexed at the IPJ & hyperextended at MTPJ
  • Muscle Wasting
    • Compression at wrist
      • Intrinsic muscles of hand
      • Weakness finger abduction adduction
    • Compression below elbow
      • Flexor carpi ulnaris
        • Weakness of wrist flexion in ulnar deviation
    • Compression at elbow
      • Flexor digitorum profundus to 4- 5th digits

Tests

  • 1. Tinel’s Sign
  • 2. Elbow Flexion test
    • Passively flex elbow to maximum & hold for 1 minute
    • Patient develops paraesthesia in small & ring finger
  • 3. Ulnar nerve compression test
    • Same as elbow flexion test but also press on the nerve