Cubital Tunnel Syndrome
Cubitus is Latin for elbow. The cubital tunnel is an anatomic passageway between the bony prominence of the inside of the elbow (medial epicondyle) and the tip of the elbow (olecranon process). Through this passageway travels the ulnar nerve as it crosses behind the elbow. To keep the nerve from displacing with motion of the elbow, the tunnel is completed by a covering of tissue called fascia. There are several other tunnels that the ulnar nerve passes through while traveling down the arm. Cubital tunnel syndrome occurs when there is compression or injury of the ulnar nerve in the cubital tunnel or in surrounding smaller tunnels.

The ulnar nerve provides sensation to the little finger and half of the ring finger. It also supplies several muscles in the forearm but most importantly it controls many of the small muscles in the hand responsible for coordinating finger motion and pinch. Patients with this condition commonly exhibit symptoms of intermittent numbness or tingling in the ring and little fingers of the affected extremity. These symptoms may occur with prolonged flexion of the elbow or resting against the elbow. There may be an associated aching discomfort along the inner forearm or elbow. If nerve damage persists, there is loss of sensation in the ring and little fingers. Eventually there is loss of pinch and grip strength.

In early stages of cubital tunnel syndrome, symptoms may be alleviated by avoiding activities requiring prolonged or repetitive elbow flexion or resting against the elbow. To prevent elbow flexion, particularly at night, it may be necessary to use a long-arm splint. An elbow pad worn during the day can be beneficial in protecting the cubital tunnel from direct pressure. At times, an oral anti-inflammatory is helpful in alleviating symptoms. When cubital tunnel syndrome is severe or fails to improve with conservative management, surgery may be indicated.