Cubital Tunnel

Dr. Steven Rueda is one of the most sought after doctors for cubital tunnel syndrome in Palm Beach. Cubital tunnel syndrome is a condition that affects a nerve in the elbow. This nerve is called the “ulnar nerve”, and is responsible for providing sensation to half of the ring finger and the small finger in the palm of the hand. Its also the most important nerve for hand movement providing function to almost all muscles in the hand. The ulnar nerve is commonly known as the “funny bone” nerve at the inner elbow.

Cubital Tunnel Symptoms and Diagnosis

The symptoms arising from cubital tunnel syndrome reflect the function of the pinched nerve at the elbow explained in the prior section. Some of the most common symptoms include:

 

  • Numbness of the hands (specially pinky and ring finger)
  • Tingling of the hands
  • Weakness of the hands
  • Pain in the hands
  • Night time awakening from symptoms

In some cases patients present with all of the symptoms, and in some cases only with some of them. In rare occasions, some patient’s may present with cubital tunnel causing numbness of all the fingers in the hand.

The diagnosis of cubital tunnel syndrome is given using a combination of history, clinical examination, and nerve studies. A typical history and examination performed by a hand surgeon are usually enough to diagnose the condition. Nerves studies, also known as nerve conduction studies and electromyography (NCS and EMG), may be ordered to confirm the diagnosis or grade de severity.

WHAT CAUSES Cubital Tunnel?

The “cubital tunnel” is the location where the nerve is pinched in the elbow. The cubital tunnel consist of a floor, walls, and a roof. The floor and walls are made by the hard bones of the elbow joint. It’s roof is made of several structures including muscle and tight bands of soft tissue called fascia. Inside the space is the ulnar nerve. In people affected by cubital tunnel syndrome, there is swelling inside the tunnel; the walls, floor, and roof are hard structures without room to expand so this swelling leads to compression and pinching of the ulnar nerve. Ultimately symptoms of numbness, tingling, weakness and pain ensue.

Cubital Tunnel Treatment Options

There are two main ways to treat cubital tunnel: activity modification with splints, and surgery. Most patient’s with recent onset mild or moderate cubital tunnel syndrome are good candidates for splints and activity modification. Surgery is indicated for patients with moderate or severe cubital tunnel that has failed conservative treatment. Not having surgery when its needed may lead to permanent hand numbness and weakness, often causing severe hand dysfunction.

Cubital Tunnel Procedure

Dr. Rueda performs two types of cubital tunnel surgery: mini-open, and traditional open. The procedures alleviate the pressure from the nerve by cutting the roof of the tunnel. This release generates more space in the tunnel and allows the nerve pressure to be reduced, therefore relieving symptoms. Dr. Rueda uses the traditional incision when the nerves needs to undergo “transposition”; this is needed if the nerve subluxes out of its location after the initial release.

Incisions

Made and hidden on the inner elbow

Incisions

Made and hidden on inner elbow, longer than mini-open

RECOVERY AND DOWNTIME

Outpatient procedure. Most patients are actually surprised at having less pain that they expected. There is tightness, swelling and bruising for first few days after surgery. An elastic bandage is applied and removed in a day or two. Numbness, tingling, and pain get better rapidly after the surgery for most patients. Those with severe cubital tunnel usually slowly improve but may have residual symptoms.

Most patients generally return to work in 1 week. Exercise is not allowed until 3 weeks after the surgery.

Why Choose Precision Hand Center for your Cubital Tunnel Procedure?

Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for cubital tunnel. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best cubital tunnel syndrome treatment Palm Beach can offer.

FREQUENTLY ASKED QUESTIONS (FAQ)

Patients with classic history, symptoms, and exam who have failed conservative treatment or those who have severe cubital tunnel are good candidates for the procedure.

It is uncommon but its possible. This is known as recurrent cubital tunnel syndrome. These patients typically have improvement after the initial surgery, but symptoms returned months to years afterwards. It is thought to occur from pinching of the nerve at the elbow from scar tissue. Treatment is focused on releasing the nerve from scar and transposing the nerve to a new location where it finds a healthier soft tissue to rest on.

Complications are very rare in cubital tunnel surgery; it is a very safe procedure. Some of the uncommon risks include infection and bleeding. There are also other major complications that are very unlikely including persistent pain, numbness, and nerve injury.