2. Cubital Tunnel Syndrome-edit Dr.fitrI

8/11/2019 2. Cubital Tunnel Syndrome-edit Dr.fitrI

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Cubital tunnel syndrome feels similar to thepain that occurs from hitting the "funny" bonein elbow.

The "funny" bone in the elbow is actually theULNAR NERVE, a nerve that crosses the elbow(the ulnar nerve begins in the side of the neck

and ends in the fingers).


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Occurs when the ulnar nerve, which passesthrough the cubital tunnel (a tunnel of

muscle, ligament, and bone) on the inside ofthe elbow, becomes irritated due to injury orpressure.


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The condition may occur :

when a person frequently bends the elbows(such as when pulling, reaching, or lifting),

constantly leans on the elbow, or sustains adirect injury to the area.


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Each individual may experience symptomsdifferently.

numbness in the hand and/or ring and littlefinger

hand pain

hand and thumb clumsiness due to muscle

weakness


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Sensory changes in ulnar nerve distribution(little+ring finger)

Intrinsic weakness (not always!) Tinels sign at medial elbow

Elbow flexion test (3 min @ 120flexionreproduces symptoms)

Wartenbergs sign

Fromments sign


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Cant adduct thumb (ulnar nerve)

Flexes thumb IP joint instead (median nerve)


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a complete medical history

physical examination

nerve conduction test - a test to determinehow fast signals travel down a nerve to detecta compression or constriction.


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electromyogram (EMG) - a test to evaluatenerve and muscle function; a test of theforearm muscles controlled by the ulnarnerve. If the muscles do not functionproperly, this may indicate that the ulnarnerve is not functioning properly.


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Specific treatment will be determined based on:

Age, overall health, and medical history

Extent of the condition Personal tolerance for specific medications,

procedures, or therapies

Expectations for the course of the condition

Personal opinion or preference fromthepatient


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The most effective treatment for cubitaltunnel syndrome is the cessation of activity

that is causing the problem. Treatment mayinclude:

reducing or ceasing any activity, such asbending, that aggravates the condition


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a splint or foam elbow pad worn at night (tolimit movement and reduce irritation)

elbow pad (to protect against chronicirritation from hard surfaces)

anti-inflammatory such as ibuprofen, tohelp reduce swelling around the nerve.


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Steroid injections Injecting steroids around theulnar nerve is generally not used because there is arisk of damage to the nerve.

Nerve gliding exercises, These exercises may alsohelp keep the arm and wrist from getting stiff STILL CONTROVERSION.

Operation


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Cubital tunnel releasethe ligament "roof" of thecubital tunnel is cut and divided. This increases the size

of the tunnel and decreases pressure on the nerve.

Ulnar nerve anterior transposition.the nerve is movedfrom its place behind the medial epicondyle to a new

place in front of it. The nerve can be moved : to lie under the skin and fat but on top of the muscle (subcutaneous

transposition)

within the muscle (intermuscular transposition)

under the muscle (submuscular transposition).


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Examples of nerve gliding exercises. With your arm in front of you

and the elbow straight, curl your wrist and fingers toward your body,

then extend them away from you, and then bend your elbow.


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