Pitfalls in the management of cubital tunnel syndrome

The ulnar nerve occupies a subcutaneous, superficial position on the medial surface of the elbow and traverses a tight myofascial-osseous (cubital) tunnel. These anatomic features make it vulnerable to a variety of insults that can produce ulnar neuropathy. Although most popularly referred to as cubital tunnel syndrome, ulnar neuropathy in the region of the elbow can arise from nerve compression at a variety of anatomic locations, and multiple levels of entrapment may occur in the same individual. Clinical differentiation of the various levels of potential entrapment is reviewed, with a discussion of metabolic and peripheral neuropathies involving the ulnar nerve.