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Metacarpal Small Incision for Carpal Tunnel Syndrome
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Cubital Tunnel Syndrome: Current Concepts.

Michael N Nakashian1, Danielle Ireland2, Patrick M Kane2

  • 1The Rothman Institute, 457 Jack Martin Blvd, Brick, NJ, 08724, USA. mikenakashian@gmail.com.

Current Reviews in Musculoskeletal Medicine
|June 1, 2020
PubMed
Summary

Cubital tunnel syndrome diagnosis and treatment lack a clear algorithm. Newer physical exam tests show promise, but no single diagnostic tool is superior. Treatment varies from nonoperative to surgical, with individualized plans recommended.

Keywords:
Cubital tunnel releaseCubital tunnel syndromeIn situ decompressionUlnar nerve compressionUlnar nerve transpositionUlnar neuropathy

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Area of Science:

  • Orthopedics
  • Neurology
  • Upper Extremity Surgery

Background:

  • Cubital tunnel syndrome, or ulnar nerve compression at the elbow, is a frequent clinical diagnosis.
  • Optimal patient care necessitates timely evaluation, accurate diagnosis, objective testing, and evidence-based treatment decisions.
  • Understanding current literature is crucial for establishing best practices in managing this condition.

Purpose of the Study:

  • To review recent literature on the diagnosis and treatment of cubital tunnel syndrome.
  • To evaluate the efficacy of various physical examination techniques and diagnostic tests.
  • To compare nonoperative and operative treatment outcomes, including surgical approaches.

Main Methods:

  • Comprehensive literature review of recent studies on cubital tunnel syndrome.
  • Analysis of physical examination tests, diagnostic modalities (electrodiagnostic testing, MRI, ultrasound), and surgical techniques (open vs. endoscopic, in situ vs. transposition).
  • Evaluation of nonoperative and operative treatment outcomes.

Main Results:

  • The glenohumeral internal rotation test and scratch collapse test are more sensitive than traditional tests for physical examination.
  • Electrodiagnostic testing, MRI, and ultrasound are effective diagnostic tools, but no single test is definitively superior.
  • Nonoperative treatment is effective for mild cases; surgical techniques (open vs. endoscopic, in situ vs. transposition) show equivocal results, with transposition not routinely recommended.

Conclusions:

  • Current literature does not provide a well-defined algorithm for diagnosing and treating cubital tunnel syndrome.
  • Physicians must individualize diagnostic and treatment plans based on patient-specific factors and available evidence.
  • Further rigorous research is needed to establish optimal surgical approaches for cubital tunnel syndrome.