Cubital Tunnel Syndrome

Book
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
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Excerpt

Neuropathy of the ulnar nerve causing symptoms of tingling, numbness, and shooting pain along the medial aspect of the forearm, also including the medial half of the fourth digit and the fifth digit, usually caused by compression or irritation of the nerve at the elbow.

Ulnar Nerve Anatomy

C8 and T1 nerve roots join and give rise to the medial cord of the brachial plexus. Ulnar nerve originates as a branch of the medial cord. The ulnar nerve then travels down the arm along with the brachial artery towards the elbow joint. At the midpoint of the arm, the nerve enters the posterior compartment by piercing the intermuscular septum(arcade of Struthers). It then traverses along the medial aspect of the triceps to enter the cubital tunnel. At this point, the ulnar nerve travels between the olecranon and the medial epicondyle and beneath the Osborne ligament. Once the nerve exits the cubital tunnel, it passes under the aponeurotic head of flexor carpi ulnaris to enter the forearm. The cubital tunnel region is where the ulnar nerve is most likely to be compressed due to its location and anatomy. However, the nerve can also get compressed at the arcade of Struthers or by the aponeurotic head of flexor carpi ulnaris resulting in symptoms of ulnar neuropathy. The ulnar nerve innervates the medial side of the forearm, ulnar side of the palm, the little finger, and ulnar half of the ring finger. It supplies motor branches to flexor carpi ulnaris, flexor profundus of the little and ring fingers, hypothenar muscles, adductor pollicis brevis, all of the interossei and the third and fourth lumbricals. It is noteworthy that the ulnar nerve gives no motor or sensory branches above the elbow.

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