Contact Fiore Hand & Wrist Surgeons
Fiore Hand & Wrist, P.A.
11307 FM 1960 RD W #250
Houston, TX 77065-4917

Telephone: (281) 970 8002
FAX: (281) 970 8770


Houston Cubital Tunnel

DIAGNOSIS AND TREATMENT FOR WEAK HANDS


A condition caused by the compression of the ulnar nerve at the elbow, cubital tunnel syndrome can cause weakness in the hand, pain, swelling, and numbness in the ring and pinky fingers. This condition is common among baseball and softball pitchers, due to repetitive elbow movement, and cyclists who tend to compress their forearms against their handlebars while riding. It is also common among individuals with professions that require them to keep their elbows bent for prolonged periods of time, or to lean on their elbows.

The ulnar nerve is the nerve affected when one hits their Òfunny boneÓ. This nerve passes through a tunnel of bone, ligament and muscle at the elbow called the cubital tunnel. When this nerve becomes compressed or pinched within this tunnel, sensation, movement, and strength in the hand can be affected.


Diagnosis

This condition is diagnosed through physical exam by a physician. In some cases, nerve tests may be needed as well.


Non-Operative Treatment:

  • Reducing activity that aggravates the nerve, such as bending or leaning on the elbow.
  • Elbow pads protecting the nerve from hard surfaces.
  • Splinting of the elbow.
  • Anti-inflammatory medication.

Operative treatment:

In-situ decompression 2-3 cm incision - Consists of decompressing the nerve from the elbow to 5 cm distal (past the elbow). Minimally invasive, however its primary weakness is that sometimes the nerve may be pinched proximal (before) the elbow. Many cases can be handled in this matter.

Transposition- Consists of decompressing the nerve both proximal and distal to the elbow and transposing (freeing up the nerve and moving it in front of the elbow). A majority of ulnar nerve decompressions in the past involved some type of transposition, whether it be under the skin and fat (subcutaneous) or sub-muscular (underneath the muscle). Research does not show any benefit for routinely doing these procedures as opposed to the in situ decompression.

Endoscopic cubital tunnel decompression- This procedure consists of a 2 cm incision, inserting a camera and decompressing the nerve endoscopically, before and after the elbow incisions are typically smaller and the recovery quicker than the traditional techniques.

Dr. Fiore has performed over 300 endoscopic cubital tunnel releases over the past several years. He typically reserves transpositions for patients who have subluxation (jumping) of the nerve.

Houston hand surgeon Dr. Fiore specializes in the diagnosis and treatment of hand and wrist injuries. He is board certified by the American Board of Surgery and fellowship trained in hand and microsurgery. For more information about cubital tunnel syndrome and the various treatment options, or to schedule a consultation, call Fiore Hand & Wrist Surgical Associates at (281) 970-8002.



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