Is there any evidence linking Cubital Tunnel Syndrome to "chronic" (persistent, non-healing) tendonitis or any other long-term/chronic issues with connective tissue in the elbow region?
Sorry for the wait!
To orient ourselves first trace the Ulnar Nerve distally to the hand from the Brachial Plexus (BP) and then review how Cubital Tunnel Syndrome ties in (it's neurological relation).
Let me know if you have a more specific question (this is most commonly what is seen -- can go into other areas. Sorry for so many abbreviations - these are old ortho notes.
Nerve Entrapment - UE
Ulnar Nerve (C7, C8, T1)
1.) Arises from medial cord of BP
2.) Travels down medial arm (anterior compartment)
3.) Once it reaches the medial epicondyle run b/n brachalis and the medial head of the triceps.
4.) Crosses elbow on medial under ulnar groove.
5.) Right after it crosses the elbow It’s travels b/n the heads of the FCU (called the cubital tunnel) then it. Innervates FCU ulnar (humeral and ulnar) heads and FDP (Medial Part) (MOTOR)
6.) In the forearm it travels b/n FDS and FDP.
8.) Exits forearm medial to FDP tendons and just before it crosses wrist gives off a branch Dorsal Brach (SENSORY)
Dorsal side sensation to medial ½ 4th finger and 5th finger
9.) Travels through Guyon Tunnel (or Canal) at wrist above flexor retiaculum and gives off 2 branches:
Deep Branch Supplies (MOTOR)
- Oppones Digiti Minimi
- Adductor DM
- 2 Lumbricals (on ulnar side)
- Dorsal and Palmar Interossi
Superficial Branch (SENSORY)
- Palmar side sensation to medial ½ 4th finger and 5th finger
Ulnar Nerve Compression Syndromes
- Ulnar groove
- Cubital tunnel (where nerve passes b/n 2 heads of FCU)
- Medial head of triceps – seen as a result of hypertrophy of that muscle
- If nerve is unstable in ulnar groove and it starts subluxing, can result in neuritis, but overtime with scaring can lead to compression.
Syndrome associated with frequent elbow flexion (ulnar nerve on stretch).
- Weight lifting
- Constricting fascia bands (ligament of strutres)
- Masses (bone abnormalities, swelling and ulnar nerve subluxation)
- Will be medial elbow discomfort (similar to medial epicondyltis)
- Parastesis of the medial ½ of the ring finger and 5th finger
- Repetieve flex/ext activites may excepabte these symptoms
- Orthopedic Testing / (+) tinnel
- Atrophy of hypothenear group
- Decreased grip strength
Night splints to help keep elbow extended (to avoid stretching of that nerve)
- Decompression, medial epicondyleptimy or transposition ulnar nerve more anteriorly. (so flexion will not stretch nerve)
- Ulnar Nerve Transposition
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