{"id":3826,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/cubitaltunnelsyndrome\/"},"modified":"2023-09-13T13:30:23","modified_gmt":"2023-09-13T12:30:23","slug":"cubitaltunnelsyndrome","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/plasticsurgery\/handsurgery\/cubitaltunnelsyndrome\/","title":{"rendered":"Cubital Tunnel Syndrome"},"content":{"rendered":"\nCubital Tunnel Syndrome<\/title>\n\n\n\n<p>\u200bThis condition involve the\ncompression of the ulnar nerve at the elbow.<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">What we will see<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Pins and needles +\/- muscle weakness and wasting in ulnar nerve distribution (little & ring fingers, intrinsic muscle weakness, wasting dorsal 1<sup>st<\/sup> web space)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"> What we won’t see<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Early <6 months intermittent pins and needles in ulnar nerve distribution without trial of non-operative treatment (eg reduced elbow flexion, simple measures at work)<\/li>\n\n\n\n<li>Radicular pain<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"> Specific tests<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Nerve conduction studies will be requested in clinic if thought appropriate<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"> Trial of therapy pre-referral<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patient education to avoid elbow flexion with pressure on the nerve<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"> Whom to direct referral to<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Any hand surgeon<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Cubital tunnel<\/strong> syndrome typically occurs with the elbow in flexion and causes intermittent paraesthesia of the little and ring fingers and ulnar aspect of the forearm. In advanced cases there may be wasting of the hypothenar and intrinsic muscles of the hand and a claw (flexion) deformity of the little and ring fingers.<\/p>\n\n\n\n<p>Conservative treatment includes awareness and avoidance of postures that initiate symptoms and avoidance of prolonged pressure at the elbow. Soft splints can limit elbow flexion and therefore relieve symptoms at night. Surgical decompression may be required and is typically performed as general anaesthetic daycase procedure through a 15-20cm incision overlying the ulnar nerve at the elbow. The speed and degree of symptomatic relief is dependant upon their duration and severity. Post-operatively, the patient may require several weeks off work.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">General points<\/h3>\n\n\n\n<p>Pain, paraesthesia and weakness may be caused by compression of the involved nerve at any point along its path. Careful history and examination, including that of the neck, will often point to the likely site of compression, but nerve conduction studies (NCS) are often arranged to confirm the diagnosis when the clinical impression is unclear.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Plastic%20Surg%20-%20PIL%20BSSH%20CARPAL%20TUNNEL%20Aug18.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg – PIL BSSH CARPAL TUNNEL Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Plastic%20Surg%20-%20PIL%20BSSH%20GANGLIA%20Aug18.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg – PIL BSSH GANGLIA Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Plastic%20Surg%20-%20PIL%20BSSH%20OA%20THUMB%20Aug18.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg – PIL BSSH OA THUMB Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Plastic%20Surg%20-%20PIL%20BSSH%20TRIGGER%20FINGERAug18.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg – PIL BSSH TRIGGER FINGERAug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/National%20Institute%20for%20Health%20and%20Care%20Excellence%20(NICE).aspx\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute for Health and Care Excellence (NICE)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Scottish%20Intercollegiate%20Guidelines%20Network%20(SIGN).aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Intercollegiate Guidelines Network (SIGN)<\/a><\/li>\n\n\n\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Plastics%20Hands%20Wrist%20Pain%20Algorithm%20of%20Differential%20Diagnoses.aspx\" target=\"_blank\">Wrist Pain Algorithm of Differential Diagnoses<\/a><\/li>\n<\/ul>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Cubital Tunnel Syndrome ​This condition involve the compression of the ulnar nerve at the elbow.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3988,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[552],"class_list":["post-3826","page","type-page","status-publish","hentry","category-cubitaltunnelsyndrome"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/plasticsurgery\/handsurgery\/cubitaltunnelsyndrome\/\" rel=\"tag\">Cubital Tunnel Syndrome<\/a>","rttpg_excerpt":"Cubital Tunnel Syndrome ​This condition involve the compression of the ulnar nerve at the elbow.","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3826","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3826"}],"version-history":[{"count":5,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3826\/revisions"}],"predecessor-version":[{"id":12121,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3826\/revisions\/12121"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3988"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3826"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3826"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}