Neurology
Cubital Tunnel Syndrome
팔꿈치터널증후군
Ulnar nerve compression at the medial elbow
- How common
- 2nd most common upper-limb compression neuropathy
- Typical age
- Ages 30–60
What is it?
Ulnar nerve traction/compression at the cubital tunnel causes neural ischemia.
Commonly affected: Ring (ulnar half), little finger, hypothenar
How it develops
- Elbow flexionFlexion reduces tunnel volume, stretches nerve
- Ulnar compressionCompression within cubital tunnel
- Neural ischemiaMicrovascular ischemia
- Muscle atrophyProgressive interosseous/hypothenar atrophy
Symptoms
- Ring/little numbnessUlnar distribution
- Intrinsic atrophyHypothenar/interosseous wasting
- Hand weaknessReduced grip strength
- Froment signAdductor pollicis weakness; thumb flexes when pinching paper
How it is examined
- Elbow TinelTap medial epicondyle → ulnar paresthesia
- Elbow flexion testHold elbow flexion 60s → symptoms
- Froment signAdductor pollicis weakness
Imaging
May show ulnar groove narrowing/spurs.
- Epicondylar spurs
NCS/EMG standard; MRI for mass/bone abnormality.
- Reduced ulnar NCV across elbow
Non-surgical care
- Elbow extension splintLimit flexion to 30–45°
- Activity modificationAvoid elbow leaning, repeated flexion
- NSAIDsPain relief
- Nerve glidingUlnar nerve gliding exercises
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Failed conservative care, atrophy, severe EMG
Procedures that may be discussed
- Simple in situ decompression
- Ulnar nerve transposition (subQ/submuscular/intramuscular)
- Medial epicondylectomy
Outlook
Mild improves 60–70% conservatively; surgery 90% success.