Cubital Tunnel Release
Cubital Tunnel Release encompasses a group of procedures used to decompress the ulnar nerve at the elbow in patients with cubital tunnel syndrome.In order to remove the pressure from the ulnar nerve, allowing it to heal with the potential restoration of strength and sensation of the forearm, wrist, and hand, the constricting ligamentous and tendinous structures crossing the ulnar nerve need to be sectioned.
Utilizing a small incision, in situ decompression is the basic operation that unroofs the cubital tunnel and removes the most common sites of compression – the transverse humeral ligament (Osborne’s Ligament) and the tendinous decussation of the two heads of the flexor carpi ulnaris muscle. Endoscopic cubital tunnel release is practically the same surgery as the small-incision in situ decompression.
When the ulnar nerve is unstable and subluxates anteriorly over the inner side of the elbow, called the medial epicondyle, during flexion, irritating the nerve and aggravating, if not causing, the symptoms of cubital tunnel syndrome, the ulnar nerve may need to be transposed out of its bony groove to a new resting position in front of the medial epicondyle. This may be submuscular or subcutaneous, depending on the patient’s physical requirements and local conditions.
Prior injury and scarring about the elbow may also influence the choice of surgical procedure. Snapping triceps tendon, due to a broad distal triceps, can exist alone or it may coexist and contribute to cubital tunnel syndrome, and needs to be part of the surgical algorithm.