Recurrent or Persistent Cubital Tunnel Syndrome

Ehsan A, Hanel DP (Kaiser Permanente Los Angeles Med Ctr, CA; Univ of Washington, Seattle, WA) J Hand Surg 37A:1910-1912, 2012^§

Abstract

Background

Patients complaining of numbness of the ring and small fingers, decreased dexterity, and perhaps weakness may be candidates for subcutaneous ulnar nerve transposition to address their cubital tunnel syndrome. However, problems may again trouble these patients and the question becomes, Are these recurrent or persistent symptoms? The diagnosis and management of cubital tunnel syndrome that appears to have recurred were evaluated according to the best available evidence.

Current Approaches

Often cubital tunnel syndrome is only reported at an advanced stage, which indicates that symptoms have gone unnoticed for an extended period of time. Patients who are convinced that surgery will help them tend to report improvements that are not indicated by nerve physiology. They interpret the “return” of symptoms as recurrence or worsening of the problem. It is agreed that patients who have new or continued symptoms after undergoing ulnar nerve decompression at the elbow do not respond as well to surgery as the typical patient with cubital tunnel syndrome. Treatment approaches include nerve decompression and neurolysis, coverage with muscle flaps, and nerve wrapping using vein or synthetic agents. The indication for surgery is controversial, with various courses chosen.

Current Evidence

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