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Cubital Tunnel Release & In situ decompression

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.

During Cubital tunnel release the ligament “roof” of the cubital tunnel is cut and divided. This increases the size of the tunnel and decreases pressure on the nerve.

After the procedure, the ligament begins to heal and new tissue grows across the division. The new growth heals the ligament, and allows more space for the ulnar nerve to slide through.

Cubital tunnel release tends to work best when the nerve compression is mild and the nerve does not slide out from behind the bony ridge of the medial epicondyle when the elbow is bent.

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. Speak with Dr. Saylor to see what surgical option is appropriate for you.