Cubital Tunnel Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Cubital tunnel syndrome is believed to be the second most common compressive neuropathy.
The elbow is the most frequent location of compression of the ulnar nerve.
Cubital tunnel syndrome is present in men more often than women.
Symptoms are:
1. Wasting and weakness of the small muscles of the hand and partial clawing of the ring and little finger caused by ulnar nerve palsy.
2. The deformity and disability: extent of the disability is dependent on the site of the lesion.
3. Numbness and tingling along the little finger and ulnar half of the ring finger, often linked with a weakened grip, and particularly when the patient rests on or flexes the elbow.
4. Pain and tenderness at the level of the cubital tunnel.
5. Loss of grip and pinch strength and loss of fine dexterity in patients with chronic ulnar neuropathy.
6. Intrinsic muscle wasting and clawing or abduction of the little finger in severe prolonged compression
There is marked neurological abnormalities in prolonged severe ulnar nerve compression.
a. Claw hand
b. Wasting of the small muscles of the hand
3. Positive Tinel's sign
Treatment methods are:
1. Physiotherapy,
2. Splinting,
3. Non-steroidal anti-inflammatory or NSAID drugs,
4. Surgical transposition of the nerve
5. Surgical decompression for cubital tunnel syndrome.

TABLE OF CONTENT
Introduction
Chapter 1 Cubital Tunnel Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Carpal Tunnel Syndrome
Chapter 8 Trigger Finger
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Oct 20, 2016
• ISBN: 9781370851805

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Cubital Tunnel

Syndrome,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2015 Smashwords Edition

Published By Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Cubital Tunnel Syndrome, Treatment and Related Conditions or in vernacular terms

(What You Need to treat Cubital Tunnel Syndrome)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://ken-med.com.

From which many free articles from the blog was taken and put together into 590 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

What is Cubital Tunnel Syndome?

Cubital tunnel syndrome is believed to be the second most common compressive neuropathy.

The elbow is the most frequent location of compression of the ulnar nerve.

Cubital tunnel syndrome is present in men more often than women.

What are the causes of Cubital Tunnel Syndome?

Causes:

1. Constricting fascial bands.

2. Compromise under general anesthetic.

3. Subluxation of the ulnar nerve over the medial epicondyle.

4. Cubitus valgus.

5. Bony spurs.

6. Joint deformity in osteoarthritis or rheumatoid arthritis: osteoarthritic or rheumatoid narrowing of the ulnar groove and constriction of the ulnar nerve as it passes behind the medial epicondyle.

7. Medial epicondylitis linkage (golfer's elbow).

8. Tumors.

9. Ganglia.

10. Direct compression, e.g. habitual leaning on elbows.

11. Frequent repetitive elbow flexion and extension, constantly playing guitar, heavy manual work.

Risk factors of ulnar nerve lesions at the elbow are:

12. Fractures: friction of the ulnar nerve due to cubitus valgus (a possible sequel to childhood supracondylar fractures - 'tardy ulnar palsy') can cause fibrosis of the ulnar nerve and ulnar neuropathy.

13. Elbow dislocation.

14. Venepuncture.

15. Severe hematoma.

What are the symptoms of Cubital Tunnel Syndome?

Symptoms:

1. Wasting and weakness of the small muscles of the hand and partial clawing of the ring and little finger caused by ulnar nerve palsy.

2. The deformity and disability: extent of the disability is dependent on the site of the lesion.

3. Numbness and tingling along the little finger and ulnar half of the ring finger, often linked with a weakened grip, and particularly when the patient rests on or flexes the elbow.

4. Pain and tenderness at the level of the cubital tunnel.

There is a varying pain severity and the distribution of pain may spread proximally or distally.

The pain may occur at intermittent intervals at first and then become more consistent.

5. Loss of grip and pinch strength and loss of fine dexterity in patients with chronic ulnar neuropathy.

6. Intrinsic muscle wasting and clawing or abduction of the little finger in severe prolonged compression

How is the diagnosis of Cubital Tunnel Syndome made?

Diagnosis:

Signs

1. Normal in recent-onset mild ulnar nerve palsy

2. Marked neurological abnormalities in prolonged severe ulnar nerve compression.

a. Claw hand (hyperextension at the metacarpophalangeal joints and flexion of the interphalangeal joints;mainly little finger and ring finger)

b. Wasting of the small muscles of the hand.

c. Loss of sensation over the palmar and dorsal aspect of the little finger and the medial half of the ring finger.

Palpation of the cubital tunnel site is done to exclude tumor mass lesions.

3. Tinel's sign:

A tap over the cubital tunnel can cause pain or tingling or electric shock-like sensation down the arm into the fingers.

A positive Tinel's sign finding is usually found in cubital tunnel syndrome but Tinel's sign may be present in people without symptoms.

4. The elbow flexion test:

This is the most diagnostic test for cubital tunnel syndrome.

The elbow of the patient is flexed past 90°, supinating the forearm, and extending the wrist.

Result is if discomfort is reproduced