Cubital Tunnel Diagnosis And Treatment in Houston, TX


A condition caused by the compression of the ulnar nerve at the elbow, cubital tunnel syndrome can cause weakness in the hand, pain, swelling, and numbness in the ring and pinky fingers. This condition is common among baseball and softball pitchers, due to repetitive elbow movement, and cyclists who tend to compress their forearms against their handlebars while riding. It is also common among individuals with professions that require them to keep their elbows bent for prolonged periods of time, or to lean on their elbows.

The ulnar nerve is the nerve affected when one hits their Òfunny boneÓ. This nerve passes through a tunnel of bone, ligament and muscle at the elbow called the cubital tunnel. When this nerve becomes compressed or pinched within this tunnel, sensation, movement, and strength in the hand can be affected.


This condition is diagnosed through physical exam by a physician. In some cases, nerve tests may be needed as well.

Non-Operative Treatment:

  • Reducing activity that aggravates the nerve, such as bending or leaning on the elbow.
  • Elbow pads protecting the nerve from hard surfaces.
  • Splinting of the elbow.
  • Anti-inflammatory medication.

Operative treatment:

In-situ decompression 2-3 cm incision - Consists of decompressing the nerve from the elbow to 5 cm distal (past the elbow). Minimally invasive, however its primary weakness is that sometimes the nerve may be pinched proximal (before) the elbow. Many cases can be handled in this matter.

Transposition- Consists of decompressing the nerve both proximal and distal to the elbow and transposing (freeing up the nerve and moving it in front of the elbow). A majority of ulnar nerve decompressions in the past involved some type of transposition, whether it be under the skin and fat (subcutaneous) or sub-muscular (underneath the muscle). Research does not show any benefit for routinely doing these procedures as opposed to the in situ decompression.

Endoscopic cubital tunnel decompression- This procedure consists of a 2 cm incision, inserting a camera and decompressing the nerve endoscopically, before and after the elbow incisions are typically smaller and the recovery quicker than the traditional techniques.

Dr. Fiore has performed over 300 endoscopic cubital tunnel releases over the past several years. He typically reserves transpositions for patients who have subluxation (jumping) of the nerve.

A 2-3cm incision occurs as opposed to the much longer historical incision (purple marker). First, the surgeon has to elevate the tissue above the nerve to create space. Dilators are then inserted over the nerve to increase the space so that the scope and the nerve decompression device can be placed.

This is the view from the scope and the decompression device. At approximately 6 o'clock is a thick white/grey cord like structure, the ulnar nerve. The nerve is visualized from the time you place the scope until it is removed, thus minimizing any chance the nerve could be cut. Once it is clear that the nerve is out of the path of the nerve, the fibrous attachments which are pinching it are then released. This occurs both before and after the elbow.

Houston hand surgeon Dr. Fiore specializes in the diagnosis and treatment of hand and wrist injuries. He is board certified by the American Board of Surgery and fellowship trained in hand and microsurgery. For more information about cubital tunnel syndrome and the various treatment options, or to schedule a consultation, call Fiore Hand & Wrist Surgical Associates at (281) 970-8002.

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