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Understanding the Basics Behind Cubital Tunnel Release
What is Cubital Tunnel Release?
There are 3 primary nerves that control sensation and function in your hand.
One of these nerves, the ulnar nerve, or “funny bone,” is located at the back of your elbow joint. When this nerve is compressed, it causes a range of symptoms, from intermittent numbness to pain and weakness in the hand and forearm.
The orthopedic elbow specialists at Kansas City Orthotic Alliance have years of experience treating many kinds of elbow conditions. After your initial examination with a KCOA physician, we will recommend the best treatment for your needs. Our practitioners provide the comprehensive care you need so you can return to the activities you enjoy.
Other indicators someone may require cubital tunnel release include:
Common Signs and Symptoms of Cubital Tunnel Syndrome
Cubital Tunnel Syndrome happens when the ulnar nerve in the elbow is injured, swollen, irritated, or compressed..
Numbness or tingling sensation in your hand, particularly in your ring or little finger, is a common symptom of cubital tunnel syndrome. When a patient visits one of our KCOA offices, a skilled orthopedic specialist will ask you questions regarding your symptoms, what aggravates/alleviates your symptoms, and whether you have attempted prior therapies. Next comes a thorough physical exam. We will then review any images you bring with you and/or take new images. After determining the cause of your pain, we can then discuss if Cubital Tunnel Syndrome treatment will work best for your needs.
Kansas City Orthopedic Alliance Elbow Injuries Assessment
Assessing the Injury
Finding the right elbow treatment in Kansas City starts with an assessment.
You can think of elbow pain as a spectrum, with some instances being more severe than others. The KCOA orthopedic specialists always focus on each individual patient and their concerns before creating a treatment plan.
Therefore, during your initial appointment, we will often ask questions such as:
The answers to these questions help shape the next steps of the assessment process and guide our physical examination. After a proper assessment, we often begin with a physical examination to help determine the origin point of your pain. In some cases, advanced testing may be required for a full diagnosis.
Also called radiographs, an X-ray captures a picture of the hip. Orthopedic physicians may order an X-ray to rule out the possibility of a fracture (broken bone), osteoarthritis, or other hip-related conditions.
Magnetic Resonance Imaging (MRI)
MRI captures images of muscles, bones, intervertebral discs, and tendons to help provide information other tests can’t detail. During an MRI, you will lie on a table that slides into a tube-shaped scanner. The machine creates a magnetic field around you, using pulsed radio waves to form the MRI images.
Electromyograms (EMG) and Nerve Conduction Studies
Our board-certified physiatrists utilize electromyograms (EMGs) and nerve conduction studies to help determine whether nerves and muscles respond properly to stimuli. The EMG measures the electrical activity of your muscles at rest and in motion, while nerve conduction studies determine how fast and effectively your nerves and muscles receive electrical signals.
Establishing a Care Plan
Based on the results of your interview, examination, and imaging studies, you can expect a custom care plan catered specifically to you.
Many people believe it’s best to wait until pain becomes severe, leading them to “put off” or delay treatments like elbow arthroscopy. If you are in constant discomfort, have shooting or stabbing pains, have limited range of motion, or an inability to perform your daily activities, elbow arthroscopy may be right for you. New technologies allow patients with elbow pain to fully recover and enjoy the benefits of a more functional, pain-free lifestyle.
Prior to surgery, you will typically receive at least 2 phone calls:
Dependent on your health history, your physician may require:
Pre-operative instructions will vary depending on your physician and the location of your surgery. Always check with your physician prior to surgery.
Most physicians require that patients not eat or drink after midnight prior to surgery the next day. Additionally, you will need a designated family member or friend to drive you home on the day you are released from the hospital. Surgical patients cannot drive themselves home.
Day of Surgery
If you schedule your surgery with a KCOA physician, you can expect the following on surgery day:
How it Works
Cubital tunnel release is a surgical procedure that alleviates ulnar nerve issues. The procedure can either decompress the ulnar nerve by releasing some of the structures around the nerve itself, or by also transposing the nerve by completely removing it from its groove. This creates a new resting point in the soft tissue in front of the elbow.
Your surgeon will determine if an ulnar nerve transposition is necessary based on your elbow and hand function, the severity of your symptoms and after visualizing the nerve and cubital tunnel during the arthroscopy.
During a cubital tunnel release, you will remain under general anesthesia. The surgeon makes a small incision along the course of the ulnar nerve, and opens the roof of the cubital tunnel to relieve pressure on the nerve.
Once they decompress the nerve, the surgeon takes the elbow through a range of motions to determine whether or not transposition is also necessary. A transposition may be needed if the ulnar nerve remains unstable after pressure is relieved. In those cases, the surgeon will reposition the nerve from behind the bony bump on the inside of your elbow to the front of the elbow.
After your surgery, you will remain in the recovery room while our experienced clinical team monitors you, providing pain relief medication, if needed. We will place your arm in a dressing and remove it during a subsequent follow-up appointment. You may also be placed in a sling or splint to protect the area.
You can expect swelling, soreness and bruising in your elbow for several days after surgery. The swelling and discoloration may also spread to your hand or lower arm. It’s important to keep your arm elevated with an ice pack after surgery to reduce swelling and soreness.
What to Expect
Early motion is allowed after surgery, but you should not lift, push, or pull anything greater than a pencil for 6 weeks after surgery. Overall recovery time varies by individual. It can take at least 2 to3 months before you start to regain normal use of the extremity. Physical therapy is often needed and starts 6 weeks after surgery. Improvement in the numbness can be immediate, but in some patients, it can take months to get better.
We recommend regular exercise, eating a balanced diet, maintaining a healthy weight, and monitoring your blood sugar levels if you’re diabetic. In doing so, you may reduce the amount of stress on your joints to slow down any potential degenerative process.
Causes of Elbow Pain
The body has different kinds of joints, and they all face different challenges. The elbow is a complex joint that connects three different bones: the humerus (upper arm), ulna (pinky side forearm), and radius (thumb side forearm). Covering the surface where these bones meet is articular cartilage, a smooth substance that protects the joint by cushioning and absorbing forces.
On the inside and outside of this joint are ligaments that hold the elbow together and prevent dislocation. Muscles also surround the elbow on the front and back sides, and there are 3 major nerves that cross the elbow joint.
Elbow pain can come from a variety of issues with any of these working parts. Most elbow pain stems from overuse, either in a sport or other repetitive movements that cause strain on the joint.
Surgery, even when minimally invasive like elbow arthroscopy, isn’t necessarily the first choice. Kansas City Orthopedic Alliance physicians prefer a more conservative approach to treatment, so we will typically exhaust all non-surgical options before recommending surgery.
Non-surgical treatments for elbow injuries include:
Kansas City Orthopedic Alliance is here to help.
Our care is personal. Our team is knowledgeable. And we’re more available than ever.
With access to board-certified specialists across Kansas City, we have the tools to meet almost every musculoskeletal condition.
Overland Park, Kansas10777 Nall Ave Suite 300 Overland Park, KS 66211
Leawood, Kansas3651 College Blvd. Leawood, KS 66211
Kansas City, MissouriSaint Luke's Medical Plaza #1 4320 Wornall Rd., Ste. 610 Kansas City, MO 64111
Belton, MissouriBelton Regional Campus 17067 S Outer Rd #301 Belton, MO 64012
Dr. Ting and his staff are the best!
Dr. Ting and his staff are the best! Sarah his nurse is kind and supportive. Dr. Tings nurse for surgery was absolutely the best! Dr. Ting, I have complete faith in. He is who I shall go to for anything he handles! Can’t say enough about him! Thank you all for making a scary time a completely peaceful event. You are the best!!
Staff is great
…just did my husbands hands on Wed. last week and can’t believe how well he is doing. We have already recommended you to our son and a few others. Your staff is great and my husband doing well. Thanks to you.
I left a very happy patient.
…I arrived a little bit late. I got checked in quickly and was back in a room within 10 minutes. Dr Rhodes was very friendly and took the time to pull up pictures of my surgery and show them and explain them to me. I left a very happy patient.
Dr. Scott Ellsworth is one of the best
Dr. Scott Ellsworth is one of the best I have ever worked with. He is knowledgeable, efficient, caring, and knows his patients. He has a special bedside manner that makes any patient in any situation feel comfortable. All of the nurses and office staff are wonderful as well.
I'm consistently impressed
In the process of treating my particular problem I’ve been to Apex probably 4-5 times. I’m consistently impressed by the professionalism of the staff and the amount of care & time they spend with me as a patient. They’re always very careful to make sure I understand the nature of the medical problem, the reasons for the diagnosis, and the type of treatment recommended. Stephanie’s care and concern is especially appreciated.