Presented by: Jaime Dickerson

1
Case Study Cubital Tunnel Syndrome

• Presented by Jaime Dickerson

2
Introduction

• Nerve entrapment in the elbow is called Cubital
  Tunnel Syndrome.
• This condition occurs when the ulnar nerve
  becomes compressed in the tunnel.
• The ulnar nerve is a superficial nerve,
  therefore, it is predisposed to injury.

3
Patient Demographics

• Age 19, Female
• Softball Player
• Second Basemen/ Short Stop
• History of Ulnar Neuritis, started in high
  school around sophomore or junior year.

4
Anatomy Involved

• Cubital Tunnel
• This tunnel runs through the space between the
  medial epicondyle and the olecranon process.
  Between these two bony prominences is where the
  ulnar nerve lies.
• To keep the nerve from slipping out of place
  there is a layer of fascia holding it in.
• The beginning of the tunnel is made up of the
  medial intermuscular septum.
• The end of the tunnel is made up of the two
  origins of the Flexor Carpi Ulnaris.

5
Mechanism

• Athlete came into Athletic Training room
  complaining of tingling radiating into the hands.
  
• It was not an acute injury, she has had elbow
  problems for a few years now.
• A thorough evaluation was done, she saw the
  doctor, and the diagnosis was Ulnar Nerve
  Entrapment or Cubital Tunnel Syndrome.

6
Immediate Management

• The athlete was not a compliant patient and
  therefore did not do her rehabilitation on a
  regular basis.
• She did, however, come once or twice to get
  stretched, ice, or ultrasound.

7
Immediate Management

• In a normal situation, where the patient is
  compliant, the rehabilitation quota calls for
• Avoiding bending exercises. Including holding a
  telephone, typing, etc.
• A splint can be made to help keep the arm
  straight.
• Anti-inflammatories may be taken by mouth to
  reduce some of the swelling and therefore reduce
  some pain and discomfort.

8
Long-Term Management

• Long-term management for this injury is sometimes
  surgery. In this case the athlete will undergo
  surgery to alleviate the nerve of the pressure.
• One procedure that is done is to cut the fascia
  overlying the nerve. This relieves the
  compression forces being put on the nerve and
  therefore cures this injury.

9
Long-Term Management

• There are a few different procedures that can be
  done. One of them is to transpose the nerve to
  the front of the elbow, therefore, relieving the
  compression forces on the nerve.
• This is the procedure this athlete will be
  getting.

10
Prognosis

• With surgery in the near future, a healthy
  recovery is expected.
• The surgery should hopefully relieve the athlete
  from all current symptoms and should be able to
  return to play after a thorough rehabilitation
  program.

11
Summary

• Cubital Tunnel Syndrome injury that occurs over
  time (chronic) and involves the ulnar nerve being
  compressed in the Cubital tunnel.
• This will send tingling down the forearm and into
  the fingers.
• A freshmen softball player was diagnosed with
  Cubital Tunnel Syndrome (Ulnar Nerve Entrapment).

12
Summary

• She did not do any rehabilitation for this
  injury.
• Now she will be undergoing surgery to transpose
  the ulnar nerve.
• This should, in the end, cure her symptoms.