REVIEW – September 2013

Cubital tunnel syndrome (CuTS)

Authors: Kennet Kõiv, Leho Kõiv

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Abstract

The cubital tunnel syndrome (CuTS) is the most common peripheral nerve entrapment syndrome of the ulnar nerve. It is the source of substantial pain and disability for patients.The first symptoms and clinical signs may indicate the ulnar nerve entrapment syndrome at the elbow, however, to be precise, extra investigation is needed.  The most important diagnostic features that help distinguish one nerve entrapment from another or differentiate CuTS from other diseases, are electro-neuralmyography and MRI. Most patients heal spontaneously or with the use of conservative treatment. Still, one third require surgery.  There exist different surgical options and the choice depends on the causes and severity of symptoms. It is important to choose the most suitable surgical method. Simple decompression, which is favoured and used by many surgeons, is considered to be the first option for patients with mild symptoms. Endoscopic surgery, which is basically the same simple decompression, is getting more and more popular as it is less traumatic and ensures faster healing. However, it has been shown that complicated cases or relapses can be better treated with anterior transposition. It is important to understand the etiology and pathophysiology of the CuTS. All this gives the chance to choose the best treatment for every patient.