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Made by AJ Julka MD
“Dr. Julka understood that it was a priority for me to get back to my job ASAP. We decided to proceed with …decompression of the ulnar nerve. He explained the risks and benefits, he instilled confidence in his success rate with the procedure and explained the process in which it would happen from start to finish. The scar is literally almost non-existent which is amazing…I would highly recommend Dr. Julka is personable, knowledgeable, and an excellent surgeon”
~ Annie from Google Reviews
The cubital tunnel is a tunnel on the inside of the elbow (Funny bone side) created by your elbow bones and a ligament. The ligament makes up the roof of the tunnel while the walls and floor of the tunnel are made by the bones of your elbow. One very important nerve knows as the Ulnar nerve travels through this tunnel and, as we age, can get pinched creating symptoms of cubital tunnel syndrome.
The key symptoms of classic cubital tunnel syndrome are numbness and tingling in the small and ring fingers. The numbness can be accompanied by issues with dexterity, hand weakness and a change in the appearance of the hand which is a sign of advanced disease. Some patients may have difficulty with fine motor activities or even drop objects. Numbness and tingling are often worse when the elbow is in a bent position such as while typing or talking on the phone.
Cubital tunnel syndrome can be diagnosed by obtaining a detailed history and an examination alone. At your visit, Dr. Julka performs a complete nerve examination including an evaluation for nerve function, nerve irritability and any effect nerve compression is having on your hand muscles. If the condition is mildly symptomatic often no further testing is needed. If the condition is serious enough to consider surgery we typically obtain a nerve conduction study and electromyography (EMG).
A nerve conduction study and an EMG for cubital tunnel are tests of nerve function performed by a neurologist or rehab physician. These two tests are performed to determine the electrical conduction ability of your nerve as well as any effects your disease may have had on your muscles. This can help us diagnose and quantify the degree of severity of your nerve compression.
Cubital tunnel syndrome can be treated with non operative measures as well as surgical treatment. Mild disease is often treated with braces and a proper nerve mobilization routine. More severe disease or disease that fails to respond to non operative measures is treated with surgery.
Dr. Julka has been a sought out leader in minimally invasive approach to cubital tunnel surgery. There is wide variation in incision sizes for cubital tunnel release. Dr. Julka performs his cubital tunnel release surgeries in a minimally invasive fasion. This technique uses a small (4cm) incision on the inside of the elbow to access the cubital tunnel and perform the release. In a small number of patients the nerve requires relocation in addition to simple decompression. This is determined at the time of your surg
Many patients wonder if they will have to have their nerve moved or transposed. Ulnar nerve transposition is a procedure in which the nerve is first decompressed and gently moved to the front of the elbow. This is required in a small number of patients in our practice. This will be determined at the time of your surgery. If you require a transposition we will likely maintain the same early mobilization program as we do with all out patients.
All of our cubital tunnel release surgeries are performed in a surgery center or hospital on an outpatient basis. You do need a driver to and from the hospital but do not need to stay overnight.
You will be placed in a small soft bandage after your surgery. Unless instructed otherwise you will be allowed to remove your bandage in 48 hours. At this time you may use the hand for light activities, shower, and perform exercises gently on your own at home.
After cubital tunnel release surgery we will release you back to your regular activities in 4-6 weeks. Patients who perform activities such as yoga, pushups or other activities that result on significant weight bearing through the elbow may have to alter their activities till 8 weeks or more.
There are cases of cubital tunnel disease that are largely asymptomic until the very late stages where muscle damage has occurred. In some cases nerve compression can lead to permanent irreversible damage to your hand or forearm muscles. For that reason I recommend evaluation sooner rather than later for most patients. If you are having progressive signs and symptoms of cubital tunnel, issues with dexterity, issues with hand strength which does not resolve quickly you may benefit from an evaluation.