Cubital tunnel

Cubital tunnel
Back of right upper extremity, showing surface markings for bones and nerves.
Anatomical terminology

The cubital tunnel is a space of the dorsal medial elbow which allows passage of the ulnar nerve around the elbow. Persistent compression of the ulnar nerve in the cubital tunnel is known as cubital tunnel syndrome.

Structure

The cubital tunnel is bordered medially by the medial epicondyle of the humerus, laterally by the olecranon process of the ulna and the tendinous arch joining the humeral and ulnar heads of the flexor carpi ulnaris.[1] The roof of the cubital tunnel is elastic and formed by a myofascial trilaminar retinaculum (also known as the epicondyloolecranon ligament or Osborne band).[2] In 14% of individuals, the roof of this tunnel is covered by the epitrochleoanconeus muscle, an accessory muscle.[3]

Clinical significance

Schematic diagram of the medial side of the elbow showing the ulnar nerve passing through the cubital tunnel

Chronic compression of the ulnar nerve in the cubital tunnel is known as cubital tunnel syndrome.[4] There are several sites of possible compression, traction or friction of the ulnar nerve as it courses behind the elbow.[5] It may also be caused by repetitive strain from the use of a cell phone for example.[6]

References

  1. ^ Moore, Keith L. (2010). Clinically Oriented Anatomy 6th Ed. Baltimore, MD: Lippincott, Williams and Wilkins. p. 770. ISBN 978-07817-7525-0.
  2. ^ Macchi, Veronica; Tiengo, Cesare; Porzionato, Andrea; Stecco, Carla; Sarasin, Gloria; Tubbs, Shane; Maffulli, Nicola; De Caro, Raffaele (2014-08-01). "The cubital tunnel: a radiologic and histotopographic study". Journal of Anatomy. 225 (2): 262–269. doi:10.1111/joa.12206. ISSN 1469-7580. PMC 4111932. PMID 24917209.
  3. ^ Suwannakhan, Athikhun; Chaiyamoon, Arada; Yammine, Kaissar; Yurasakpong, Laphatrada; Janta, Sirorat; Limpanuparb, Taweetham; Meemon, Krai (2021). "The prevalence of anconeus epitrochlearis muscle and Osborne's ligament in cubital tunnel syndrome patients and healthy individuals: An anatomical study with meta-analysis". The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. 19 (6): e402 – e411. doi:10.1016/j.surge.2020.12.006. ISSN 1479-666X. PMID 33551294.
  4. ^ Szabo RM; et al. (2007). "Natural History and Conservative Management of Cubital Tunnel Syndrome". Hand Clinics. 23 (3): 311–318. doi:10.1016/j.hcl.2007.05.002. PMID 17765583.
  5. ^ Graf, A; Ahmed, AS; Roundy, R; Gottschalk, MB; Dempsey, A (July 2023). "Modern Treatment of Cubital Tunnel Syndrome: Evidence and Controversy". Journal of Hand Surgery Global Online. 5 (4): 547–560. doi:10.1016/j.jhsg.2022.07.008. PMC 10382899. PMID 37521554.
  6. ^ "Cubital Tunnel Syndrome: Cell Phone Elbow | Health News and Tips For Computer Users and Abusers". Archived from the original on 2007-07-14. Retrieved 2007-08-31.


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