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Other Conditions & Treatments: Carpal Tunnel Syndrome | Trigger Finger | Ganglion Cyst Cubital Tunnel Syndrome | Mallet Finger | Tennis Elbow DeQuervain's Disease | Dupuytren's Contracture or Disease Basal Joint Arthritis of the Thumb
There are multiple possible causes. Having the elbow bent, or flexed, for long periods may stretch the nerve, as can repetitive elbow flexion. Direct trauma to the nerve may be involved, or previous injury to the elbow resulting in bony deformity. In rare cases, there may be cysts or other growths that take up room and narrow the tunnel. Other conditions can be involved, such as diabetes.
Numbness is one of the most prominent symptoms. This is typically felt in the outside half of the ring finger and in the small finger. It may radiate up the hand and forearm to the elbow. The numbness is often felt at night, first thing in the morning, or associated with bending the elbow. Pain can also occur, radiating from the elbow to the small and ring fingers. In more advanced cases, weakness in the hand occurs.
The diagnosis is usually made based on symptoms and examination in the office. In many cases, electrical testing ("EMG's") of the nerves is done to confirm the diagnosis. X-rays of the elbow may be needed.
Non-surgical treatment is usually started, unless findings are very advanced. Basic measures include the following:
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| In cases where non-surgical treatment does not solve this problem, surgery is often performed. There are many approaches to this surgery, including releasing the nerve, or burying it under muscle in front of the bone. Our most common approach is to remove a portion of the medial epicondyle, which prevents the nerve from being stretched during elbow flexion. This approach is called a medial epicondylectomy. The surgery is done on an outpatient basis. A plastic splint is worn essentially full-time for two weeks after surgery, then gradually less for another 4 weeks. Elbow exercises need to be done to regain range of motion after surgery. Recovery of nerve function depends on nerve status before surgery, and may take longer than is seen after the more common surgery for carpal tunnel syndrome. | |||
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