What is Cubital Tunnel Syndrome?
Cubital tunnel syndrome is the term for entrapment of the ulnar nerve in the elbow. Although the nerve entrapment occurs in the elbow, people who have cubital tunnel syndrome experience numbness and tingling in their ring and small fingers. This condition is caused when the elbow is held in a bent position for extended periods of time, when there is prolonged pressure on the elbow., or when there is a traumatic injury to the elbow.
Treatment for Cubital Tunnel Syndrome
Treatment for cubital tunnel syndrome can be done conservatively through occupational or physical therapy; or through surgical intervention if conservative treatment has failed. Conservative treatment includes nighttime bracing through the use of an elbow extension orthosis keeping the elbow straight with a slight bend of 30 degrees. It is recommended to wear this nighttime brace for 3 months to allow symptoms to resolve. Additional therapeutic treatment can include nerve gliding exercises prescribed by your therapist and education regarding computer ergonomic modifications and activity adaptations.
Surgical Options for Cubital Tunnel Syndrome
Patients who have ulnar nerve entrapment in the cubital tunnel may benefit from an ulnar nerve decompression or an ulnar nerve transposition. In an ulnar nerve decompression, the surgeon will release the fascia covering the cubital tunnel in order to decrease the compression and allow the ulnar nerve to glide more fluidly. With an ulnar nerve transposition, the ulnar nerve is moved anteriorly beneath the flexor muscle mass. By moving the nerve from behind the elbow to the front of it, it will allow the nerve to decompress and relieve the numbness and tingling symptoms. Therapy after these procedures should begin within 2 weeks from surgery and the rehabilitation may last from 1-3 months. Therapy after surgery will focus on decreasing scar tissue adhesions, regaining range of motion and regaining functional strength.
What is a Distal Radius Fracture?
Distal radius fractures are one of the most common types of fractures. They often occur due to falling on an outstretched hand, sports injuries, or direct trauma. The radius bone is one of the two long bones located in the forearm. People with a distal radius fracture will initially feel pain in the wrist and may experience swelling through the lower arm and into the hand. Distal radius fractures are often diagnosed through imaging tests such as x-rays or CT scans.
Conservative Treatment for Distal Radius Fractures
Distal Radius fractures can be treated conservatively with casting for 4-6 weeks. Once the cast is removed, it is recommended to begin hand therapy with a wrist orthosis. The therapist may make a custom orthosis or the patient may be placed in a prefabricated brace provided by your doctor. The therapist will initially work on regaining range of motion and then will begin strengthening the wrist and hand once cleared to begin strengthening by the referring doctor. A patient should expect a full return to most activities 3 - 4 months after the initial injury.
Surgical Options for Distal Radius Fractures
If a fracture is not able to heal conservatively, surgical intervention may be appropriate. In surgery, your surgeon may use plates, screws, or pins to hold the broken bone in place in order to allow the fracture to heal. Depending on the severity of the fracture, patients should expect to begin therapy 7-10 days after surgery. Occasionally, a patient may be casted postoperatively for up to 4 weeks, and then therapy will begin once the cast is removed. At the patient’s first therapy visit postoperatively, the therapist will fabricate a custom wrist brace that the patient should plan to wear aside from exercises and bathing until cleared by the therapist or physician. The patient will begin range of motion exercises, scar control techniques, and learn techniques to manage swelling. The patient will be instructed to hold off from heavy lifting, gripping, pulling, pushing or weight bearing tasks until cleared by the therapist or referring physician. Patients should expect a full return to most activities around 3 - 4 months postoperatively.
If you or someone you know is suffering from a hand injury, we encourage you to schedule a consultation with one of our experienced orthopaedic surgeons or hand therapists at CAO. We are committed to helping our patients achieve optimal outcomes and return to their active lifestyles as quickly and safely as possible. Schedule an appointment with a hand and upper extremity specialist today!