2. Cubical Tunnel Release
The outpatient procedure, performed under general or regional
anesthesia, alleviates compression of the ulnar nerve.T his nerve travels
along the inner side of the elbow and down to the hand .Cubical tunnel
release is used to treat cubical tunnel syndrome.
Preparation
Anesthesia is administered ,and the patient is positioned to allow access
to the inner side of arm. The area is cleaned and sterilized.
Accessing the Joint
The surgeon makes an incision along the inner side of the elbow to
access the cubical tunnel ,The open space is surrounded by muscle and
bone that provides a channel for the ulnar nerve.
Relieving the Compression
The surgeon carefully opens the roof of cubical tunnel at the site of the
compression creating more space for the ulnar nerve. The nerve is often
moved out of tunnel and repositioned along a new path to prevent it
from being compressed in the future. If the nerve is compressed in
multiple places, more than one section of the tunnel may require
treatment.
End of procedure and Aftercare
The incision is closed with sutures, and the arm is bandaged and placed in
splint. The patient is allowed to go home the same day. Physical therapy
may required after the arm has healed
SPORTS AND SPINE ORTHOPEDICS
SOSCCALIFORNIA.COM
3. Ulnar Nerve Transposition at the Elbow
This outpatient procedure, performed under general or regional
anesthesia, repositions the ulnar nerve to prevent it from sliding against or
becoming pinched by the medical epicondyle (the bony bump on the inner
side of the elbow). Ulnar nerve transposition is used to treat cubital tunnel
syndrome.
Preparation
Anesthesia is administered, and the patient is positioned to allow access to
the inner side of the arm. The area is cleaned and sterilized.
Accessing the Joint
The surgeon makes an incision along the inner side of the elbow to access
the ulnar nerve and medial epicondyle.
Rerouting the Nerve
The surgeon carefully moves the ulnar nerve from behind the medial
epicondyle to a new position in front of this bony bump. The nerve can
be routed over, through, or under the muscles of the forearm. The new
placement will prevent the nerve from being compressed against the
medial epicondyle when the elbow is bent .
End of procedure and Aftercare
The incision is closed with sutures, and the arm is bandaged and placed in a
splint. The patient is allowed to go home the same day . The patient may be
required to wear a splint for one to two weeks after the surgery.
Occupational of physical therapy may be required after the arm has healed.
SPORTS AND SPINE ORTHOPEDICS
SOSCCALIFORNIA.COM
4. SPORTS AND SPINE ORTHOPEDICS
SOSCCALIFORNIA.COM
About Throwing Injuries of the Elbow
Repetitive throwing places severe stress on the elbow joint. The throwing motion
stretches the tendons and ligaments on the inner side of the elbow and compresses
the structures on the outer side. These forces can damage tissue and the bone,
especially in young athletes whose bones have not fully matured.
Medical Epicondylitis
This condition commonly called golfer’s elbow, results from overuse of the muscles
and tendons of the forearm. This can gradually deteriorate the common flexor
tendon, which attaches to the medical epicondyle (the bony bump on the inner side
of the elbow).It can be usually treated without surgery.
Medical Ulnar Collateral Ligament (UCL) Injury
Repetitive throwing can sprain or tear the MUCL ligament, typically the anterior band
located on the inner side of the elbow between the ulna and humerus. A MUCL
injury causes pain on the inner side of elbow. A complete tear may require a type of
reconstructive surgery commonly called Tommy John Surgery.
Medical Apophysitis
This condition commonly called Little League elbow, Usually occurs in children before
the reached pubery. Children’s bones have growth plates on the end - areas that
allow the bones to expand. Repetitive throwing can damage the ligaments or fracture
the growth plates, causing pain and swelling on the inner side of elbow. In severe
cases, surgery may required.
Osteochondritis Dessicans
Repetitive throwing can disrupt the blood supply to the cartilage that cushions the
end of the bones. This can cause sections of cartilage and bone to pull away or break
or loose completely. This condition commonly causes pain on the outer side of the
elbow and may cause joint to click or lock. Surgery may be required to remove any
loose fragments
