肘管综合征

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Cubital tunnel syndrome causes ulnar nerve compression at the elbow — symptoms, diagnosis, and treatment options.

Updated Jun 2026

一幅手绘插图，描绘了一个没有面孔的人，肘部弯曲，正在抖动其手部发麻的小指和无名指。 — 肘管综合征：尺神经在内肘部受压。 Kieran Hirpara 4.0

您的感受

您可能正在经历无名指和小指的疼痛、刺痛或麻木。这是因为尺神经在肘部受到挤压。这种情况被称为肘管综合征。这是该神经最常见的卡压形式。它也是上臂第二常见的神经压迫问题。

不适感通常在长时间弯曲肘部时加重。您可能会注意到，当手臂蜷曲睡觉时，症状会加剧。许多患者发现症状在夜间或醒来时发作。向后伸手扣内衣可能会变得困难。塞衬衫也可能引发疼痛或无力。您可能会感到手部不稳定或笨拙。

患有此病的男性更有可能注意到手部肌肉萎缩。这称为肌肉萎缩。这种情况在男性中比在女性中更常见。该状况也可能影响面临经济困难的人群。这些患者通常比其他人更早需要手术。

如果您的症状轻微或中度，您可能从非手术治疗中受益。大多数病情严重程度处于这些水平的患者无需手术即可改善。然而，如果您是儿童或青少年，这种情况很少见。非手术治疗不太可能解决年轻患者的症状。

您的外科医生将根据概率而非确定性来讨论您的诊断。没有任何单一测试能以 100% 的准确性确认此状况。临床评估是诊断中最重要的部分。近百分之四十被初步诊断的患者要么存在其他神经问题，要么测试结果正常。如果您的症状严重，您可能受益于更早转诊进行手部外科评估。

实际发生了什么

肘管综合征是由于尺神经在肘部受到挤压或牵拉所致。该神经从颈部一直延伸至手部，经过肘内侧一个狭窄的通道。可以将此通道想象成一件紧身袖套。当内部空间变窄时，神经的活动自由度就会丧失。

肘部并非简单的铰链关节，而是骨骼与软组织相互作用的复杂关节。当您弯曲手臂时，肘部的形态会发生变化。通道内的骨骼会向空间内突出，使通道进一步变窄。这种动态变化会对神经产生压力。即使您没有完全弯曲手臂，重复性的弯曲动作仍可能造成损害。事实上，反复的部分弯曲可能比保持手臂完全伸直或完全弯曲对神经的刺激更大。

在您活动手腕和手指时，神经也需要顺畅地滑动。如果肩部位置发生改变，会牵拉肘部的神经。这种额外的张力会增加本已敏感区域的负担。对于部分人群，额外的肌肉或松弛的韧带会施加更大的压力。这种情况较少见，但会进一步卡压神经。

当神经受到压迫时，无法正常传递信号。这会导致无名指和小指出现麻木、刺痛或无力感。问题不仅在于静态压力，还在于挤压、牵拉以及神经血供减少的共同作用。理解这一点有助于您的外科医生选择适当的治疗方案。手术的目的是为神经创造更多空间，使其能够再次自由滑动。

我们能做什么

大多数轻中度症状患者可通过保守治疗获得缓解。您的治疗通常从自我管理开始，并辅以物理治疗。您可能被建议避免肘部受压或长时间保持屈曲。物理治疗旨在减轻刺激并改善神经滑动。这种方法不太可能使儿童和青少年患者的症状得到解决，因此儿童可能需要不同的治疗路径。在考虑其他选项之前，请给非手术治疗一个充分的机会。

药物治疗侧重于控制疼痛和炎症。您的外科医生可能会推荐止痛药或抗炎药，以帮助您进行日常活动。虽然现有证据并未详细说明针对此病症的具体注射治疗（如皮质类固醇、透明质酸或富血小板血浆），但您的临床医生将根据您的具体情况讨论合适的治疗方案。目标是使受刺激的神经平静下来，以便您能够参与康复训练。请注意，近 40% 被初步诊断为该病的患者实际上存在其他神经病变或神经传导研究结果正常，因此在开始药物治疗之前，准确的诊断至关重要。

如果保守治疗达到极限，可考虑手术治疗。手术治疗肘管综合征疗效确切，超过 90% 的患者治愈或症状改善。目前对于单一最佳手术方式尚未达成共识，大多数外科医生会根据您的具体情况采用多种手术方式。部分患者可能受益于早期转诊至手外科进行评估。对于保守治疗失败的患者，初次手术后的翻修手术也能提供令人满意的结果。您的外科医生将为您讨论最佳治疗方案，同时牢记临床评估在诊断中的首要地位。

预期情况

肘管综合征通常发展缓慢。与腕管综合征患者相比，您可能更早注意到症状，但该病进展更为缓慢。对许多人而言，该病无法自行缓解。部分患者可能受益于早期转诊至手外科进行评估及早期手术。这有助于预防长期的神经损伤。

手术通常有效。超过 90% 的患者在接受治疗后痊愈或症状改善。您的外科医生旨在减轻尺神经的压力。该神经穿行于肘部。肘管松解术后，超尺神经分布区的症状可得到缓解。患者报告结局良好，但受术前症状严重程度的影响。如果您症状持续时间较长，恢复过程可能与新发症状患者不同。

并发症并不常见。肘管综合征手术的短期并发症率较低（3.2%）。然而，慢性肾脏病患者的并发症率较高。您的外科医生将密切注意肘部周围结构，以避免不必要的翻修手术。

如果需要再次手术，其效果不如初次手术可预测且令人满意。对于保守治疗失败的患者，肘管综合征初次手术后的翻修手术结果令人满意，但并不能保证预后。目前对于肘管综合征的最佳手术方式尚无共识。您的外科医生将根据您的具体解剖结构及其经验选择手术方法。

恢复过程循序渐进。如果您手臂存在异常肌肉，可能会注意到症状改善更快。随着疼痛减轻，大多数人可恢复正常活动。然而，在肘管综合征中，开放手术与牵开器辅助内镜下原位尺神经松解术的长期结局无显著差异。治疗目标是恢复功能并减轻不适。通过适当护理，您在治疗后有望获得良好的生活质量。

何时就诊

若疼痛持续且休息后无改善，请咨询全科医生。若发现手部无力或不稳，请要求专科医生评估。肘管综合征是尺神经卡压最常见的形式，也是上肢第二常见的神经压迫综合征。与腕管综合征患者相比，您可能在疾病较早阶段即出现症状。影响睡眠或工作的症状是寻求帮助的明确指征。大多数轻中度症状患者可从保守治疗中获益。然而，临床评估至关重要，因为电生理检查的敏感性往往不足。诊断应基于概率而非确定性进行探讨。

Evidence & references

Overview

Cubital tunnel syndrome involves related anatomy, clinical presentation, and current management options [1].
A subset of patients with cubital tunnel syndrome may benefit from earlier referral for hand surgery evaluation and earlier surgery [2].
Patient-reported outcomes of surgical treatment for cubital tunnel syndrome are good but are affected by preoperative symptom severity [4].
Surgery is effective in treating cubital tunnel syndrome, with more than 90% of patients cured or showing improvement [5].
More rigorous scientific studies are needed to determine the most effective surgical approaches for cubital tunnel syndrome [6].
A treatment algorithm has been proposed to provide clarity about the challenges of treating the complex patient population with cubital tunnel syndrome [7].
There is currently no consensus on the best surgical treatment of cubital tunnel syndrome [8].
Carpal tunnel and cubital tunnel syndrome requiring surgery is more common in deprived patients and occurs at an earlier age [12].
Endoscopic cubital tunnel decompression has gained popularity, with early short-term results showing satisfactory outcomes and minimal complications [14].
The selection of operative procedures for cubital tunnel syndrome is influenced by patient factors and surgeon preference, with most surgeons using more than one operative procedure [29].

Anatomy & Pathophysiology

Definitions for the degree of ulnar nerve instability at the elbow are not uniformly agreed upon [28].
With elbow flexion, the ulnar nerve did not move appreciably in the distal–proximal direction directly at the cubital tunnel [49].
Maximal ulnar nerve excursion during elbow flexion occurs in the fatty region proximal to the elbow [49].
The humeral trochlea protrudes into the cubital tunnel during elbow flexion, causing dynamic morphologic changes in the ulnar nerve [50].
Tearing of the ulnar collateral ligament significantly increases elbow valgus laxity, which elongates the ulnar nerve during simulated throwing motion [51].
Increased elbow flexion influences the intraneural blood flow of the ulnar nerve in patients with cubital tunnel syndrome [57].
Exposure to lesser extraneural pressure by repetitive non-maximum elbow flexion might be more deleterious than maximum flexion pressure in cubital tunnel syndrome [55].
Shoulder position changes the ulnar nerve strain around the elbow in living patients with cubital tunnel syndrome [56].
The mechanism of symptom provocation by the elbow flexion test cannot be explained simply by dynamic pressure in the cubital tunnel, suggesting other pathophysiological factors contribute [58].
Ulnar nerve gliding is most severe during passive wrist movement in elbow flexion and forearm supination [59].
The study could not detect a definitive effect of elbow deformity (cubitus valgus/varus) on ulnar nerve strain or demonstrate the extent of acceptable clinical elbow deformity [61].
The throwing elbow is a common source of nerve injuries due to the unique combination of anatomy, high forces, and sheer repetition associated with throwing sports [62].
Dynamic ulnar nerve compression at the elbow due to the anconeus epitrochlearis muscle is an uncommon disorder with much remaining to be elucidated about its incidence and pathophysiologic mechanisms [64].

Classification

Cubital tunnel syndrome is the most common form of entrapment of the ulnar nerve [18].
Cubital tunnel syndrome is the second most common nerve compression syndrome of the upper extremity [18].
Definitions for the degree of ulnar nerve instability at the elbow are not uniformly agreed upon [28].
Further development of a classification system for ulnar nerve instability may be warranted to standardize treatment [28].
High-resolution ultrasound (HRU) shows good correspondence to clinical and ENMG classifications in cubital tunnel syndrome [35].
An intraoperative ulnar nerve subluxation classification system has promise in preventing adverse complications of ulnar nerve hypermobility after endoscopic cubital tunnel release [43].

Clinical Presentation

Cubital tunnel syndrome is the most common form of entrapment of the ulnar nerve [18].
Cubital tunnel syndrome is the second most common nerve compression syndrome of the upper extremity [18].
Patients with cubital tunnel syndrome present earlier in the course of their disease than patients with carpal tunnel syndrome [3].
Men with cubital tunnel syndrome are more likely to present with muscle atrophy than women [10].
Carpal tunnel and cubital tunnel syndrome requiring surgery is more common in deprived patients and occurs at an earlier age [12].
The majority of patients suffering from cubital tunnel syndrome with mild or moderate symptoms benefit from conservative treatment [20].
Cubital tunnel syndrome in pediatric or adolescent patients is rare [19].
Non-operative treatment of cubital tunnel syndrome in pediatric and adolescent patients is unlikely to resolve symptoms [22].
There is no consensus reference standard for the diagnosis of Cubital Tunnel Syndrome [11].
Provocative tests for Cubital Tunnel Syndrome have inadequate or inconsistent sensitivity and specificity [11].
Diagnosis of Cubital Tunnel Syndrome should be discussed in terms of probabilities rather than certainties [11].
Clinical evaluation is paramount in the diagnosis of cubital tunnel syndrome because electrodiagnostic testing often is not sufficiently sensitive to detect changes associated with the syndrome [17].
Nearly forty percent of patients with a provisional diagnosis of Cubital Tunnel Syndrome had either another nerve pathology or a normal nerve conduction study [21].

Investigations

Provocative tests for cubital tunnel syndrome have inadequate or inconsistent sensitivity and specificity [11].
There is no consensus reference standard for the diagnosis of cubital tunnel syndrome [11].
Diagnosis of cubital tunnel syndrome should be discussed in terms of probabilities rather than certainties [11].
Electrodiagnostic testing is often not sufficiently sensitive to detect changes associated with cubital tunnel syndrome [17].
Clinical evaluation is paramount in the diagnosis of cubital tunnel syndrome [17].
Nearly forty percent of patients with a provisional diagnosis of cubital tunnel syndrome had either another nerve pathology or a normal nerve conduction study [21].
Ulnar nerve cross-sectional area (CSA) measured by ultrasound is useful for the diagnosis of cubital tunnel syndrome [47].
Ulnar nerve CSA measured by ultrasound is most significantly different between patients and controls at the medial epicondyle [47].
Power Doppler ultrasound has high predictive value for severe cubital tunnel syndrome defined by axonal loss [54].
MRI is an effective diagnostic modality for identifying primary synovial chondromatosis as a causative factor of cubital tunnel syndrome [38].
Only a small number of individuals with MRI evidence of an anconeus epitrochlearis muscle (AEM) had clinical evidence of ulnar neuropathy [48].
Cubital tunnel decompression is associated with prior trauma to the anatomic site [53].

Treatment

Non-Operative Management

The majority of patients with mild or moderate cubital tunnel syndrome symptoms benefit from conservative treatment [20].
Non-operative treatment is unlikely to resolve symptoms in pediatric and adolescent patients [22].

Operative Management: General Principles and Selection

There is currently no consensus on the best surgical treatment for cubital tunnel syndrome [8].
Most surgeons use more than one operative procedure for cubital tunnel syndrome, with selection influenced by patient factors and surgeon preference [29].
Surgery is effective in treating cubital tunnel syndrome, with more than 90% of patients cured or showing improvement [5].
None of the surgical techniques has demonstrated universal superiority above all others, but all appear to be effective [41].
A subset of patients may benefit from earlier referral for hand surgery evaluation and earlier surgery [2].
Reoperation after primary surgery provides satisfactory results for patients who fail conservative treatment [15].
In situ decompression of the ulnar nerve is a reliable treatment with a low failure rate [40].

Operative Techniques: Decompression

Simple decompression with a small skin incision yielded satisfactory results in 14 of 18 elbows with no postoperative dislocation of the ulnar nerve [32].
Endoscopic and open in situ decompression techniques demonstrate similar effectiveness, outcomes, complication profiles, and reoperation rates for idiopathic cubital tunnel syndrome [39].
The patient-reported outcome of surgical treatment is good but is affected by preoperative symptom severity [4].

Operative Techniques: Transposition and Other Procedures

Both minimal medial epicondylectomy and anterior subcutaneous transposition can be used for cubital tunnel syndrome with a high rate of satisfaction [37].
Medial epicondylectomy is recommended for patients with cubital tunnel syndrome associated with abnormal nerve-conduction velocity [33].
The procedure offers complete release of constricting structures while preserving blood supply to the nerve and allowing early postoperative elbow mobilization [25].

Operative Techniques: Specialized and Combined Procedures

Bony encasement of the ulnar nerve secondary to heterotopic ossification of the elbow is treated with an approach that leads to superior range of motion, improved or resolved ulnar neuropathy, and good to excellent long-term functional outcomes [26].
Dual endoscopic carpal and cubital tunnel release is a safe and effective treatment option for patients with concurrent syndromes recalcitrant to nonsurgical management [36].

Complications

Surgery was effective in treating cubital tunnel syndrome with more than 90% of patients cured or showing improvement [5].
The short-term complication rates of cubital tunnel surgery are low (3.2%) [24].
Short-term complication rates for cubital tunnel surgery are higher for patients with chronic kidney disease [24].
Endoscopic cubital tunnel decompression shows satisfactory outcomes and minimal complications [14].
Reoperation after primary surgery of cubital tunnel syndrome gave satisfactory results for patients who fail conservative treatment [15].
Results of revision surgery for recurrent or persistent cubital tunnel syndrome are less predictable and satisfying than primary surgery [31].
Poor outcomes and unnecessary revision surgeries for cubital tunnel syndrome can be avoided with intraoperative attention to 7 structures distal to the medial epicondyle [44].

Recovery

Patients with carpal tunnel syndrome present earlier in the course of their disease than patients with cubital tunnel syndrome [3].
A subset of patients with cubital tunnel syndrome may benefit from earlier referral for hand surgery evaluation and earlier surgery [2].
The patient-reported outcome of surgical treatment of cubital tunnel syndrome is good but is affected by preoperative symptom severity [4].
Surgery was effective in treating cubital tunnel syndrome with more than 90% of patients cured or showing improvement [5].
Symptoms in an extra-ulnar distribution can resolve following cubital tunnel release [9].
Reliable, reproducible, and valid outcomes measures are lacking from the surgical literature for cubital tunnel syndrome [13].
Endoscopic cubital tunnel decompression shows satisfactory outcomes and minimal complications in early short-term results [14].
Reoperation after primary surgery of cubital tunnel syndrome gave satisfactory results for patients who fail conservative treatment [15].
The short-term complication rates of cubital tunnel surgery are low (3.2%), but higher for patients with chronic kidney disease [24].
Treatment of bony encasement of the ulnar nerve secondary to heterotopic ossification leads to superior range of motion, improved or resolved ulnar neuropathy, and good to excellent long-term functional outcomes [26].
There are no significant differences in long-term outcomes after open and retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome [30].
Results of revision surgery for recurrent or persistent cubital tunnel syndrome are less predictable and satisfying than primary surgery [31].
Patients with an anomalous muscle (AE) experience quicker symptom improvement after cubital tunnel release than those without the anomalous muscle [34].

Key Evidence

[L5] This article reviews related anatomy, clinical presentation, and current management options for cubital tunnel syndrome with an emphasis on contemporary outcomes research. [1] (10.1016/j.jhsa.2015.03.011)
[L3] A subset of patients with cubital tunnel syndrome may benefit from earlier referral for hand surgery evaluation and earlier surgery. [2] (10.1177/15589447211058821)
[L4] Patients with carpal tunnel syndrome present earlier in the course of their disease than patients with cubital tunnel syndrome. [3] (10.1016/j.jhsa.2007.03.009)
[L3] The patient-reported outcome of surgical treatment of cubital tunnel syndrome is good but is affected by preoperative symptom severity. [4] (10.1016/j.jhsa.2009.05.014)
[L4] Surgery was effective in treating cubital tunnel syndrome with more than 90% of patients cured or showing improvement. [5] (10.1016/j.otsr.2014.03.009)
[L4] More rigorous scientific studies are needed to determine the most effective surgical approaches for cubital tunnel syndrome. [6] (10.1007/s12178-020-09650-y)
[L4] The purpose of this review is to summarize the most up-to-date literature regarding cubital tunnel syndrome and propose a treatment algorithm to provide clarity about the challenges of treating this complex patient population. [7] (10.1016/j.jhsg.2022.07.008)
[L5] There is currently no consensus on the best surgical treatment of cubital tunnel syndrome. [8] (10.1016/j.ocl.2012.07.017)
[L3] This study documents resolution of symptoms in an extra-ulnar distribution after cubital tunnel release. [9] (10.1007/s11552-014-9688-9)
[L4] Men with cubital tunnel syndrome are more likely to present with muscle atrophy than women. [10] (10.1177/1558944716643096)
[L4] There is no consensus reference standard for the diagnosis of Cubital Tunnel Syndrome, and provocative tests have inadequate or inconsistent sensitivity and specificity; diagnosis should be discussed in terms of probabilities rather than certainties. [11] (10.1016/j.jhsa.2011.03.021)
[L4] Carpal tunnel and cubital tunnel syndrome requiring surgery is more common in deprived patients and occurs at an earlier age. [12] (10.1177/1753193420939384)
[L3] Reliable, reproducible, and valid outcomes measures are lacking from the surgical literature for cubital tunnel syndrome. [13] (10.1016/j.jhsa.2009.05.010)
[L5] Endoscopic cubital tunnel decompression has gained popularity with early short-term results being encouraging, showing satisfactory outcomes and minimal complications. [14] (10.1136/jisakos-2020-000506)
[L4] Clinical evaluation is paramount in the diagnosis of cubital tunnel syndrome because electrodiagnostic testing often is not sufficiently sensitive to detect changes associated with the syndrome. [17] (10.1016/j.hcl.2013.08.019)
[L5] Cubital tunnel syndrome is the most common form of entrapment of the ulnar nerve and the second most common nerve compression syndrome of the upper extremity. [18] (10.1016/s0749-0712(21)00356-5)
[L3] Cubital tunnel syndrome in pediatric or adolescent patients is rare and can be treated successfully with surgical intervention. [19] (10.1016/j.jhsa.2012.01.016)
[L2] The majority of patients suffering from cubital tunnel syndrome with mild or moderate symptoms benefit from conservative treatment. [20] (10.1177/1753193408098480)
[L4] Nearly forty percent of patients with a provisional diagnosis of CubTS had either another nerve pathology or a normal test. [21] (10.1016/j.jse.2020.01.064)
[L4] Non-operative treatment of cubital tunnel syndrome in pediatric and adolescent patients is unlikely to resolve symptoms. [22] (10.1016/s0363-5023(11)60063-4)
[L4] The short-term complication rates of cubital tunnel surgery are low (3.2%), but higher for patients with chronic kidney disease. [24] (10.1016/j.jhsa.2017.01.020)
[L5] The procedure offers complete release of constricting structures while preserving blood supply to the nerve and allowing early postoperative elbow mobilization. [25] (10.1016/s0749-0712(21)00325-5)
[L4] This treatment approach leads to superior range of motion, improved or resolved ulnar neuropathy, and good to excellent long-term functional outcomes. [26] (10.1016/j.jse.2023.12.003)
[L4] Most surgeons use more than one operative procedure in their treatment of patients with cubital tunnel syndrome and the selection of the operative procedure is influenced by patient factors and surgeon preference. [29] (10.1007/s11552-008-9133-z)
[L3] There are no significant differences in long-term outcomes after open and retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome. [30] (10.1227/neu.0b013e3182846dbd)
[L4] Results of revision surgery for recurrent or persistent cubital tunnel syndrome are less predictable and satisfying than primary surgery. [31] (10.1016/j.jhsa.2011.11.024)
[L4] The technique yielded satisfactory results in 14 of 18 elbows with no postoperative dislocation of the ulnar nerve. [32] (10.1054/jhsb.2002.0821)
[L4] The procedure is recommended for patients with cubital tunnel syndrome associated with abnormal nerve-conduction velocity. [33] (10.2106/00004623-198062060-00016)
[L3] Patients with an AE experience quicker symptom improvement after cubital tunnel release than those without the anomalous muscle. [34] (10.1016/j.jhsa.2017.06.033)
[L4] HRU proved to be an effective diagnostic tool for cubital tunnel syndrome and its etiologies, showing good correspondence to clinical and ENMG classifications. [35] (10.1016/j.otsr.2014.03.008)
[L4] Preliminary data demonstrate that dual endoscopic carpal and cubital tunnel release is a safe and effective treatment option for patients who present with concurrent cubital and carpal tunnel syndromes recalcitrant to nonsurgical management. [36] (10.1007/s11552-013-9552-3)
[L3] Both methods can be used for the treatment of cubital tunnel syndrome with a high rate of satisfaction. [37] (10.1016/j.jse.2005.10.007)
[Case_report] MRI is an effective diagnostic modality, and clinicians should be aware of primary synovial chondromatosis as a causative factor of cubital tunnel syndrome. [38] (10.1177/1758573216683396)
[L1] The current study demonstrates similar effectiveness between the endoscopic (ECTuR) and open (OCTuR) techniques for treatment of idiopathic cubital tunnel syndrome with similar outcomes, complication profiles, and reoperation rates. [39] (10.1177/1558944715616097)
[L4] In situ decompression of the ulnar nerve is a reliable treatment for cubital tunnel syndrome with a low failure rate. [40] (10.1177/1753193408101467)
[L4] None of the techniques in this review has demonstrated universal superiority above all others, but all appear to be effective in the treatment of cubital tunnel syndrome. [41] (10.3389/fsurg.2018.00048)
[L4] Our preliminary report of patients shows satisfactory outcomes, which suggests that our intraoperative ulnar nerve subluxation classification system has promise in preventing adverse complications of ulnar nerve hypermobility after endoscopic cubital tunnel release. [43] (10.1016/j.jhsg.2020.05.001)
[L5] Poor outcomes and unnecessary revision surgeries for cubital tunnel syndrome can be avoided with intraoperative attention to 7 structures distal to the medial epicondyle. [44] (10.1177/1558944718771390)
[L1] The ulnar nerve CSA measured by US imaging is useful for the diagnosis of cubital tunnel syndrome (CuTS), and is most significantly different between patients and controls at the medial epicondyle. [47] (10.1016/j.apmr.2017.08.467)
[L4] Only a small number of individuals with MRI evidence of an AEM had clinical evidence of ulnar neuropathy. [48] (10.1016/j.jse.2018.03.021)
[L5] With elbow flexion, the ulnar nerve did not move appreciably in the distal–proximal direction directly at the cubital tunnel, but maximal excursion was in the fatty region proximal to the elbow. [49] (10.1016/j.jhsa.2012.03.016)
[L5] The humeral trochlea protrudes into the cubital tunnel during elbow flexion, causing dynamic morphologic changes in the ulnar nerve. [50] (10.1016/j.jse.2022.05.026)
[L5] Tearing of the UCL significantly increased elbow valgus laxity, which in turn elongated the ulnar nerve during simulated throwing motion. [51] (10.1016/j.jse.2019.02.009)
[L4] Cubital tunnel decompression is associated with prior trauma to the anatomic site. [53] (10.1016/j.jhsa.2017.07.009)
[L3] Power Doppler ultrasound demonstrated high predictive value for severe cubital tunnel syndrome defined by axonal loss. [54] (10.1177/15589447221127334)
[L4] The increased pressure in the cubital tunnel could still be important, as exposure to a lesser extraneural pressure by repetitive non-maximum elbow flexion might be more deleterious. [55] (10.3109/2000656x.2012.747962)
[L4] To the best of our knowledge, this is the first study showing that shoulder position changes the ulnar nerve strain around the elbow in living patients with CubTS. [56] (10.1016/j.jse.2015.01.014)
[L3] Increased elbow flexion in patients with CuTS influences the intraneural blood flow of the ulnar nerve. [57] (10.1016/j.jhsa.2021.06.024)
[L3] The mechanism of provocation of symptoms of cubital tunnel syndrome by the elbow flexion test could not be explained simply by dynamic pressure in the cubital tunnel, and other pathophysiological factors could also be contributing. [58] (10.1016/j.jhsa.2010.11.013)
[L4] Ulnar nerve gliding was most severe during passive wrist movement in elbow flexion and forearm supination. [59] (10.5397/cise.2024.00934)
[L5] The study could not detect a definitive effect of elbow deformity on ulnar nerve strain or demonstrate the extent of acceptable clinical elbow deformity. [61] (10.1186/s12891-022-05786-9)
[L5] The throwing elbow is a common source of nerve injuries due to the unique combination of anatomy, high forces, and sheer repetition associated with throwing sports. [62] (10.1016/j.csm.2004.04.012)
[L4] Dynamic ulnar nerve compression at the elbow due to the anconeus epitrochlearis muscle is an uncommon, little-known disorder with much remaining to be elucidated about its incidence and pathophysiologic mechanisms. [64] (10.1016/j.jhsg.2022.11.002)

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