Cubital tunnel syndrome in the presence of ulnar nerve instability: a review of current treatment options

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Cubital tunnel syndrome (CuTS) is a common ulnar nerve entrapment of the elbow that can be caused by a variety of stresses and inflammatory conditions. Ulnar nerve instability (UNI) is a loosely defined term to describe ulnar nerve hypermobility at the elbow that has a widely varied symptom profile. CuTS and UNI can occur individually or comorbidly, and the causality of their relationship is unclear. The purpose of this review is to examine literature on treatment options for CuTS in the presence of UNI. Hand surgeons have accepted initial surgical treatment to be anterior transposition, but recent literature suggests that a combination of endoscopic decompression and traditional, or partial medial epicondylectomy may be efficacious for some patients. Until large scale studies are performed comparing the approaches, surgeons must take into account how they were trained, the patient’s presentation, and the patient’s goals when determining what approach to utilize.