What is the pathophysiology of ulnar neuropathy within the cubital tunnel?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Within the cubital tunnel, the measured mean intraneural pressure is significantly greater than the mean extraneural pressure at elbow flexion of 90° or more. [52] With the elbow flexed 130°, the mean intraneural pressure is 45% higher than the mean extraneural pressure. With this degree of flexion, significant flattening of the ulnar nerve occurs; however, with full elbow flexion, there is no evidence for direct focal compression, which suggests that traction on the nerve in association with elbow flexion is responsible for the increased intraneural pressure.

In addition, studies have shown that the intraneural and extraneural pressures within the cubital tunnel are lowest at 45° of flexion. As a result of these studies, 45° of flexion is considered to be the optimum position for immobilization of the elbow to decrease pressure on the ulnar nerve.


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