Elbow Pathologies

Ulnar Nerve Entrapment

Ulnar nerve (cubital nerve) entrapment occurs when the ulnar nerve becomes compressed or irritated. The ulnar nerve is one of three major nerves in the arm. It runs from the neck to the hand and can be compressed in multiple locations along its course. Depending on the location of the compression, it can lead to numbness or pain in the elbow, the hand, the wrist and the fingers.

The most common zone of entrapment is located at the elbow, and is referred to as the ulnar tunnel syndrome. Occasionally, the compression takes place near the wrist, under the clavicle, or at the level of the neck.

Prolonged elbow flexion

Cubitus valgus

Ulnar nerve instability (Childress syndrome)

Compression zones :

  • Medial head of the triceps muscle
  • Intermuscular septum
  • Struthers arcade
  • Epitrochleo-olecranian groove (ulnar tunnel)
  • Arcade of the Flexor Carpi Ulnaris
  • Osborne arcade
  • (Amadio & Beckenbaugh’s arcade)


The ulnar tunnel syndrome (entrapment at the level of the elbow) can lead to pain at the level of the elbow. However, most symptoms take place at the level of the hand.

Numbness and a prickling sensation in the ring finger and little finger are the most common symptoms of ulnar nerve entrapment. These symptoms are not usually permanent, at least in the early phase. They happen most often when the elbow is bent, such as when one is driving, reading in bed, or holding the phone.

Some people wake up at night because their fingers feel numb.

A lack of strength as well as clumsiness might be experienced. In some cases, it can be difficult to move the fingers sideways apart from each other and back. Such symptoms usually only happen in the more serious cases of nerve compression.

Hand muscle waste may happen when the nerve is overly compressed or has been compressed for an extended period of time. In such cases, the resulting muscle atrophy is irreversible. For this reason, it is critical to seek medical advice if the symptoms appear serious or if they have been experienced for a period longer than 6 weeks.

Electromyographic study (EMG) is the key examination, allowing to establish the diagnosis and evaluate the severity of the nerve compression which is determinant for the prognosis after treatment.

Injections are ineffective.

A splint preventing the patient from bending his or her elbow at night may positively impact early forms of ulnar nerve entrapment.

Adjustment of the workstation may also be useful in early cases

When non-medical options are ineffective, or if the entrapment is serious and/or causes amyotrophy.

- Decompression of the ulnar nerve
- In some cases anterior transposition of the nerve
- In some other case epicondylectomy

It is an outpatient procedure under regional anesthesia. A dressing is applied for 2 weeks. The leave of absence is usually 3 to 6 weeks, depending on the patient’s occupation.

Post-operative recovery is usually progressive, and never as spectacular as for the carpal tunnel. It may occasionally take a long time when the nerve has been severely compressed, especially in long-standing cases. Some residual numbness may be experienced.


Institut de la main

In 20 years of existence, the INSTITUT DE LA MAIN has become one of the main hand and upper limb surgery centers in Europe. Its nine surgeons on staff can treat all hand and upper limb problems. 


Contact Us

Institut de la Main
Clinique Bizet
21 rue Georges Bizet
75016 PARIS

Front Desk : +331 84 13 04 56

Hand Emergencies : +331 84 131 131