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桡管综合征

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Radial tunnel syndrome — causes forearm pain, weakness straightening fingers, and is distinct from tennis elbow.

Updated Jun 2026
插图显示一个人因疼痛而紧握上臂外侧前臂。
桡管综合征引起肘部下方外侧前臂的钝痛。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能正在经历上臂外侧和前臂外侧的疼痛。这种不适源于对桡神经后骨间神经的压迫。可以将这条神经想象为一根沿手臂后侧向下延伸的电缆。当它在桡管处受到挤压时，会发出信号，感觉像是一种深部的酸痛或压痛。

疼痛在使用手臂时往往会加重。您可能会注意到，在进行涉及前臂旋转或抓握物体的活动后，症状会加剧。例如，转动门把手、使用螺丝刀或提起沉重的购物袋都可能诱发这种感觉。此外，早晨刚醒来时，不适感可能更为明显。

日常任务可能会变得困难。将手伸到背后扣文胸或把衬衫塞进裤子里可能会引起尖锐的疼痛。您可能会发现很难侧卧在患侧手臂上睡觉，因为压力会加重神经症状。虽然肌肉无力较少见，但有些人会随着时间的推移发现手部感觉无力或协调性下降。

重要的是要知道，这种情况很少见。目前没有单一的检查可以确诊桡管综合征。医生通常根据您的症状和体格检查来进行诊断。部分患者在 MRI 上可见变化，例如受该神经支配的肌肉出现肿胀。然而，这些发现并非总是存在。

治疗通常从非手术选项开始。休息、活动调整和物理治疗是您的外科医生可能会推荐的第一步。如果这些措施在一段时间后没有效果，可能会考虑手术减压。该手术涉及释放神经周围的狭窄区域以减轻压力。

您的体验可能会有所不同。有些人通过保守治疗获得缓解，而另一些人则需要手术。目标是减轻疼痛并恢复功能，以便您能恢复正常活动。记录什么能让您的疼痛加重或减轻。这些信息有助于您的外科医生为您量身定制有效的治疗方案。

实际发生了什么

桡管综合征是桡神经的压迫性神经病。这意味着桡神经在穿过前臂时受到挤压或卡压。桡神经是一条主要的组织束，负责将信号从大脑传递到手臂肌肉和皮肤。当这条“电缆”受到压迫时，无法正常传递信息。

桡神经穿过前臂中一个狭窄的纤维性隧道。可以将这个隧道想象成一个紧身的袖套或狭窄的管道。在某些情况下，隧道周围的结构会对神经产生压迫。这种压力会刺激神经，导致手臂和手部出现疼痛、无力或麻木。这种压迫的确切原因因人而异。

关于此病症的大多数信息来自小型研究或个案报告。由于这是一种不常见的病症，缺乏大量高水平证据来指导每一项决策。这就是为什么您的外科医生可能会依靠其临床经验和您的具体症状来确定最佳的治疗方案。

非手术治疗是桡管综合征的一线治疗方法。这通常包括休息、活动调整，以及可能的物理治疗，以减少对神经的压力。许多人通过这些保守措施获得缓解。

如果非手术治疗无效，对于难治性病例，手术减压是一个可行的选择。该手术通过松解神经周围的紧张结构，为神经提供更多空间。通常在症状在其他治疗下仍持续存在时考虑进行。关于桡管综合征的诊断和预后存在持续争议，因此清楚了解您的具体情况非常重要。

我们能采取的措施

您的外科医生可能会首先采用非手术治疗作为桡管综合征的一线治疗方案。这种方法侧重于休息和避免肘关节屈曲，以减轻对神经的压力。大多数肘部神经压迫病例通过这种保守治疗均可改善。您应给予这种长期的非手术治疗足够的时间来发挥作用，因为在大多数情况下这是必要的。

如果单纯休息无法缓解症状，您的外科医生可能会推荐特定的锻炼或疗法。尽管证据强调休息和避免活动，但物理治疗通常旨在恢复功能而不加重压迫。目标是让受刺激的神经平静下来。许多患者发现，日常活动的简单调整和轻柔运动足以有效控制症状。

药物治疗可以帮助您在恢复期间控制疼痛。您的外科医生可能会建议使用抗炎药物以减少神经周围的肿胀。在某些情况下，可能会考虑注射治疗以提供针对性缓解。这些治疗旨在减轻炎症并缓解不适。这些干预措施的效果因人而异，但它们常被用作在神经自然愈合之前过渡的手段。

仅当桡管综合征对非手术治疗无效时，才会考虑手术。对于保守治疗无效的病例，手术仍是一个可行的选择。您的外科医生将评估是否有必要进行手术减压。该手术涉及释放对神经的压力以恢复其正常功能。它通常仅保留用于对其他治疗无反应的高位桡神经卡压性神经病病例。

如果需要手术，您的外科医生将讨论最适合您具体情况的手术方式。该手术旨在通过沿神经全长解剖纤维隧道来减压神经。这有助于缓解引起您疼痛的压迫。术后恢复情况因人而异，但大多数患者的症状会有显著改善。您的外科医生将指导您进行术后护理，以确保顺利康复。

需要注意的是，桡管综合征是一种由前臂近端骨间后神经受压引起的疼痛综合征。诊断主要依赖临床评估，因为影像学检查可能并不总是显示明确迹象。MRI 可用于识别与该病症相关的肌肉变化。然而，您的外科医生将主要依据您的症状和体格检查来制定治疗决策。

大多数神经压迫病例通过非手术或手术治疗均可改善。您的外科医生将根据您的需求量身定制治疗方案，从侵入性最小的选项开始。与医疗团队保持开放沟通是管理康复的关键。通过遵循推荐步骤，您可以解决疼痛的根本原因并恢复正常活动。

预期情况

桡管综合征是前臂桡神经受压所致。该病较为罕见。由于发病率低，大多数医学信息来源于小型研究而非大型临床试验。专家们在如何诊断该病以及治疗效果如何方面仍存在争议。这意味着目前尚无统一的诊断标准。

非手术治疗是大多数患者的首选治疗方案。许多患者无需手术即可获得缓解。如果保守治疗未能改善您的症状，手术减压是一个可行的选择。特别是对于存在高位桡神经卡压且对其他治疗反应不佳的患者，更是如此。您的外科医生可能需要仔细检查神经周围纤维隧道的全长，以解除压迫。

预后因人而异。部分患者恢复良好，而另一些患者可能持续存在症状。由于诊断过程复杂，结果并不总是可预测的。如果需要手术，选择经验丰富的外科医生至关重要。通过术中仔细操作，有时可以避免不良预后。

若不予治疗，症状可能会持续存在。然而，许多病例会随时间推移并通过非手术治疗而缓解。如果您确实需要手术，康复是一个过程。您应预期在数周至数月内逐渐改善。不要期望立即缓解。治疗目标是减轻疼痛并恢复功能。

诚然，并非所有病例都能完全治愈。部分患者可能对治疗效果不满意。如果主要手术后症状复发或持续存在，可能会考虑翻修手术。然而，翻修手术的效果往往不如初次手术可预测，且满意度通常较低。大多数患者需要二次手术的风险总体较低，但对于50岁以下患者或患有某些健康状况（如慢性肾病）的患者，风险可能较高。

您的预后取决于身体对治疗的反应。请对康复过程保持耐心。与您的外科医生就您的进展保持开放沟通。合理的期望有助于您自信地应对这一疾病。

何时就医

桡管综合征是一种由前臂神经受压引起的罕见疼痛状况。由于缺乏确诊该病的标准检查，专业评估至关重要。如果您有持续性疼痛且休息后未改善，请咨询您的全科医生。如果您注意到无力、不稳定，或症状干扰了您的睡眠或工作，请要求专科医生进行会诊。症状突然加重也需要立即就医。虽然肌肉变化可能在 MRI 上显现，但只有临床医生才能确定最佳的治疗方案。早期评估有助于避免不必要的操作，并确保您获得针对这一罕见神经问题的适当治疗。

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Overview

  • Radial tunnel syndrome is a compression neuropathy of the radial nerve [2].
  • Most publications regarding uncommon upper extremity compression syndromes, including radial tunnel syndrome, are small retrospective series or case reports [2].
  • Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence [2].
  • Nonsurgical management is the first-line treatment for radial tunnel syndrome [1].
  • Surgical decompression is a viable option for refractory cases of radial tunnel syndrome [1].
  • There is ongoing controversy regarding the diagnosis and outcomes of radial tunnel syndrome [1].
  • High radial nerve entrapment neuropathy cases resistant to conservative treatment are advocated for surgical intervention [14].
  • Surgical treatment for high radial nerve entrapment neuropathy requires dissecting the entire length of the fibrous tunnel [14].

Anatomy & Pathophysiology

  • Bony encasement of the ulnar nerve can occur secondary to heterotopic ossification of the elbow [3].
  • Chronic structural adaptations of the shoulder and elbow are correlated in professional baseball pitchers, but adaptations in shoulder strength or range of motion are not significantly related to chronic structural adaptations of the elbow [35].
  • The humeral trochlea protrudes into the cubital tunnel during elbow flexion, causing dynamic morphologic changes in the ulnar nerve [38].
  • Shoulder position increases ulnar nerve strain at the elbow in patients with cubital tunnel syndrome [45].
  • Increased elbow flexion influences the intraneural blood flow of the ulnar nerve in patients with cubital tunnel syndrome [47].
  • The mechanism of symptom provocation by the elbow flexion test in cubital tunnel syndrome cannot be explained simply by dynamic pressure in the cubital tunnel, suggesting other pathophysiological factors contribute [51].
  • Ulnar nerve gliding is most severe during passive wrist movement in elbow flexion and forearm supination [53].
  • A cadaveric 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 [57].
  • 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 [58].
  • Dynamic ulnar nerve compression at the elbow can be caused by the anconeus epitrochlearis muscle, an uncommon disorder with pathophysiologic mechanisms that remain to be elucidated [64].

Classification

  • Radial tunnel syndrome is defined as a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm [11].
  • Radial tunnel syndrome is considered an illness construct based on speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [5].
  • Radial tunnel syndrome and posterior interosseous nerve syndrome are viewed as a single condition presenting along a spectrum of nerve entrapment [26].
  • Radial tunnel syndrome and posterior interosseous nerve syndrome are distinct entities within the review of history, anatomy, and clinical presentation [6].
  • Radial tunnel syndrome is classified as an unusual compression neuropathy of the forearm [12].
  • Radial tunnel syndrome is classified as an uncommon compression syndrome of the radial nerve [2].
  • Radial neuropathies are rare compared to other entrapment neuropathies [4].

Clinical Presentation

  • Radial tunnel syndrome is a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm [11].
  • Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [5].
  • Radial tunnel syndrome and posterior interosseous nerve syndrome are viewed as a single condition presenting along a spectrum of nerve entrapment [26].
  • The deep branch of the radial nerve and the posterior interosseous nerve are distinct entities requiring consistent terminology distinction [26].
  • Radial neuropathies are rare [4].
  • Muscle denervation edema or atrophy along the distribution of the posterior interosseous nerve is the most common MR finding in radial tunnel syndrome [27].

Investigations

  • Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [5].
  • Radial tunnel syndrome is a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm [11].
  • Muscle denervation edema or atrophy along the distribution of the posterior interosseous nerve is the most common MR finding in radial tunnel syndrome [27].
  • MRI has emerged as the imaging modality of choice for the evaluation of elbow pain in the athlete due to its high spatial resolution, excellent soft tissue contrast, and multiplanar imaging capabilities [67].
  • 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 [10].
  • Ultrasound may be able to better identify patients with early stages of ulnar neuropathy with negative electrodiagnostic findings [69].
  • MRI is an effective diagnostic modality, and clinicians should be aware of primary synovial chondromatosis as a causative factor of cubital tunnel syndrome [21].
  • Only a small number of individuals with MRI evidence of an anconeus epitrochlearis muscle (AEM) had clinical evidence of ulnar neuropathy [46].
  • Radial neuropathies are rare [4].
  • Ulnar neuropathies are more frequent in men [4].

Treatment

Non-Operative Management

  • Nonsurgical management is the first-line treatment for radial tunnel syndrome [1].
  • Initial treatment of most compressive neuropathies at the elbow is nonoperative, consisting of rest and avoidance of elbow flexion [36].
  • Most cases of ulnar nerve compression improve with nonsurgical treatment [43].
  • A prolonged nonsurgical approach is warranted in most cases for median nerve or anterior interosseous nerve (AIN) compression, as surgical decompression is rarely indicated [44].

Operative Management: Radial Tunnel Syndrome

  • Surgical decompression remains a viable option for radial tunnel syndrome cases that are refractory to nonsurgical management [1].
  • Surgery is advocated for high radial nerve entrapment neuropathy cases that are resistant to conservative treatment [14].
  • In cases of high radial nerve entrapment requiring surgery, it is important to dissect the entire length of the fibrous tunnel [14].

Operative Management: Cubital Tunnel Syndrome (General)

  • Treatment decisions for cubital tunnel syndrome are not typically based on high levels of evidence, as most publications are small retrospective series or case reports [2].
  • Surgery was effective in treating cubital tunnel syndrome, with more than 90% of patients cured or showing improvement in a multicenter study with a mean follow-up of 92 months [20].
  • Most cases of ulnar nerve compression get better with surgical decompression [43].
  • Reoperation after primary surgery of cubital tunnel syndrome gave satisfactory results for patients who fail conservative treatment [18].

Operative Techniques: In Situ Decompression

  • In situ decompression of the ulnar nerve is a reliable treatment for cubital tunnel syndrome with a low failure rate [39].
  • In situ decompression represents an efficient and safe method for cubital tunnel syndrome management [54].
  • The endoscopic technique has proven effective in the treatment of cubital tunnel syndrome [42].

Operative Techniques: Transposition and Epicondylectomy

  • Medial epicondylectomy is recommended for patients with cubital tunnel syndrome associated with abnormal nerve-conduction velocity [13].
  • Both minimal medial epicondylectomy and anterior subcutaneous transposition can be used for the treatment of cubital tunnel syndrome with a high rate of satisfaction [37].
  • Partial epicondylectomy represents an efficient and safe method for cubital tunnel syndrome management [54].

Operative Techniques: Comparative Outcomes

  • Current evidence suggests that different surgical methods to treat ulnar neuropathy at the elbow do not differ in their clinical outcomes [15].
  • There is similar effectiveness between endoscopic (ECTuR) and open (OCTuR) techniques for the treatment of idiopathic cubital tunnel syndrome, with similar outcomes, complication profiles, and reoperation rates [40].
  • The patient-reported outcome of surgical treatment of cubital tunnel syndrome is good but is affected by preoperative symptom severity [9].

Operative Considerations and Diagnosis

  • 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 [10].
  • Elbow arthroscopy is not necessarily contraindicated in patients with a subluxating or transposed ulnar nerve [52].

Complications

  • Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [5].
  • Most publications regarding uncommon compression syndromes of the radial, ulnar, and median nerves are small retrospective series or case reports [2].
  • Treatment decisions for uncommon compression syndromes are not typically based on high levels of evidence [2].
  • Radial neuropathies are rare [4].
  • The short-term complication rate of cubital tunnel surgery is 3.2% [28].
  • The short-term complication rate of cubital tunnel surgery is higher for patients with chronic kidney disease [28].
  • Reoperation after primary surgery of cubital tunnel syndrome gave satisfactory results for patients who fail conservative treatment [18].
  • Results of revision surgery for recurrent or persistent cubital tunnel syndrome are less predictable and satisfying than primary surgery [29].
  • For patients with idiopathic cubital tunnel syndrome, the risk of revision surgery following in situ ulnar nerve decompression is low [66].
  • The risk of revision surgery following in situ ulnar nerve decompression for idiopathic cubital tunnel syndrome is increased in patients younger than 50 years [66].
  • Poor outcomes and unnecessary revision surgeries for cubital tunnel syndrome can be avoided with intraoperative attention to 7 structures distal to the medial epicondyle [17].

Recovery

  • Surgical decompression is a viable option for refractory cases of radial tunnel syndrome despite ongoing controversy regarding diagnosis and outcomes [1].
  • Most publications on uncommon compression syndromes of the radial nerve are small retrospective series or case reports, and treatment decisions are not typically based on high levels of evidence [2].
  • Radial neuropathies are rare [4].

Key Evidence

  • [L4] The article reviews the anatomy, diagnosis, and treatment of radial tunnel syndrome, noting that while nonsurgical management is first-line, surgical decompression remains a viable option for refractory cases despite ongoing controversy regarding diagnosis and outcomes. [1] (10.5435/jaaos-d-23-00314)
  • [L4] This article reviews uncommon compression syndromes of the radial, ulnar, and median nerves, noting that most publications are small retrospective series or case reports and treatment decisions are not typically based on high levels of evidence. [2] (10.1016/j.hcl.2013.04.014)
  • [L4] This treatment approach leads to superior range of motion, improved or resolved ulnar neuropathy, and good to excellent long-term functional outcomes. [3] (10.1016/j.jse.2023.12.003)
  • [L3] Ulnar and radial neuropathies were less common, with ulnar neuropathies more frequent in men and radial neuropathies being rare. [4] (10.1177/1753193419886741)
  • [L5] Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis. [5] (10.1016/j.jhsa.2010.03.020)
  • [Paper] This article is a review of the history, anatomy, and clinical presentation of radial tunnel syndrome (RTS) and posterior interosseous nerve syndrome (PINS). [6] (10.1016/s0749-0712(21)00357-7)
  • [L3] The patient-reported outcome of surgical treatment of cubital tunnel syndrome is good but is affected by preoperative symptom severity. [9] (10.1016/j.jhsa.2009.05.014)
  • [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. [10] (10.1016/j.hcl.2013.08.019)
  • [L5] Radial tunnel syndrome is a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm. [11] (10.1016/j.ocl.2012.07.022)
  • [L5] This article is a review examining unusual compression neuropathies of the forearm, specifically focusing on the radial nerve, including posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome). [12] (10.1016/j.jhsa.2009.10.016)
  • [L4] The procedure is recommended for patients with cubital tunnel syndrome associated with abnormal nerve-conduction velocity. [13] (10.2106/00004623-198062060-00016)
  • [Case_report] The authors advocate for surgery in high radial nerve entrapment neuropathy cases resistant to conservative treatment, emphasizing the importance of dissecting the entire length of the fibrous tunnel. [14] (10.1016/j.jse.2025.02.060)
  • [L4] Current evidence suggests that different surgical methods to treat ulnar neuropathy at the elbow do not differ in their clinical outcomes. [15] (10.1016/j.hcl.2013.04.013)
  • [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. [17] (10.1177/1558944718771390)
  • [L4] Surgery was effective in treating cubital tunnel syndrome with more than 90% of patients cured or showing improvement. [20] (10.1016/j.otsr.2014.03.009)
  • [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. [21] (10.1177/1758573216683396)
  • [L5] The authors advocate for consistent use of the terminology distinguishing the deep branch of the radial nerve (DBRN) and the posterior interosseous nerve (PIN), and recommend viewing radial tunnel syndrome and posterior interosseous nerve syndrome as a single condition presenting along a spectrum of nerve entrapment. [26] (10.1177/17531934241254706)
  • [L4] Muscle denervation edema or atrophy along the distribution of the posterior interosseous nerve is the most common MR finding in radial tunnel syndrome. [27] (10.1148/radiol.2401050028)
  • [L4] The short-term complication rates of cubital tunnel surgery are low (3.2%), but higher for patients with chronic kidney disease. [28] (10.1016/j.jhsa.2017.01.020)
  • [L4] Results of revision surgery for recurrent or persistent cubital tunnel syndrome are less predictable and satisfying than primary surgery. [29] (10.1016/j.jhsa.2011.11.024)
  • [L3] However, no significant relationships between adaptations in shoulder strength or ROM were related to chronic structural adaptations of the elbow. [35] (10.1177/03635465251317509)
  • [L5] Initial treatment of most compressive neuropathies at the elbow is nonoperative, consisting of rest and avoidance of elbow flexion. [36] (10.5435/00124635-199809000-00004)
  • [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)
  • [L5] The humeral trochlea protrudes into the cubital tunnel during elbow flexion, causing dynamic morphologic changes in the ulnar nerve. [38] (10.1016/j.jse.2022.05.026)
  • [L4] In situ decompression of the ulnar nerve is a reliable treatment for cubital tunnel syndrome with a low failure rate. [39] (10.1177/1753193408101467)
  • [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. [40] (10.1177/1558944715616097)
  • [L4] The technique has proven effective in the treatment of cubital tunnel syndrome. [42] (10.1177/1753193408094443)
  • [L5] Surgical decompression of the median nerve or the AIN in the forearm is rarely indicated; a prolonged nonsurgical approach is warranted in most cases. [44] (10.5435/jaaos-d-16-00010)
  • [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. [45] (10.1016/j.jse.2015.01.014)
  • [L4] Only a small number of individuals with MRI evidence of an AEM had clinical evidence of ulnar neuropathy. [46] (10.1016/j.jse.2018.03.021)
  • [L3] Increased elbow flexion in patients with CuTS influences the intraneural blood flow of the ulnar nerve. [47] (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. [51] (10.1016/j.jhsa.2010.11.013)
  • [L4] Elbow arthroscopy is not necessarily contraindicated in patients with a subluxating or transposed ulnar nerve. [52] (10.1016/j.arthro.2009.04.024)
  • [L4] Ulnar nerve gliding was most severe during passive wrist movement in elbow flexion and forearm supination. [53] (10.5397/cise.2024.00934)
  • [L3] In situ decompression and partial epicondylectomy both represent efficient and safe methods for cubital tunnel syndrome management. [54] (10.1016/j.jse.2009.10.014)
  • [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. [57] (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. [58] (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)
  • [L3] For patients with idiopathic cubital tunnel syndrome, the risk of revision surgery following in situ ulnar nerve decompression is low, but increased in patients younger than 50 years. [66] (10.1016/j.jhsa.2015.12.012)
  • [L5] MRI has emerged as the imaging modality of choice for the evaluation of elbow pain in the athlete due to its high spatial resolution, excellent soft tissue contrast, and multiplanar imaging capabilities. [67] (10.1016/j.csm.2010.06.004)
  • [L4] Ultrasound may be able to better identify patients with early stages of ulnar neuropathy with negative electrodiagnostic findings. [69] (10.1016/j.jhsa.2023.08.014)

References

[1] Radial Tunnel Syndrome: Review and Best Evidence. Journal of the American Academy of Orthopaedic Surgeons. 2023. DOI: 10.5435/jaaos-d-23-00314 [2] Uncommon Upper Extremity Compression Neuropathies. Hand Clinics. 2013. DOI: 10.1016/j.hcl.2013.04.014 [3] Bony encasement of the ulnar nerve secondary to heterotopic ossification of the elbow: an evaluation of long-term outcomes. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2023.12.003 [4] Incidence and operations of median, ulnar and radial entrapment neuropathies in Finland: a nationwide register study. Journal of Hand Surgery (European Volume). 2019. DOI: 10.1177/1753193419886741 [5] Radial Tunnel Syndrome. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.03.020 [6] RADIAL TUNNEL SYNDROME. Hand Clinics. 1996. DOI: 10.1016/s0749-0712(21)00357-7 [9] Patient-Rated Outcome of Ulnar Nerve Decompression: A Comparison of Endoscopic and Open In Situ Decompression. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.05.014 [10] Minimal-Incision In Situ Ulnar Nerve Decompression at the Elbow. Hand Clinics. 2014. DOI: 10.1016/j.hcl.2013.08.019 [11] Radial Tunnel Syndrome. Orthopedic Clinics of North America. 2012. DOI: 10.1016/j.ocl.2012.07.022 [12] Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.10.016 [13] Cubital tunnel syndrome. Treatment by medial epicondylectomy.. The Journal of Bone & Joint Surgery. 1980. DOI: 10.2106/00004623-198062060-00016 [14] High radial nerve entrapment neuropathy: an anatomical cadaver study and case report. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2025.02.060 [15] Ulnar Neuropathy at the Elbow. Hand Clinics. 2013. DOI: 10.1016/j.hcl.2013.04.013 [17] The 7 Structures Distal to the Elbow That Are Critical to Successful Anterior Transposition of the Ulnar Nerve. HAND. 2018. DOI: 10.1177/1558944718771390 [18] 10.1055-s-2001-19937. 2001. [20] Cubital tunnel syndrome: Comparative results of a multicenter study of 4 surgical techniques with a mean follow-up of 92 months. Orthopaedics & Traumatology: Surgery & Research. 2014. DOI: 10.1016/j.otsr.2014.03.009 [21] Ulnar nerve palsy caused by synovial protrusion in synovial chondromatosis of the elbow: a case report and literature review. Shoulder & Elbow. 2016. DOI: 10.1177/1758573216683396 [26] Nomenclature of the radial nerve: distinguishing between the deep branch of the radial nerve and the posterior interosseous nerve. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241254706 [27] MR Imaging Features of Radial Tunnel Syndrome: Initial Experience. Radiology. 2006. DOI: 10.1148/radiol.2401050028 [28] Rates of Complications and Secondary Surgeries After In Situ Cubital Tunnel Release Compared With Ulnar Nerve Transposition: A Retrospective Review. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.01.020 [29] Recurrent or Persistent Cubital Tunnel Syndrome. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2011.11.024 [35] Chronic Structural Adaptations of the Shoulder and Elbow Are Correlated in Professional Baseball Pitchers. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251317509 [36] Compressive Ulnar Neuropathies at the Elbow: II. Treatment. Journal of the American Academy of Orthopaedic Surgeons. 1998. DOI: 10.5435/00124635-199809000-00004 [37] Comparative study between minimal medial epicondylectomy and anterior subcutaneous transposition of the ulnar nerve for cubital tunnel syndrome. Journal of Shoulder and Elbow Surgery. 2006. DOI: 10.1016/j.jse.2005.10.007 [38] Dynamic analysis of the ulnar nerve and cubital tunnel morphology using ultrasonography: a cadaveric study. Journal of Shoulder and Elbow Surgery. 2022. DOI: 10.1016/j.jse.2022.05.026 [39] Incidence of Re-Operation and Subjective Outcome Following in Situ Decompression of the Ulnar Nerve at the Cubital Tunnel. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408101467 [40] Endoscopic Versus Open Cubital Tunnel Release. HAND. 2016. DOI: 10.1177/1558944715616097 [42] Endoscopic Anatomical Nerve Observation and Minimally Invasive Management of Cubital Tunnel Syndrome. Journal of Hand Surgery (European Volume). 2008. DOI: 10.1177/1753193408094443 [43] 10.1007-s12593-009-0020-9. n.d.. [44] Ulnar Tunnel Syndrome, Radial Tunnel Syndrome, Anterior Interosseous Nerve Syndrome, and Pronator Syndrome. Journal of the American Academy of Orthopaedic Surgeons. 2017. DOI: 10.5435/jaaos-d-16-00010 [45] Shoulder position increases ulnar nerve strain at the elbow of patients with cubital tunnel syndrome. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2015.01.014 [46] Quantitative magnetic resonance imaging analysis of the cross-sectional areas of the anconeus epitrochlearis muscle, cubital tunnel, and ulnar nerve with the elbow in extension in patients with and without ulnar neuropathy. Journal of Shoulder and Elbow Surgery. 2018. DOI: 10.1016/j.jse.2018.03.021 [47] Dynamic Evaluation of Intraneural Microvascularity of the Ulnar Nerve Using Contrast-Enhanced Ultrasonography in Patients With Cubital Tunnel Syndrome. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2021.06.024 [51] Association Between the Elbow Flexion Test and Extraneural Pressure Inside the Cubital Tunnel. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.11.013 [52] Is Elbow Arthroscopy Safe in Patients with a Subluxating ulnar nerve or Previous Ulnar Nerve Transposition? (SS‐24). Arthroscopy. 2009. DOI: 10.1016/j.arthro.2009.04.024 [53] Biomechanical analysis of ulnar nerve gliding and elongation: implications for nonsurgical ulnar nerve release in cubital tunnel syndrome. Clinics in Shoulder and Elbow. 2025. DOI: 10.5397/cise.2024.00934 [54] Comparative study of surgical treatment of ulnar nerve compression at the elbow. Journal of Shoulder and Elbow Surgery. 2010. DOI: 10.1016/j.jse.2009.10.014 [57] A cadaveric study of ulnar nerve strain at the elbow associated with cubitus valgus/varus deformity. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-022-05786-9 [58] Nerve injuries in the throwing elbow. Clinics in Sports Medicine. 2004. DOI: 10.1016/j.csm.2004.04.012 [64] Dynamic Compression of the Ulnar Nerve Associated With the Anconeus Epitrochlearis Muscle: Do We Really Know Everything?. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2022.11.002 [66] Predicting Revision Following In Situ Ulnar Nerve Decompression for Patients With Idiopathic Cubital Tunnel Syndrome. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.12.012 [67] Magnetic Resonance Imaging of the Elbow in Athletes. Clinics in Sports Medicine. 2010. DOI: 10.1016/j.csm.2010.06.004 [69] Diagnosis of Ulnar Neuropathy at the Elbow Using Ultrasound — A Comparison to Electrophysiologic Studies. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.08.014

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