4.5 of 62 Ratings
A 51-year-old man complains of elbow pain and numbness into the hand. He is an electrician and enjoys playing outfield in his competitive softball league, and was a minor league baseball pitcher. He has a multiyear history of numbness and tingling into his ring and small fingers. On physical exam, he has decreased 2-point discrimination in his small finger and a positive Jeanne's sign. His active elbow range of motion is 0-120 degrees with full pronosupination, but flexion elicits a snapping sensation over his medial elbow. His radiographs are shown in figure A. What is the best treatment for this problem?
Arthroscopic elbow debridement
In situ cubital tunnel decompression
Medial ulnar collateral ligament reconstruction
Cubital tunnel decompression with anterior transposition
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A 55-year-old patient presents with numbness and pain in the right ring and small fingers. He reports that his symptoms are worse at night. On examination, he has decreased sensation on the dorsal ulnar distribution of the hand with a positive Tinel sign at the medial elbow. There is no palpable subluxation at the medial elbow with flexion and extension. Electrodiagnostic studies from 3 months ago demonstrated decreased nerve conduction velocities in the ulnar nerve. Figures A and B demonstrate the radiographs of the right elbow. Symptoms continue to worsen despite nighttime extension splinting and NSAIDs. What is the best next step in treatment and the most likely site of compression for the patient?
Repeat EMG; herniated nucleus pulposus
In situ cubital tunnel release; flexor carpi ulnaris aponeurosis
Medial epicondyle ostectomy; osteophyte
Anterior submuscular transposition; anconeus epitrochlearis
Anterior subcutaneous transposition; ligament of struthers
The physical exam finding demonstrated on the patient's right hand in the video (Figure V) is found with neuropathy of which of the following nerves?
Anterior Interosseious Nerve (AIN
Cubital tunnel syndrome is caused by compression of the ulnar nerve between what two structures as it passes posterior to the medial epicondyle?
Osborne's ligament and the MCL
MCL and Arcade of Struthers
Osborne's ligament and the intermuscular septum
MCL and medial head of the triceps
Ulnar and humeral heads of the flexor carpi ulnaris muscle
A 50-year-old man complains of numbness and tingling along his right small finger. Elbow flexion reproduces the numbness and tingling. Physical therapy and splinting have failed to relieve the symptoms. Which of the following is the most appropriate surgical intervention to alleviate the symptoms while minimizing complications?
Simple ulnar nerve decompression at the cubital tunnel
Ulnar nerve decompression at the cubital tunnel with anterior submuscular transposition
Ulnar nerve decompression at the cubital tunnel with anterior subcutaneous transposition
Open carpal tunnel release
Endoscopic carpal tunnel release
All of the following are possible sites of compression for the ulnar nerve EXCEPT:
arcade of Struthers
ligament of Struthers
flexor carpi ulnaris fascia
medial intermuscular septum
A 20-year-old college football quarterback reports a 5-month history of gradually increasing medial elbow pain that occurs with throwing. The pain occasionally refers distally along the ulnar aspect of the forearm. He denies any weakness; however, he notes occasional paresthesias on the volar and dorsal aspect of his small finger. A nerve conduction velocity study demonstrates only slightly increased latency across the cubital tunnel. What structure may be contributing to his symptoms?
Arcade of Frohse