Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive paresthesia and numbness in the right small finger and ulnar half of the ring finger. Symptoms are exacerbated by prolonged elbow flexion and nocturnal positioning. Reports weakness in intrinsic hand muscles and occasional clumsiness with fine motor tasks. Denies trauma, neck pain, or radicular symptoms.
Clinical Examination Findings
Right upper extremity exam reveals positive Tinelβs sign at the cubital tunnel and positive elbow flexion test. Sensory testing demonstrates diminished light touch sensation in the ulnar nerve distribution. Motor exam shows 4+/5 strength in interossei and adductor pollicis. No visible atrophy of the hypothenar eminence or first dorsal interosseous muscle. Elbow range of motion is full and painless.
Treatment Protocol
Conservative management initiated including nocturnal elbow extension splinting, activity modification to avoid repetitive elbow flexion, and ergonomic adjustments. NSAIDs prescribed for inflammation. Referral for nerve conduction studies (NCS) and electromyography (EMG) to assess severity. If symptoms persist, surgical consultation for cubital tunnel release will be considered.