Cubital Tunnel Syndrome Presenting With Carpal Tunnel Symptoms: Clinical Evidence for Sensory Ulnar-to-Median Nerve Communication
Shafic A. Sraj, MD, Charbel D. Moussallem, MD, and James B. Stafford, MD
Dr. Sraj is Fellow, Hand and Upper Extremity Surgery, Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas.
Dr. Moussallem is Resident, Department of Orthopedic Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Dr. Stafford is Assistant Professor, Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas.
Abstract not available. Introduction provided instead.
Interneural communications in the upper extremity have been described in various schemes. They have remained, however, the subject of diagnostic, anatomical, and neurophysiologic interest and have seldom related directly to clinical decision making. In this report, we describe the case of a patient who, despite typical clinical complaints of carpal tunnel syndrome, did not manifest any of the clinical signs of median nerve compression. She showed evidence of ulnar nerve compression at the elbow, and provocative testing of the cubital tunnel reproduced the “carpal tunnel” symptomatology. Awareness of the presence of ulnar-to-median nerve communication led to the correct yet counterintuitive decision to perform cubital tunnel release.