Management of cubital tunnel syndrome – A survey of UK specialist clinical practice

Abstract

Introduction

The purpose of this survey was to establish the current UK practice in managing patients with cubital tunnel syndrome (CuTS), in order to design a future research trial on the effectiveness of night splints.

Methods

We conducted a closed survey of the surgeon membership of the British Elbow & Shoulder Society and British Society for Surgery of the Hand in 2025.

Results

We received 137 valid responses. The minimum criteria for diagnosis were intermittent sensory loss in the ring and little fingers (74%) and positive Tinel's test (63%). Nerve tests were required by 59%, with 72% of those accepting mild slowing of the ulnar nerve as diagnostic and 28% moderate slowing as the diagnostic threshold. The criteria for surgery were heterogenous. Only 15% trial night splints before surgery and 50% never recommend them. The criteria for urgent surgery were muscle wasting (77%), sensory deficit with objective motor weakness (72%), ulnar clawing (66%), severe nerve conduction loss (62%).

Discussion

This survey highlights the lack of routine use of night splints and need for a high-quality effectiveness trial. The findings provide a snapshot of current UK practice that may be used to plan future trials involving patients with CuTS.