Meet Our SurgeonLonnie D. Davis, MD

  • Dr. Davis is like no other...his compassion and kindness is superior! Easy to talk to, explains everything, open to all questions and takes time with you.

    Bonnie - Fairfax VA

  • He did an excellent job on my surgery and follow up. All was as expected. He answers questions thoroughly but does not waste patient time.

    Irene - Reston VA

  • Given the extent of my injury and accident, Dr. Davis did a miraculous job getting me back to normal. He always kept me informed of what to keep an eye on, and how to address certain aspects of my new life adjusting to this injury.

    Jake - Reston VA

  • He was very knowledgeable and excellent at translating what the issue with my knee was from medical terminology into layman's terms. He was extremely thorough and with this being my third opinion on my knee, I immediately decided I would continue through the surgery process with Dr. Davis.

    Eva - Washington DC

  • He is fantastic! Very kind. Smart. Answered my questions. I know nothing. And he was so patient. Treated my son with wonderful kindness and dignity. Dr. Davis is a good man. Glad to have met him! Will definitely go to his office in the future if we have a need for it.

    Jodi - Reston VA

  • It was my first appointment with Dr. Davis and he impressed me with his concern for my wellbeing. He is extremely thorough, spends plenty of time with you and has an excellent bedside manner. I would recommend him to anyone with a sports related injury.

    Lauren - Alexandria VA

  • I'm pretty active and have seen Dr. Lonnie Davis for a number of sports-related injuries for the past few years. I've seen him for a torn ACL, stress fracture in the foot, rock-climbing hand and ankle injuries, etc. I was really impressed with how well my ACL surgery, care and recovery went. He's been great at diagnosing the problems and getting me back to sports.

    Jennie - Annandale VA

Read More
Lonnie D Davis MD

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome is a condition characterized by compression of the ulnar nerve in an area of the elbow called the cubital tunnel.

The ulnar nerve travels down the back of the elbow behind the bony bump called the medial epicondyle, and through a passageway called the cubital tunnel. The cubital tunnel is a narrow passageway on the inside of the elbow formed by bone, muscle, and ligaments with the ulnar nerve passing through its center. The roof of the cubital tunnel is covered with a soft tissue called fascia.

When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump. When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed leading to a variety of symptoms, called cubital tunnel syndrome.

Signs and Symptoms

In general, signs and symptoms of Cubital Tunnel Syndrome arise gradually, progressing to the point where the patient seeks medical attention. Left untreated, Cubital Tunnel Syndrome can lead to permanent nerve damage in the hand. Commonly reported symptoms associated with Cubital Tunnel Syndrome include:

  • Intermittent numbness, tingling, and pain to the little finger, ring finger, and the inside of the hand. These symptoms occur more frequently at night, and with elbow bending or prolonged resting on the elbow.
  • Aching pain to the inside of the elbow
  • Weakness in hand with diminished grip strength
  • Diminished sensation and fine motor control in the hand causing the person to drop objects or have difficulty in handling small objects.
  • Muscle wasting in the hand and permanent nerve damage, if left untreated.

Causes

The common causes responsible for cubital tunnel syndrome, include:

  • Trauma
  • Repetitive motion
  • Frequent pressure on the elbow for extended periods due to sitting posture
  • Medical Conditions such as bone spurs, ganglion cysts, or tumors in the cubital tunnel leading to pressure and irritation of the ulnar nerve.

Diagnosis

Your physician will perform the following:

  • Medical History
  • Physical Examination

Your physician may order X-ray and electrodiagnostic tests such as electromyography and nerve conduction studies. These tests can assist your doctor in determining how well the nerve is functioning and locate areas of muscle wasting and nerve compression.

Treatment

Your physician will recommend conservative treatment options initially to treat the symptoms unless muscle wasting or nerve damage is present.

Conservative treatment options may include:

  • Avoid frequent bending of the elbow.
  • Avoid pressure to the elbow by not leaning on it. Elbow pads may be worn to decrease pressure when working at a desk.
  • Wear a brace or splint at night while sleeping to keep the elbow in a straight position. You can also wrap the arm loosely with a towel and apply tape to hold in place.
  • Avoid activities that tend to bring on the symptoms.
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen or aspirin, may be ordered to reduce swelling.
  • Referral to OT (Occupational Therapy) for instruction in strengthening and stretching exercises may be recommended.

If conservative treatment options fail to resolve the condition or if muscle wasting or severe nerve compression is present, your surgeon may recommend a surgical procedure to treat your condition.

The goal of Cubital Tunnel surgery is to reduce the pressure on the ulnar nerve by providing more space for the nerve to move freely and to increase blood flow to promote healing of the ulnar nerve. There are different surgeries that can be performed to treat your condition, such as:

Medial Epicondylectomy: This surgery involves removing the medial epicondyle, the bony bump on the inside of the elbow, enabling the ulnar nerve to glide smoothly when the elbow is flexed and straightened.

Ulnar Nerve Transposition: This surgery involves creating a new tunnel in front of the medial epicondyle and transposing (moving) the ulnar nerve to the new tunnel.

Your surgeon will decide which options are best for you depending on your specific circumstances.

Post-Operative Care

After surgery, your surgeon will give you guidelines to follow depending on the type of repair performed and the surgeon’s preference. Common post-operative guidelines include:

  • A bulky dressing with a plaster splint is usually applied following surgery for 10-14 days.
  • Elevating the arm above heart level and moving the fingers are important to prevent swelling.
  • The arm dressing is removed after 10-14 days for removal of the sutures.
  • Elbow immobilization for 3 weeks after surgery is usually indicated, longer depending on the repair performed.
  • Ice packs are applied to the surgical area to reduce swelling. Ice should be applied over a towel to the affected area for 20 minutes every hour. Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
  • Occupational Therapy will be ordered a few weeks after surgery for strengthening and stretching exercises to maximize use of the hand and forearm

Risks and Complications

The majority of patients suffer no complications following Cubital Tunnel surgery, however, complications can occur following elbow surgery and include:

  • Infection
  • Nerve damage causing permanent numbness around the elbow or forearm.
  • Elbow instability
  • Elbow flexion contracture
  • Pain at site of scar
  • Symptoms unresolved even after the surgery

Useful Links

  • The American Academy of Orthopaedic Surgeons
  • Medical Society of Virginia
  • American Orthopaedic Society for Sports Medicine
  • American Board of Orthopaedic Surgery
  • mid atlantic shoulder elbow society
  • mclean high school
  • STOP Sports Injuries