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.