Charlie Sheen Ruptures Ulnar Nerve While Filming “Major League” Sequel
“Winning” actor Charlie Sheen ruptured his ulnar nerve during batting practice on the set of the “Major League” movie sequel. The injury was so severe that Sheen is unable to grip the bat and must watch the action from the stands. The accident occurred in Phoenix at Chase Field, home of the Arizona Diamondbacks. This is another blow to the comeback of the former star of the hit TV show “Two and Half Men.” It’s a personal setback as well for the huge baseball fan. Sheen told SI.com, baseball is “not just a hobby, it’s a religion. All I watch is MLB. I don’t care what’s going on in the friggin’ world. This is what’s going on in the world. Baseball is all that matters.”
Complications from Cubital Tunnel Surgery
Cubital Tunnel Syndrome (CuTS) is an injury to the ulnar nerve in the arm that can result in moderate to severe pain and numbness in the elbow and ring & little fingers. Untreated, CuTS can result in extreme pain and an unusable hand. Conservative treatment such as splints, exercises and anti-inflammatory medication can help minor cases. But most CuTS victims eventually require surgery. Studies show the success rate is roughly the same for the three major types of cubital tunnel surgery. About 70% of patients see significant improvement, 20% see some improvement, and 10% may see no change or even get worse. From anecdotal evidence in the CuTS forums, surgery seems to help most patients at least a little bit. CuTS surgery is a relatively minor surgery, but like all medical procedures, it does have complications and risks. However, don’t let these potential problems prevent you from seeking necessary surgery. Even with a minor chance of complication, surgery is a much better bet than a life of pain, numbness and weakness from CuTS. Following are the most common complications from cubital tunnel surgery:
The Ulnar Nerve Explained
Nerves are cylindrical bundles of fibers that emanate in branches from the brain and spinal cord to every part of the body. Nerves carry impulses that move muscles, receive sensory input, and control involuntary functions such as heartbeat. The ulnar nerve is a nerve that runs near the ulna bone in the arm. The ulnar nerve is the largest nerve in the human body unprotected by muscle or bone, so injury is common.
Subcutaneous vs. Submuscular Cubital Tunnel Surgery
There are four main types of cubital tunnel surgery:
LeBron James May Have Cubital Tunnel Syndrome
Cleveland Cavaliers basketball superstar LeBron James may be suffering from cubital tunnel syndrome. Cubital tunnel syndrome (CuTS) is a nerve injury that can result in moderate to severe pain and numbness in the elbow and ring & little fingers. Untreated, CuTS can result in extreme pain, surgery or an unusable hand, all of which would be devastating to a professional athlete. James’ right elbow was tightly wrapped and didn’t seem to bother him too much in the Cavaliers’ 96-94 Game 5 victory over the Chicago Bulls on Tuesday. However, it was obvious that James was in some pain when he missed a one-handed free throw late in the game:
In a post-game interview, James said his elbow felt like he’d hit his funny bone. Doctors performed an MRI on his elbow Monday and found nothing significant. However, a nerve conduction velocity (NCV) test is a much better indicator of CuTS.
James will be able to rest his elbow for a few days before the Cavaliers begin their series against the Boston Celtics. James doesn’t believe he’ll miss any action in the playoffs, though cubital tunnel surgery in the offseason may be possible.
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Study Shows Transposition Surgery Trending Better Than Decompression for Cubital Tunnel Syndrome
A study on cubital tunnel surgery published in October 2008 has some interesting results: 1. Transposition is better than decompression 2. Subcutaneous = submuscular The report is called “Simple Decompression Versus Anterior Subcutaneous and Submuscular Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome: A Meta-Analysis” written by Sheina A. Macadam, MD and others. The study analyzed ten other studies involving a total of 449 simple decompressions, 342 subcutaneous transpositions, and 115 submuscular transpositions. The report indicates a need for additional studies that use reproducible pre- and post-operative measures to produce a more definitive conclusion on which types of surgery are best for cubital tunnel syndrome.
Odds of improvement with simple decompression versus anterior transposition were 0.751. This indicates a trend toward an improved clinical outcome with transposition of the ulnar nerve as opposed to simple decompression. In other words, transposition surgery has a slightly better success rate than decompression.
The type of transposition technique (subcutaneous or submuscular) did not render a statistically significant result. In other words, subcutaneous transposition surgery has about the same success rate as submuscular transposition.
Cell Phone Elbow or “Cellbow” Damages the Nerve in Your Arm
If your elbow aches, or your ring and little fingers tingle or feel numb, then you may have “cell phone elbow” or “cellbow.” Orthopedic doctors report a surge of cellbow cases in which patients pinch or damage the ulnar nerve in their arm by bending their elbows too tightly for too long. When cell phone users hold their small phone to their ears, they stretch the nerve that runs from the neck, through the shoulder, around the elbow and into the small fingers in the hand. When people talk for a long time in this position, it “chokes the blood supply to the nerves. It makes the nerves short-circuit. The next thing you know, there’s tingling in the ring and small finger,” said Dr. Peter J. Evans, Director of the Hand and Upper Extremity Center at the Cleveland Clinic in Ohio. Though the nerves are designed to stretch, it’s not normal for the nerve to be stretched this way for hours.
Athletics Pitcher Dan Giese Out with Ulnar Nerve Problems
Oakland Athletics relief pitcher Dan Giese was placed on the Disabled List with an irritated ulnar nerve. Lefty Gio Gonzalez has replaced him. “The nerve in my elbow jumped ship and it causes numbness down to my hand when it bounced around,” Giese said. “I’ve had it before, but not this bad.” Giese has had the problem on and off since 2007. The problem arose again during his last game and caused him to fall to his knees in pain after a pitch. He said it’s usually at least two weeks before he can pitch again. Giese suffers from Cubital Tunnel Syndrome (CuTS), a repetitive stress injury (RSI) that can result in moderate to severe pain and numbness in the elbow and ring & little fingers. Untreated, CuTS can result in extreme pain, surgery or an unusable hand. People suffering from CuTS can seek information and answers at the Cubital Tunnel Forums online. Surgery is sometimes the only solution to CuTS. Reliever Russ Springer had surgery to relocate his ulnar nerve. Though athletes usually require 4-6 months of rehab after ulnar nerve surgery, Springer only rested for 10 days. He said he returned to the mound so fast that his arm was still black and blue its entire length. “I don’t recommend it,” he said.
Cubital Tunnel Diagram
Vanumu has created a helpful anatomical diagram that shows how the ulnar nerve can become pinched in the cubital tunnel groove on the elbow. The cubital tunnel is a fibro osseous canal, where ligaments and tendons attach to the bone. The tunnel is formed by the medial condyle (bony point on the elbow), ulnar collateral ligament, and flexor carpi ulnaris muscle. Bending the elbow stretches the nerve and decreases the volume of the channel, possibly entrapping the ulnar nerve and resulting in the pain and numbness of cubital tunnel syndrome.
Books About Cubital Tunnel Syndrome and the Ulnar Nerve
There are only a few books in print about cubital tunnel syndrome and the ulnar nerve: The Ulnar Nerve 
by Dan Zlolotow and Vincent Pellegrini
Despite much study devoted to the ulnar nerve, no consensus exists as to how to treat even the most frequent causes of ulnar nerve dysfunction. With a review of the anatomy and pathophysiology, we explore the rationale behind the most common techniques for treating pathology of the ulnar nerve via reflexions by both current thought leaders and emerging voices in the field.
