Ulnar Nerve Entrapment and Treatment
Cubital tunnel release is surgery to treat cubital tunnel syndrome, a condition characterized by compression of the ulnar nerve in an area of the elbow called the cubital tunnel. This can cause symptoms such as
- 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.
Your surgeon may recommend a cubital tunnel release If conservative treatment options fail to resolve the condition or if muscle wasting or severe nerve compression is present
The goal of cubital tunnel release 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 achieve this:
- 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 option is best for you depending on your specific circumstances.
Postoperative Care for Cubital Tunnel Release
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, or 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 of Cubital Tunnel Release
Most patients suffer no complications following Cubital Tunnel surgery, however, complications can occur following elbow surgery and include:
- 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.