Ulnar Nerve Surgery of the Elbow

What is the Ulnar Nerve?

The ulnar nerve runs the length of your arm. It begins at the brachial plexus and the end is in the pinky and ring finger. The nerves are cord-like structures that deliver signals between the nervous system and the other organs. They help sense and react to stimuli, such as pressure and temperature. The ulnar nerve is used to supply both sensation and motion.

Ulnar Nerve Entrapment

Ulnar nerve entrapment is the result of abnormal pressure building up around the nerve. It impairs sensation and restricts normal function. The pressure of this nerve is caused by compression in the elbow area; the pain and discomfort is felt in the ring finger, little finger, and the palm of the hand. If ulnar nerve entrapment is left untreated, the condition can cause impaired joint mobility in the fingers and hands, irreversible muscle wastage, and permanent lack of strength and hand-grip. Ulnar nerve surgery can be used to treat ulnar nerve entrapment of the elbow.

Ulnar Nerve Surgery

The ulnar nerve surgery procedure is performed to release the trapped nerve, repair any damaged tissues, and clear sufficient space around the nerve. This will allow free movement of the joint without further compression and irritation on the nerves surface. The procedure can be performed under general anesthesia (where the person is asleep) or a regional anesthetic (where the patient is awake and the area is deadened). The operation takes an hour to perform depending on the complexity of the condition.

In some cases, the ulnar nerve might be difficult to decompress because of its surrounding tissues. The nerve will be repositioned from behind the elbow joint to a new position on the front of the joint. This is called a ’transposition’ procedure.

Recovery After Ulnar Nerve Surgery

The patient is encouraged to be active immediately after they have recovered from anesthesia. This aids in the prevention of joint stiffness and other complications such as deep vein thrombosis. Shorts walks and gentle exercises are encouraged on the day of the surgery.

Once progressive improvement of mobility improves and pain control is normal, a patient will be discharged from the hospital. The usually occurs the day of or 24 hours following surgery. At this time, the patient are fully mobile and wearing a light weight dressing and support splint on the effected elbow joint.

The 6 weeks following the surgery, the patient is expected to work on improving their new elbow joints mobility and stability. The patient must be dedicated to their upper limb physiotherapy regime given by the doctor or physical therapist.

The patients range of motion and stability will be assessed six weeks after surgery; then again after three months. This is to evaluate how successful the procedure has been. Full physical recovery normally takes four to six months to achieve.

References

NYU Medical Center: Ulnar Nerve Compression at the Elbow - www.med.nyu.edu/neurosurgery/pns/conditions/compressions/neck/ulnar_elbow.html

American Academy of Orthopedic Surgeons: Ulnar Nerve Entrapment - https://orthoinfo.aaos.org/topic.cfm?topic=A00069&return_link=0