Surgical
If symptoms do not resolve despite conservative medical treatment and changes in your daily activities, your doctor may determine that surgery is the best treatment to stop further damage to the ulnar nerve. Surgery may also be recommended if the nerve is significantly compressed or muscle weakness and damage has occurred. The aim of surgical treatment is to simply release the pressure and stress on the ulnar nerve as it pasases throught the cubital tunnel.
Surgical Treatment Options
Nerve Decompression/Ulnar Nerve Anterior Transposition
- With this technique, the surgeon moves the nerve from behind the medial epicondyle to the front of it, creating a new tunnel and placing the nerve in a more comfortable position.
Cubital Tunnel Release
- The ligament or “roof” of the cubital tunnel is cut and divided to allow for more space within the tunnel, decreasing the pressure on the nerve.
- This treatment option is most successful for mild and moderate levels of nerve compression where the ulnar nerve does not slide over the medial epicondyle with elbow flexion.
Medial epicondylectomy
- With this procedure, part of the medial epicondyle is removed to prevent the nerve from being caught on the bony ridge and stretching as the elbow flexes.
For all procedures, small incisions are made to allow entry of surgical apparatus. Incisions are closed with sutures and are covered with a surgical bandage.
Goal
Reducing pressure on the ulnar nerve.
Recovery
- A splint may need to be worn for a few weeks following surgery
- Physical therapy is recommended to regain range of motion and strengthen the muscles of the arm.
Complications
- Bleeding
- Infection
- Permanent numbness
- Unresolved symptoms
Outcomes
- Success rates of surgery are generally good
- If muscle damage was present or the nerve was significantly compressed before surgery, the nerve may not be able to return to normal and some symptoms may still be present after surgery.
- Nerves recover slowly, therefore it may take some time to know how the nerve responded to surgery.
