Ulnar nerve decompression and transposition

The ulnar nerve is the nerve that travels in the back of the elbow through a passageway called the cubital tunnel. When the ulnar nerve is compressed or entrapped, the nerve can become inflamed leading to pain and numbness in the hand which is called cubital tunnel syndrome. The ulnar nerve decompression and transposition aim to release pressure and stress on the ulnar nerves running in the cubital tunnel.

Signs and symptoms of Ulnar nerve entrapment

The signs and symptoms of ulnar nerve compression include.

Aching pain in the hand
Numbness, tingling, pain in the little finger and ring finger and inside the hand. These symptoms occur with prolonged resting on the elbow and repetitive elbow bending
Weakness in the hand grip
Pain in the elbow and inside of the forearm

Causes of the Ulnar nerve decompression

Various causes of Ulnar Nerve entrapment are-

Overview of cubital tunnel syndrome treatment:

Most of the cases of ulnar nerve entrapment can be treated with medicines, physiotherapy and elbow splint. In some cases when the pain is not responding to the medicines and physiotherapy or if there is significant weakness of the hand muscles, surgical intervention is required.

Surgery can be of two types namely

The steps of Ulnar Nerve Decompression and Transposition

For this procedure, the patients are usually given sedation and regional anesthesia. A regional nerve block leads to temporary paralysis of the arm for about 3-4 hours. An incision is made long enough to decompress the ulnar nerve completely and then the entire ulnar nerve is exposed to relieve the compression of the nerve. Once this is done, the nerve is shift to the front of the elbow and secured below the skin (subcutaneous ulnar nerve transposition), or fascia (sub fascicular ulnar nerve transposition) or muscle (submuscular ulnar nerve transposition). The surgical wound is closed in layers. Then, the wound is dressed and the patient’s hand is wrapped loosely. The patients are recommended to stay in the hospital for the next 24-48 hours after the ulnar nerve surgery to monitor the recovery.

Risks and complications of Ulnar nerve Decompression and Transposition surgery

The Ulnar nerve decompression and transposition is a safe procedure and most of the patients don’t face any complications but some do. The potential risks and complications of this surgery might include-

Infection
Bleeding
Elbow stiffness
Nerve damage causing permanent numbness in the hands or wrist
Pain at the treatment site
Symptoms unresolved after the surgery

If you have been suffering from ulnar nerve compression and your doctor has recommended you to undergo a surgical procedure, then get a second opinion from another neurosurgeon to explore all the available treatment options.

Dr. Arun Rajeswaran

Consult Dr. Arun with a professional experience of more than 13 years in the field of Neurosurgery

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