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Ulnar nerve decompression surgery is a routine surgical procedure that can lead to a complete or substantial reduction in the symptoms of ulnar nerve entrapment.
Ulnar neuropathy refers to pain, tingling, or numbness in one or both hands resulting from compression of the ulnar nerve, almost always at the elbow (rarely at the wrist). The ring and little fingers are generally affected by numbness, with pain often experienced around the inside of the elbow and forearm. The ulnar nerve is responsible for the “funny bone” phenomenon when you hit your elbow. Damage to this nerve, usually from some form of trauma or other injury or in rare instances a tumor, can lead to a permanent sensation of numbness or tingling similar to the “funny bone” sensation.
Ulnar nerve decompression is a surgical procedure to explore the region around the elbow through which the ulnar nerve passes and remove anything that is compressing the nerve and causing dysfunction. Compression may occur around the triceps muscle in the upper arm, in the bony groove in the elbow and in another passage through the muscle in the forearm. Ulnar nerve decompression explores these three areas and removes any constrictions that are trapping the nerve.
It is performed under local, regional or general anaesthetic. If you have open ulnar nerve decompression surgery, Dr Singh will make an incision along the elbow, revealing the ulnar nerve. He then examines the nerve and removes any tissue that is causing compression. The nerve may then be moved in front of the medial epicondyle to prevent it from being pinched or irritated when the elbow is bent, which is called a transposition. The incisions are closed with sutures.
Alternatively, you may be offered endoscopic or keyhole surgery which uses much smaller incisions and an endoscope, which has a camera at one end. The surgeon will be able to see inside your joint using the endoscope and will perform surgery using miniature surgical instruments. This minimally invasive form of surgery generally results in quicker recovery.
You can normally go home the same day as the procedure; however, the arm needs to be kept elevated for 24-48 hours after surgery to prevent swelling and you may need to wear a splint on your elbow for a few weeks while the area heals. The sutures are removed after ten to fourteen days and you can normally resume light everyday activities soon after surgery and you should be able to return to work within one or two weeks, depending on the nature of your job.
Recovery times will vary from person to person, from weeks to months depending on your age, health and the extent of the problem. Symptoms may improve quickly but in some cases they can take up to six months to go away fully. In some severe cases, some symptoms may persist after surgery.
The major risks of the operation are bleeding and infection. The risk of either of these complications is usually less than 5%. Patients are given antibiotics before the procedure to limit the risk of infection, and the procedure is performed in careful fashion to limit damage to blood vessels that may cause significant bleeding. Additionally, even with exploration and decompression of the ulnar nerve, there is the risk that, in some cases, surgery will fail to improve a patient’s symptoms of ulnar neuropathy.
