The Ulnar Nerve Decompression Operation
The “cubital tunnel” is a groove in the arm bone, with a thick ligament over the top of it, which forms a roof over the tunnel. Sitting in the tunnel is the ulnar nerve with some small blood vessels. This large nerve causes the fingers to move to make a fist and to move away and towards each other. It also gives feeling to the little finger and part of the ring finger. The ulnar nerve behind the elbow in the cubital tunnel is also known as the “funny bone”.
The large ulnar nerve being squashed behind the elbow, in its groove, causes cubital tunnel syndrome. The squashing of the nerve reduces the blood flow, which brings about pins and needles and a loss of feeling. The operation for cubital tunnel syndrome releases the pressure on the nerve by cutting the ligament that is squashing it or moving the nerve out of its groove. This allows better blood flow around the nerve, reducing the risk of ongoing nerve damage and frequently, but not always, improving the symptoms.
After The Operation
You will find a large bandage with a plaster splint on your elbow. You will not fully be able to use the operated elbow for a short while after surgery and so will not be able to drive. It is important to move your arm including the shoulder and hand after the operation to stop them stiffening. The bandage will be removed 10-14 days after the surgery and you will be asked to start massaging the scar with a moisturiser and begin moving your elbow joint.
You may get back to driving after the bandage is removed if you feel safe to do so, and can consider going back to work although people doing heavy manual jobs may need up to 6 weeks off.
Risks Of Surgery
Generally, this procedure is considered to be effective and low risk. However some people may have problems. The commonest of these is tenderness of the scar, which is usually temporary and is helped by scar massage. There may also be numbness surrounding the scar. The sutured wound may break open with movement of the elbow. This may require further dressing. Other problems are swelling and stiffness of the elbow which, if severe, is called “reflex sympathetic dystrophy” and is rare. Infection is also rare. Occasionally the symptoms return after a period of time. The main aim of the surgery is to prevent further deterioration of nerve function and it should be accepted that the symptoms in the hand might continue after surgery. This does not necessarily mean that the procedure has been unsuccessful.