Indications for surgery:
Signs and symptoms suggestive of ulnar neuropathy with electrophysiology evidence ulnar neuropathy.
Benefits of surgery:
Typically, rapid relief of hand pain and some improvement in weakness or numbness depending on the severity of pre operative deficit.
Risks of surgery:
Very low risk of major complications. Small risk of serious allergic reaction to antibiotics or surgical preparation fluids.
~5% risk of recurrent symptoms requiring repeat surgery, worsened weakness or numbness in forearm or hand. Some patients may also have numbness on the inner forearm after the surgery.
Brief description of the surgery:
The operation is performed under general anaesthetic.
A small incision is made on the inside of the elbow allowing the band of tissue forming the roof of the cubital tunnel that is compressing the nerve (ulnar) to be divided and the nerve compression ‘released’. The wound is then closed in layers.
The operation usually takes about 30 minutes.
The arm will be bandaged. The bandage should stay intact, clean and dry for 1 week after the surgery. After a week the bandage can come off with the dressing left in place. You should see your GP or practice nurse 10 days after the surgery when the wound can be inspected. The sutures are usually under the skin and do not need to be removed.
I encourage elbow movement during this time but for 2 weeks after the surgery you should not use the arm to lift anything heavy.
In order to wash or shower you will need to place the arm in a plastic bag, with an elastic band around the upper arm, elevated so no water goes on the bandages. If for some reason the dressings or bandages do get wet you will need to have them changed.
The wound heals over a few months and normal arm activity can resume after about 4 weeks.
You should avoid driving until the hand can be used without pain so as to be able to react normally in a driving emergency situation.
Return to work is very dependant upon the type of work you do and if you have a job involving heavy lifting and manual labour you may need 4-6 weeks off work.