Definition

Ulnar nerve transposition is a surgery to move a nerve at the elbow. A new path will be made for the nerve to sit in.

Reasons for Procedure

This surgery is done in people with cubital tunnel syndrome. This happens when there is pressure on the ulnar nerve inside the elbow. It can lead to tingling and weakness in the arm. This surgery will ease the pressure on the nerve.

The Hand

Pressure on the ulnar nerve can cause problems in the pinky and ring fingers of the hand.

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Possible Complications

Problems are rare, but all procedures have some risk. Some may be:

  • Sore throat
  • Nausea and vomiting
  • Reaction to anesthesia
  • Bleeding or blood clots
  • Infection
  • Nerve injury

Before your procedure, talk to your doctor about ways to lower your risk of problems. Things that may raise your risk are:

What to Expect

Prior to Procedure

Before surgery:

  • Arrange for a ride home.
  • Talk to your doctor about all medicines and supplements you are taking. Some may need to be stopped up to one week before surgery.
  • Do not eat or drink after midnight the night before surgery.
  • Arrange for help at home as you recover.

Anesthesia

Surgery may be done using:

Description of the Procedure

A cut will be made near the inside of the elbow. The ulnar nerve will be located. It will be moved from behind the elbow to the front. The nerve will be seated in one of these places:

  • Under the skin and fat but above the muscle
  • Within the muscle
  • Under the muscle

How Long Will It Take?

About an hour

Will It Hurt?

Anesthesia will prevent pain during surgery. Medicine can help with pain after surgery.

Post-procedure Care

At the Care Center

After surgery, the staff may:

  • Raise your arm using pillows.
  • Put ice on the elbow to ease swelling.
  • Apply a splint, bandages, and dressing to support the area.

During your stay, staff will take steps to lower your chances of infection by:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your chances of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding your care team to wear gloves or masks
  • Not letting others touch your incisions

At Home

It will take a few weeks for the elbow to fully heal. Some activity will be limited for up to four weeks.

Call Your Doctor

Call your doctor if you are not recovering or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, a lot of bleeding, or any discharge from the incision
  • Changes in the skin color of the fingers
  • Tingling and numbness in the hand
  • Pain that you cannot control with medicine
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org

Health Canada
http://www.canada.ca

REFERENCES:

Cubital tunnel syndrome. American Society for Surgery of the Hand website. Available at: http://www.assh.org/handcare/hand-arm-conditions/cubital-tunnel. Published 2015. Accessed December 9, 2019.

Palmer BA, Hughes TB. Cubital tunnel syndrome. J Hand Surg Am. 2010 Jan;35(1):153-163.

Soltani AM, Best MJ, Francis CS, Allan BJ, Panthaki ZJ. Trends in the surgical treatment of cubital tunnel syndrome: an analysis of the National Survey of Ambulatory Database. J Hand Surg. 2013;36(8):1551-1556.

Ulnar nerve entrapment at the elbow (cubital tunnel syndrome). OrthoInfo—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00069. Updated September 2015. Accessed December 9, 2019.

Ulnar nerve entrapment of elbow. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/ulnar-nerve-entrapment-of-elbow. Updated June 18, 2018. Accessed December 9, 2019.

Last reviewed September 2019 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS  Last Updated: 12/9/2019