Ulnar nerve transposition is a surgery to relocate a nerve at the elbow and create a new path for the nerve to sit in.
Ulnar nerve transposition is done to treat cubital tunnel syndrome (CTS), also called ulnar nerve entrapment at the elbow. The cubital tunnel is an area on the inside back of the elbow. It is often called the “funny bone”. A major nerve of the arm, called the ulnar nerve, passes through this tunnel just behind the bump of the inner elbow. Sometimes structures of this tunnel can swell and put pressure on the nerve. The pressure causes CTS, a range of symptoms such as numbness, tingling, or weakness.
An ulnar nerve transposition helps relieve the pressure on the nerve by relocating the nerve.
The surgery can help relieve many symptoms. If the nerve has been badly injured, some symptoms may remain.
Pressure on the ulnar nerve can cause problems in the pinky and ring fingers of the hand.
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Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Before the surgery, your doctor may:
Leading up to your procedure:
This procedure may be done using:
An incision will be made near the inside elbow. The ulnar nerve will be located and moved from behind the elbow to the front. A new area will be created for the nerve to sit in. Depending on your specific needs the nerve may be placed in 1 of the following:
The doctor will discuss the options with you before the surgery.
About an hour
Anesthesia will prevent pain during the procedure. After the anesthesia wears off, there will be some discomfort at the incision. The changes to the nerve may also cause some symptoms during recovery. Pain medication will be given to help manage pain after the procedure.
At the Care Center
You will be monitored in a recovery area until you are ready to go home. Right after the procedure, the staff may:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
It will take a few weeks for the incision and involved muscles to fully heal. Physical activity will need to be limited during recovery:
Call your doctor if any of these occurs:
If you have an emergency, call for medical help right away.
The National Institute for Occupational Safety and Health
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Centre for Occupational Health and Safety
Canadian Orthopaedic Foundation
Cubital tunnel syndrome. American Society for Surgery of the Hand website. Available at: http://www.assh.org/handcare/hand-arm-conditions/cubital-tunnel. Accessed June 2, 2016.
Jaddue D, Saloo S, et al. Subcutaneous vs. submuscular ulnar nerve transposition in moderate cubital tunnel syndrome. Open Orthop J. 2009;3:78-82. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738827. Accessed June 2, 2016.
Liu CH, Wu SQ, Ke XB, Wang HL, Chen CX, et al. Subcutaneous versus submuscular anterior transposition of the ulnar nerve for cubital tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials and observational studies. Medicine. 2015;94(29):e1207. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602994/pdf/medi-94-e1207.pdf. Accessed June 2, 2016.
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 June 2, 2016.
Ulnar nerve entrapment of elbow. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 6, 2014. Accessed June 2, 2016.
Last reviewed June 2016 by Laura Lei-Rivera, PT, DPT, GCS Last Updated: 6/2/2016