Ulnar Nerve Transposition
(Ulnar Nerve Decompression)
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.
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:
- Smoking
- Alcohol use disorder
- Health problems like diabetes or obesity
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 1 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:
- General anesthesia—You will be asleep.
- Local anesthesia—The elbow will be numbed.
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 4 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: 9/11/2020