Why Choose Cedars-Sinai Marina del Rey Hospital for Ulnar Nerve Decompression?
At Cedars-Sinai Marina del Rey Hospital we have the best team of board-certified hand surgeons. Equipped with state-of-the-art technology they will help you recover lost functions. Ulnar nerve decompression is a procedure that treats pain, restores function, strength, and flexibility of your arms and fingers.
The ulnar nerve passes through the cubital space around the elbow and this nerve is usually associated with the funny bone experience when you tap your elbow. Due to an injury or a tumor, around the ulnar nerve, there will be excess pressure and stretching that results in numbness or tingling sensation of the ring or small fingers, dysfunction of hand muscles, pain in the forearm and on the inner side of the elbow. This condition is also called cubital tunnel syndrome or entrapment of the ulnar nerve or compression/entrapment neuropathy.
Ulnar nerve decompression involves a surgical intervention to create space around the compressed ulnar nerve at the elbow. Most often, the ulnar nerve at the elbow region is explored in order to get rid of any connective tissues or muscles (within the nerve passage) that may exert pressure on the ulnar nerve. The most common sites where the ulnar nerve may get compressed include the triceps muscle in the upper arm and a bony groove located in the elbow through which the ulnar nerve travels.
- Compressed ulnar nerve due to an injury or excess pressure exerted on the ulnar nerve.
- The ulnar nerve getting entrapped by its surrounding structures due to cubital tunnel syndrome or rheumatoid arthritis.
- Worsening of the hand’s ability to move.
- Clawing or drawing back of the last 2 fingers of the hand.
The procedures that may be followed during the treatment of ulnar decompression includes:
- In-situ decompression
- Simple decompression
- Anterior subcutaneous transposition
- Anterior submuscular transposition
- Medial epicondylectomy
- Endoscopic cubital tunnel release
Local anesthesia is preferred over general anesthesia, sedatives are injected into the veins and at the local area around the elbow to reduce pain and discomfort.
Nerve blocks can also be used to numb the sensation of the complete stretch of the ulnar nerve. An incision of around 4 inches is made on the thumb side of the elbow between the radius and ulnar bones. The incision will go deep till the ulnar nerve is visible. The ulnar nerve is traced from the forearm to the upper arm triceps along the passage, to make sure there is no compression. The structures around the nerve are positioned in places, the connective tissues around the nerve and skin are closed with sutures. The arm is finally wrapped loosely and the patient is advised to keep the hand elevated up to 2 days to avoid swelling. In around 2 weeks time, the sutures will be removed.
Some of the risks and complications of ulnar nerve decompression are given below:
- the symptoms may persist after the surgery if the decompression is not complete, done inadequately or because of the ulnar nerve getting entrapped again
- there can be bleeding and infection
- scar formation can happen around the wound, affecting the ulnar nerve due to hemostasis
- rupturing of the wound where the surgical incision is made
- visible scar at the area of the incision
- damaging the ulnar nerve at the time of surgical incision
- dislocation of the nerve and structures around it
This surgical procedure may provide significant relief from the symptoms of neural compression. The surgeon will discuss with the patient the post-operative benefits.
However, the potential benefits of ulnar nerve decompression include:
- undergoing this procedure the patient avoids any further damage to the ulnar nerve
- numbness and other symptoms decrease with the release of the compressed nerve
Medication: NSAIDs (non-steroidal anti-inflammatory drugs) are generally advised by the doctor to control pain and swelling. The dosage has to be followed as advised by the doctor to avoid kidney issues and bleeding in the stomach.
Warm padding: warm pad may be used in the area of the incision to control pain.
Other precautions: the wound has to be kept dry to heal quickly while showering. Special wash proof bandages can we used. Lifting of heavy weights must be avoided.
Follow-up: if the pain persists even after medications and for other complications reach out to the doctor immediately.
Call the doctor if you are experiencing any of the following:
Are you suffering from pain in your arms and fingers, difficulty in holding and picking items? We are looking forward to scheduling a consultation and to showing you just how life-changing this procedure is.