Ulnar Nerve Release Surgery Overview
The ulnar nerve is a nerve that runs near the ulna, one of the two long bones in the forearm. This nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.
This nerve can cause an electric shock-like sensation by striking the medial epicondyle of the humerus posteriorly, or inferiorly with the elbow flexed. The ulnar nerve is trapped between the bone and the overlying skin at this point. This is commonly referred to as bumping one's "funny bone".
When the ulnar nerve enters the palm of the hand passing via a canal, it then branches off, making it vulnerable to pinching, crushing, and other types of injuries. Overuse injuries, cysts as well as other trauma can injure or compress the nerve. Injury of the ulnar nerve at different levels causes specific sensory deficits such as pain, numbness, tingling and weakness, and can also affect fine motor movements of the fingers.
Ulnar Nerve Release Surgical Procedure
Ulnar Nerve Release procedure involves relieving pressure on the ulnar nerve in the elbow by cutting a band of tissue, moving the nerve, or by removing a portion of bone in the elbow to create more space. This helps alleviate pain and other functional symptoms of cubital tunnel syndrome.
The Ulnar Nerve Decompression procedure may usually be performed under local anesthesia with or without sedation.
There are multiple methods of releasing the compression on the nerve.
- Simple decompression
- The fibrous tissues overlying the ulnar nerve may be cut to create more space
- Simple decompression with epicondylectomy
- Apart from the fibrous tissue, a portion of bone may also be removed
- Subcutaneous transposition
- After freeing the nerve from compression, the ulnar nerve is moved into a position under the skin
- Simple decompression with epicondylectomy
- Submuscular transposition
- This may be done under general anesthesia and the surgeon moves the ulnar nerve under the muscles near the elbow, by cutting them and re-suturing them after placing the nerve underneath.
Ulnar Nerve Release Recovery
Usually, no specific post-operative care is required after the Ulnar Nerve Decompression procedure. At home, the following post-operative care is recommended after an Ulnar Nerve Decompression procedure:
- Slowly resume regular/daily activities as early as possible, which aids in faster recovery
- It may be necessary to wear a splint
- Physical therapy should be done as advised
- Use a heat pad or warm compress to relieve pain due to the incision
- Showering may be resumed after surgery, provided the wound is kept bandaged, clean, and dry.
- Avoid taking baths until the surgical wound is completely healed
- Avoid lifting of heavy weights
- Avoid driving for a few days after the procedure
