Ulnar Nerve Transposition

Ulnar nerve transposition is an outpatient surgical procedure. The ulnar nerve runs in the inner arm to a bony protrusion on the inner section of the elbow. The nerve provides sensation for the muscles of the hand and forearm.

When you come to our clinic in Bethesda, MD, with pain in your elbow or you report numbness in your arm or fingers, we’ll examine you carefully. If we diagnose you with cubital tunnel syndrome or your ulnar nerve has been compressed or damaged, we may recommend ulnar nerve transposition surgery.

While ulnar nerve compression (or entrapment) may not be a life-threatening situation, it can cause permanent damage to the hand if you don't get it treated promptly. Fortunately, with the correct diagnosis and treatment, you can make a full recovery.

What Is the Ulnar Nerve?

The ulnar nerve is one of the major nerves in your arm, and it gives sensation to the fourth and fifth fingers. It gets its name from the ulna bone. This bone is in the forearm on the side of the little finger. The ulnar nerve is a long nerve that begins at your neck and goes through your shoulder and down the arm, wrist and fingers. The ulnar nerve allows you to use your fourth and fifth fingers and forearm to feel things.

What Is Ulnar Nerve Entrapment?

The ulnar nerve runs through the whole arm, and there are areas where the nerve can get compressed or irritated. This irritation or compression is called ulnar nerve entrapment, which takes place most often at the elbow, especially on the inner part. The issue is also called cubital tunnel syndrome. Compression may take place near the wrist or between the elbow and the shoulder.

What Causes Ulnar Nerve Compression?

The ulnar nerve may get compressed for a variety of reasons that apply pressure to the part of the arm containing the ulnar nerve. Some of the factors that cause this condition include:

  • Leaning on your elbow on a desk or hard surface for several hours in a day
  • Medical conditions like rheumatoid arthritis
  • A fracture, displacement or dislocation at the elbow joint

What Are the Signs and Symptoms of Ulnar Nerve Compression?

Some of the common signs of ulnar nerve compression include:

  • Elbow pain: You may feel pain on the inner side of your elbow. Tenderness at the elbow joint is one of the early warning signs of ulnar nerve compression.
  • Numbness or tingling: Numbness may occur in the fourth and fifth fingers, especially when your elbow is bent. This feeling is sometimes called a sensation of falling asleep.
  • Poor finger coordination: You may find it difficult to use your fingers, especially the pinky and ring fingers, for your daily activities. For instance, you may have difficulty using your fingers to type on a computer or grasp things.

If conservative treatment like wearing a splint or taking anti-inflammatory medication isn't effective, we may recommend surgery to reposition your ulnar nerve.

How Is Ulnar Nerve Compression Diagnosed?

To determine if you have ulnar nerve compression, we’ll ask you about your symptoms, identify the type of pain you feel and take your medical history. We’ll also examine your elbow, arm and hand. We may test your arm for sensation, strength and signs of nerve damage or irritation. Then, we’ll use X-ray, MRI scan, ultrasound and electromyogram to check for the actual cause of your symptoms and evaluate the nerve and tissue of the cubital tunnel.

What Happens If the Ulnar Nerve Is Damaged?

If the ulnar damaged, the sheath covering it or a substantial part of the nerve itself may be damaged. When such a problem happens, the nerve won’t be able to transmit signals from the fingers, arm or elbow to the brain. In mild cases, the signals will be slow. In severe cases, they'll be prevented. If your diagnosis shows that you have a severely damaged nerve, you’ll need to have surgery to repair and reposition the nerve.

Is Ulnar Nerve Transportation Surgery Painful?

The surgery for ulnar nerve compression is a procedure performed with regional or general anesthesia. The surgery helps reposition the ulnar nerve and relieve it from further compression or total damage.

To start, an incision will be made at the elbow, which will give your surgeon access to the nerve. The nerve will then be moved to a new position near the front of the elbow. The new location of the nerve will be directly below the skin or within a muscle.

The procedure is generally safe, effective and without any major risk of post-operative infection. While some tenderness may occur in a few patients, it usually goes away after a few months.

Recovery From Ulnar Nerve Transposition

After the procedure, you’ll need to wear a cast or splint around your elbow to keep it in a bent position. If the nerve was placed under the skin, the elbow will be kept at 45 degrees. If the nerve was placed inside a muscle, the elbow will be bent at 90 degrees. This positioning will allow the incision to heal and help the nerve to remain secure in its new position. It will be held up to about one month.

After removing the splint or cast, you’ll start physical therapy. During this exercise, your full range of motion will be restored around the elbow joint. You’ll do some toning and muscle stretching exercises. In many cases, full recovery after surgery may take anywhere from three to six months.

Learn More About Ulnar Nerve Transposition at OrthoBethesda

If you have severe pain in your elbow joint from a sports injury or you’re feeling constant pain in your elbow, please contact OrthoBethesda. Call us now at (301) 530-1010, and we’ll offer you a free appointment to discover the source of your pain and get started fixing it. We offer ulnar nerve transposition surgery at our Bethesda, MD, clinic location only, but we serve residents in surrounding areas with personalized and compassionate orthopedic treatment and care.

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