Cubital Tunnel Release
Why is this surgery done?
Cubital tunnel release surgery is performed when a patient with cubital tunnel syndrome is not getting better with nonsurgical treatments such as medication, therapy or bracing. Patients with cubital tunnel syndrome will typically have numbness or pins/needle sensations in the ring and small fingers of the affected hand. With time, it can lead to weakness and muscle damage in the hand, which can result in a weakened or reduced grip, difficulty using the hand and pain which may wake a patient at night. Symptoms are commonly made worse when the elbow is bent for a long time. The symptoms are caused by pressure on the ulnar nerve as it travels down the back of the arm and into the hand through the cubital tunnel, a canal behind the bony bump on the inside of the elbow (the “funny bone”). The nerve can become pinched and damaged. The goal of surgery is to decompress the nerve.
How is cubital tunnel release done?
Cubital tunnel release surgery is performed through a small (about three-inch) incision on the elbow. The nerve is released, moved or partially removed, depending on your situation. This does not cause any instability in the elbow. The skin is then closed with stitches that will need to be removed in about two weeks. The surgery often takes less than an hour. It can be done with mild sedation and numbing medicine or under general anesthesia.
What are my risks? What are common complications?
Cubital tunnel release surgery is very safe. Complications are uncommon, but may include infection, incision pain, nerve injury and failure to improve symptoms. Patients with diabetes are more likely to have problems with the incision. They are less likely to get significant improvement with surgery, but the surgery typically prevents the symptoms from getting worse.
What do I need to know before surgery?
You may be asked to stop taking some of your medications (aspirin, ibuprofen and blood thinners) one week before your scheduled surgery. Tell your doctor if you’re experiencing any illnesses, such as cold, fever or virus before surgery. You will need someone to drive you home. Do not eat for eight hours prior to surgery.
General discharge instructions
- Keep pressure off your elbow by using the splint or brace as directed.
- Keep your splint/brace clean and dry.
- When showering, use plastic to cover your arm. (Tape can secure the plastic.) Shower as needed.
- Use an ice pack, bag of frozen peas or something similar wrapped in a thin towel on your elbow. Leave the ice pack on for 20 minutes, then take it off for 20 minutes. Repeat as needed during the first few days at home.
- Keep your arm elevated above your heart for 24 to 48 hours after surgery.
- Take pain medicine as directed.
- Don’t drive until your doctor approves it. Never drive while you are taking opioid pain medicine.
What should I expect while recovering?
Early motion is allowed, but you should not lift, push or pull anything greater than a pencil for six weeks after surgery. Overall recovery time varies by individual, lasting from 2 – 3 months before you start to feel normal in your arm and hand. Improvement in the numbness can be immediate, but in some patients can take months to get better.
Possible physical therapy exercises
Physical therapy may be needed and generally starts six weeks after surgery.