Cubital Tunnel Syndrome Surgery

Consultation & diagnosis

Getting the right diagnosis is the first step toward effective treatment for cubital tunnel syndrome. At your consultation, your orthopaedic surgeon will talk to you about your symptoms, go over your medical history, and carefully examine your elbow and hand. They’ll be looking for signs of pressure on the ulnar nerve.

To get a clearer picture, you may have nerve conduction studies – these tests measure how well signals travel through your nerves. Sometimes the results can be normal even if you’re having symptoms, so your doctor may also recommend an EMG (electromyography) to get more details. Together, these tests help guide the next steps in your care.

Preparing for surgery

If surgery is recommended, you’ll be advised on how to prepare for it, to ensure everything goes smoothly on the day. You’ll likely be asked to stop smoking, as this can reduce infections. You may also have to fast or stop taking certain medications, depending on your consultant’s advice.

Before your surgery date, you’ll have a pre-admission assessment to make sure everything is in order. This includes reviewing your health and going over what to expect on the day of surgery.

Planning, like stocking your freezer with easy meals and arranging for someone to drive you back home, can also help to make the whole process easier.

During the operation, your surgeon will make a small incision along the inner side of your elbow to access the ulnar nerve. The goal is to relieve the pressure that has been building up inside the cubital tunnel – a narrow passage the nerve travels through. To do this, your surgeon may cut through or remove the tight band of tissue that is compressing the nerve.

In some cases, the surgeon may decide to perform a procedure called anterior transposition, where the ulnar nerve is gently moved from behind the elbow to a new position in front of it. This helps protect the nerve from being stretched or irritated when the elbow bends. If bone is contributing to the compression, a small part may also be shaved down or removed.

The surgery usually takes around 30 to 45 minutes, depending on the complexity and techniques used. It can be performed regional anaesthesia (numbing the whole arm), or general anaesthesia, where you’re fully asleep – the choice depends on your health, preferences, and your surgeon’s recommendation.

It is usually performed as a day case.

Immediate post-surgery care

Once the procedure is done, you’ll be taken to a recovery area. Your arm will be bandaged and may be put in a sling. Some pain, swelling, and numbness are normal and can be managed with prescribed medications. You’ll get instructions on caring for your incision, managing discomfort, and moving your fingers to prevent stiffness.

Managing pain and protecting the arm are key. Pain relief like paracetamol or ibuprofen is usually enough but always reach out to your doctor if you’re struggling with discomfort.

Start doing gentle movements of your wrist, fingers, and elbow several times a day to avoid stiffness and promote healing. Some people feel an improvement in sensation right away, but full recovery can take up to 1 year. In certain cases if the symptoms have been ongoing for too long- the surgery won’t eradicate your symptoms but will stop it deteriorating further.

Long-term recovery process

The long-term recovery process following cubital tunnel release surgery can vary significantly from patient to patient. Some individuals may experience symptom improvement within several weeks, while others may need a couple of months to recover fully. Factors such as the severity of the condition and the specific surgical procedures performed can influence recovery time.

During the recovery period, you should avoid heavy lifting and repetitive work for 4-6 weeks to prevent further strain on the ulnar nerve. Light exercise can typically be resumed within 2-4 weeks, allowing you to gradually regain strength and flexibility. Most people can return to work in 2-4 weeks, depending on the nature of their job, while those with physically demanding roles may need at least 6 weeks off.

By following these guidelines and gradually resuming normal activities, you can achieve a successful long-term recovery.

Risks and complications

As with any surgery, there are some risks. General risks include bleeding, infection, or scarring. Specific to this procedure, there may also be ongoing numbness, pain, or a recurrence of symptoms if scar tissue forms.

There’s also a small chance of nerve injury or an allergic reaction to materials used during the procedure. While most patients see real improvements, it’s important to talk through any concerns with your surgeon, so that you can make an informed decision and feel confident moving forward.