Treatment - How can I help

Ulnar Nerve Entrapment

Other popular names

None

Who does it affect?

Anyone

Why does it happen?

The ulnar nerve is the "funny bone" nerve which travels between the tip of the elbow and the inner elbow bone.  At this site it can be "pinched" by normal structures or swollen structures after injury.  This pinching is referred to as entrapment.  

Symptoms

When ulnar nerve entrapment occurs, numbness and tingling of the little and ring finger of the hand may be felt.  Pain may occur in the entire forearm, usually the inner side.  Hand dexterity can be affected.  Sometimes, the numbness is reproduced by elevating the hand.

Diagnosis

This is a common condition and can be easily diagnosed through simple visual inspection and flexion movements.
Nerve Conduction Studies are usually carried out to confirm that the nerve is being pinched at the elbow.

Non-surgical treatment

Treatment consists of avoiding repeated trauma or pressure to the elbow area and resting the elbow joint.  Occasionally, ice can help.

Surgical treatment

The nerve can be relieved of the pressure as it goes around the back of the elbow. In severe cases, surgical repositioning of the ulnar nerve can be required.  This relocates the ulnar nerve to a position where it will not be continually compressed by the surrounding structures.  Surgery is carried out as a day case procedure usually under general anaesthetic and takes about 15-20 minutes.

Surgery is performed through a 5-8 cm incision, the skin is incised and then the underlying fat is retracted.  The nerve is decompressed or moved.   The skin is sutured and a bulky dressing is applied.

Post-surgery rehabilitation

You can go home soon after the operation. Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off.  The arm should be elevated as much as possible for the first 5 days to prevent the hand and fingers swelling. Gently bend and straighten the fingers and elbow from day 1. The dressing will be removed soon after your operation.  The wound is cleaned and redressed with a simple dressing. The sutures are removed at about 12 days.  You should notice an improvement in symptoms within a few weeks but the final result may take up to 18 months for the nerve to recover.

Return to normal routine

Keep the wound dry until the stitches are out at 12 days.

Return to driving:

The hand needs to have full control of the steering wheel and left hand the gear stick.  You are advised to avoid driving for at least 7 days or until the sutures (stitches) are removed.

Return to work:

Everyone has different work environments.  You will be given advice on your own particular situation.

Risks

Overall over 95% are happy with the result. However complications can occur.

General risks (less than 1% each):

Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any elbow surgery from a minor procedure to a complex reconstruction).

Specific risks:

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