Everything you need to know
Cubital tunnel release surgery often is necessary for those who suffer from persistent and severe symptoms associated with the cubital tunnel syndrome.
Cubital tunnel syndrome is a condition in which the ulnar nerve becomes compressed or irritated at the elbow, leading to a range of symptoms, such as:
- Tingling in the fingers at night
- Tingling in the ring finger and little fingers
- Numbness or weakness when the elbow is bent
- A disturbed sleep from the symptoms suffered
- Muscle weakness in the hand
- Difficulty in grip strength.
Although this may not seem like a serious issue, if cubital tunnel is left untreated then the symptoms can worsen. This can lead to patients struggling with everyday activities, a permanent weakness in their hand, and further complications, such as nerve damage.
Cubital tunnel surgery is usually only considered if conservative treatment methods, such as splinting, physical therapy and activity modification, have failed. The specific approach to surgery might vary depending on the severity of your symptoms and your individual needs.
Before
Before you decide whether cubital tunnel release surgery is right for you, you’ll first need to book an appointment with an orthopaedic consultant.
During your initial consultation, they’ll be able to assess your condition, discuss any of your previous treatments, send you for additional tests, such as an X-ray, ultrasound and nerve conduction studies and, if necessary, explain the surgical procedure to you.
Like any surgical procedure, cubital tunnel release surgery also carries some risks. Patients should discuss the risks and benefits of the procedure with their surgeon before making a decision. However, rest assured that the surgeon will discuss all available treatment options, to make sure that all non-operative methods have been exhausted.
Before your surgery, you will need to come into hospital for a pre-assessment, where we can check your fitness for surgery. This is a standard check and includes a physical exam, blood tests, heart, and lung function tests.
If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. You will also be provided with specific pre-operative instructions to follow in the days leading up to your surgery.
During
Your consultant will discuss your options for anaesthesia, such as general anaesthesia or local anaesthesia, and help you choose the best option for your needs.
The surgical process starts with a small incision on the inside of the elbow joint. The next step is for the team to isolate the trapped nerve, once it is identified then the tissue causing the numbness is released.
Before releasing the nerve, the team will ensure there’s no severe swelling, pressure, injury, tension or wound that may be worsened by releasing it. Providing there isn’t, the tunnel release is then complete.
If the nerve is found to be unstable or if there is a risk of it being compressed again in its original position, the surgeon may perform a transposition. Transposition involves carefully moving the ulnar nerve from its current location to a new position, usually to the front of the elbow, where it is less likely to experience compression or irritation.
After
The procedure takes a few hours and if everything goes to plan, you will be allowed to leave the hospital the same day.
During your recovery, you’ll need to keep your elbow in a splint for security and ensure that you keep an eye on the wound. Some things to look out for include:
- Nerve pain
- Tingling in the little and ring fingers
- Infection
- A worsening of your previous symptoms
Rehabilitation will be overseen by the hand therapy team, with full recovery expected to take 3-6 months until symptoms resolve.
Medically reviewed by Mr Abbas Rashid - BSc(Hons) MBBS FRCS(Tr&Orth) on 02/02/2024
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.