Ulnar nerve release surgery is a procedure for cubital tunnel syndrome – also known as ulnar nerve entrapment. Cubital tunnel syndrome is a condition in which nearby tissue puts pressure on the nerve inside the cubital tunnel, a narrow space through which the ulnar nerve passes around the elbow. One of the main nerves of the arm, the ulnar nerve travels from the neck to the fingers and is responsible for the sensitive area known as the “funny bone.” The cubital tunnel’s narrowness and minimal soft tissue make the ulnar nerve especially vulnerable to irritation.

Cubital tunnel syndrome can be caused by a repetitive stressor, such as frequently bending or leaning on the elbow, or by fluid buildup or trauma to the elbow. Symptoms of cubital tunnel syndrome include pain, numbness and a “pins and needles” tingling in the elbow that can extend to the ring finger and little finger. Other symptoms include muscle weakness and impaired muscle control in the fingers. When these symptoms do not improve with nonsurgical therapies, your physician may recommend a surgical procedure called cubital tunnel release.

Baptist Health is nationally recognized for excellence in treating cubital tunnel syndrome with ulnar release surgery. We offer a full spectrum of neurosurgical care and surgical approaches. Best of all, you’ll appreciate convenient appointment times, locations near you and a personalized focus to meet your needs before, during and after your procedure.

What is Ulnar Nerve Release?

Similar to the surgery performed for carpal tunnel syndrome, the ulnar nerve release operation helps reduce pressure on the ulnar nerve by cutting and separating the overlying ligament. The ligament may gradually grow back together post-surgery, but there will be more space in the ulnar tunnel. Similar to the surgery performed for carpal tunnel syndrome, the ulnar nerve release decompression operation helps reduce pressure on the ulnar nerve by cutting and separating the overlying ligament. The ligament may gradually grow back together post-surgery, but there will be more space in the ulnar tunnel. 

What Can Ulnar Nerve Release Accomplish?

Surgical cubital tunnel release may be recommended if nonsurgical treatment does not help symptoms. The procedure can enhance comfort and mobility, including:

• Relieve pain and numbness
• Prevent permanent nerve damage
• Improve hand function

What Can I Expect During Ulnar Nerve Surgery?

Most cubital tunnel release surgeries are performed on an outpatient basis. You may be under general anesthesia and asleep during surgery. Or, you may be given local anesthesia, which numbs just your arm and hand, plus a light sedative to keep you relaxed during surgery. The surgery will take less than one hour.

There are two surgical techniques your surgeon may use – a traditional open surgery or a minimally invasive endoscopic variation. The goal of both is to increase the size of the cubital tunnel and relieve pressure on the ulnar nerve.

Open Ulnar Nerve Release

During open cubital tunnel release surgery, the surgeon makes a 3- to 4-inch incision on the inside edge of the elbow, allowing the cubital tunnel below to be viewed and accessed. The surgeon then divides the overlying ligament, known as Osborne’s ligament, increasing the size of the tunnel and reducing pressure on the ulnar nerve.

Endoscopic Ulnar Nerve Release

In endoscopic cubital tunnel release surgery, the surgeon makes one or two smaller skin incisions and inserts a thin instrument equipped with a miniature camera – called an endoscope. Viewing the surgery site on the monitor, your surgeon uses a small, specialized knife to divide the ligament covering the cubital tunnel and create more space for the ulnar nerve. This minimally invasive option can reduce the impact of the surgery for faster healing.

Ulnar Nerve Surgery Recovery

Your doctor may recommend that you keep your arm elevated above your heart for 24 to 48 hours after surgery to prevent swelling. It may be necessary to wear a splint on your elbow for a few weeks to help the area heal, and moving your fingers or applying an ice pack can help prevent swelling and stiffness.

Patients can resume most everyday activities soon after surgery. Your physician will tell you which movements or activities to avoid and may recommend physical therapy exercises to build strength and mobility. Depending on the physical demands of your job, you may be able to return to work one or two weeks after surgery, though at first you may need to limit your work to less physical tasks.

Ulnar Nerve Release Estimated Recovery Timeline

Recovery from cubital tunnel release surgery varies from patient to patient, taking anywhere from several weeks to several months. Symptoms such as numbness or tingling may improve quickly or may take up to six months to go away.

Some symptoms may persist after surgery if ulnar nerve compression was severe or went untreated for a long period of time.  If your decompression procedure also involved operation on nearby bone or relocation of the ulnar nerve, this may extend your recovery time.

Ulnar Nerve Release Possible Risks

Any surgery carries risks, but cubital tunnel release surgery is typically a safe and effective procedure. You will be given instructions about how to avoid these specific risks, as well as what to do if you experience these issues after your procedure:

• Pain
• Bleeding
• Infection of the surgical wound
• Continued or returning numbness in your ring and little fingers
• Continued irritation of the ulnar nerve and related symptoms