Ulnar Nerve Entrapment at the Elbow

Because of the anatomic positioning of the ulnar nerve, it is subject to entrapment and injury by a wide variety of causes. It is the second most common entrapment neuropathy in the upper extremity (the first being the median nerve and its branches). Because of its superficial position at the elbow, it is often injured by excessive pressure in this area (leaning on the elbow during work or while driving a car). This article discusses the most common type of entrapments of the ulnar nerve, which occur most frequently at the elbow and wrist.

An abrupt injury or long term pressure on the any nerve can cause severe injury to a nerve. Since the ulnar nerve is in such a vulnerable location, injury to this nerve is common. You may have hit your "crazy bone" on occasion and experienced numbness and tingling done your arm to the little finger. The "crazy bone" is not a bone at all. It is actually the ulnar nerve. Repeated injury over a long period, or one severe traumatic event can make these symptoms persistent. And if the trauma to the nerve continues, the muscles supplied by this nerve will fail to function and the numbness becomes permanent.

The treatment for ulnar nerve injury at the elbow is to get the nerve out of harm’s way, and relieve any ongoing compression. There are several techniques used, the most common and reliable is to move the nerve from its position behind of the elbow bone to in front of the bone. This is called a "transposition" of the nerve. During the process, any scaring or compression of the nerve is relieved.

Going Home After Ulnar Nerve Surgery

1. The local anesthetic may last 4-8hrs. Therefore, you may feel numbness in your arm and hand for that length of time.
2. As the anesthetic wears off your elbow will become painful
3. Keep your arm elevated on a couple of pillows as often as you can.
4. You will be sent home with some ice on your elbow. Try to ice the area often for the first several days.
5. Wear the sling if it’s comfortable. I prefer that you didn’t wear it all of the time. It’s best if you straighten and bend your elbow often to prevent scaring around the nerve.
6. You can expect some pain, and should use the pain medication prescribed, if you need it.
7. Take the bandage off after 72 hours. You may shower at this point.
8. I’d like to see you in my office about one week after your surgery. Your sutures (clips) will be removed at that time.
9. I will see you again three weeks after that visit.

You can expect the soreness and swelling of the elbow to take a few more weeks to completely resolve.

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