Ulnar Nerve Release

The ulnar nerve release is a surgical procedure designed to relieve compression of the ulnar nerve, which runs from the neck down to the hand, passing through the elbow and into the forearm. This nerve is responsible for controlling movement and sensation in the ring and little fingers.

Why is Ulnar Nerve Release Performed?

The primary reason for performing an ulnar nerve release is to alleviate symptoms associated with ulnar nerve compression or entrapment, commonly known as cubital tunnel syndrome. Symptoms may include:

• Numbness or tingling in the ring and little fingers
• Pain in the forearm or hand
• Weakness in the hand, particularly affecting the ability to grip or hold objects
• Muscle wasting in the hand (in severe cases)

Procedure Overview

The ulnar nerve release procedure can be performed under local, regional, or general anesthesia. The surgery involves making an incision at the elbow to access the ulnar nerve. The goal is to relieve pressure on the nerve by:

• Releasing the ligament that forms the roof of the cubital tunnel (the passage through which the ulnar nerve runs at the elbow)
• Moving the nerve to a new location, if necessary, to prevent further compression
• Removing any bone spurs or other structures that may be compressing the nerve

Surgical Techniques

There are several surgical techniques for ulnar nerve release, including:

• In situ decompression: This involves releasing the pressure on the nerve without moving it from its original position.
• Anterior transposition: The ulnar nerve is moved from its original position behind the medial epicondyle (a bony bump at the elbow) to a new location in front of it, reducing tension and pressure on the nerve.
• Medial epicondylectomy: This involves removing part of the medial epicondyle to relieve pressure on the ulnar nerve.

Postoperative Care and Recovery

After surgery, patients typically experience some pain, swelling, and bruising at the surgical site. The arm may be placed in a splint or dressing to protect it during the initial healing process. Physical therapy is often recommended to regain strength and mobility in the hand and forearm.

Risks and Complications

As with any surgery, there are potential risks and complications associated with ulnar nerve release, including:

• Infection
• Bleeding or hematoma formation
• Nerve damage (temporary or permanent)
• Recurrence of symptoms
• Scarring

Outcomes and Prognosis

The outcome of ulnar nerve release surgery can vary depending on the severity of the compression, the duration of symptoms before surgery, and individual factors such as overall health and adherence to postoperative rehabilitation. Generally, most patients experience significant improvement in their symptoms, with some noticing relief immediately after surgery.