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Cubital tunnel release (ulna nerve)

This operation releases an entrapped ulna nerve at the elbow.  The operation is performed under general anaesthetic as a day case procedure. An incision is made just behind the inside knuckle (medial epicondyle) of your elbow.  Your ulna nerve is identified and freed throughout its course around the elbow.  Occasionally the nerve is unstable, in that it flips in front of the inner knuckle when the elbow is bent.  If the nerve is unstable it is transposed so that it lies in front of the knuckle the whole time. 

How effective is the surgery?

The operation is effective at resolving the pins and needles you may have been suffering in your little and ring finger. You are also likely to notice slow improvement in fine touch sensation, although your touch sense may never recover fully.

If you already have significant weakness or loss of muscle bulk in your hand, this is unlikely to improve even though the nerve recovers, because the muscles’ nerve endings will have degraded.  The operation should however, stop further progression of weakness and so preserve what power you have.

What is my recovery?

You will go home a few hours after your operation with a sling to rest your arm. Please start taking your painkillers as soon as you get home.   You can take down your bulky bandages after 3 days, but please keep your wound dressed and ry for two weeks. You can begin gentle elbow motion once your bulky bandage is off. You will be seen two weeks after your operation, your wound will be checked and your suture ends will be trimmed.  After your wound has healed you can resume normal activities as long as it's comfortable.  Scar massage can begin after  3 weeks - this helps to desensitise your scar. 

What can go wrong?

This operation is very safe and the vast majority of patients enjoy a successful outcome.  There are however some specific risks of cubital tunnel release:

Nerve injury

- The risk of injury to your ulna nerve is very low (1%)

- There are small sensory nerve branches that cross the medial side of the elbow.  Care is taken to avoid injury to these, but they may get damaged.  Injury to these cutaneous nerves can cause a tender spot as the nerve sprouts new fibres.  This is occasionally painful enough to require further treatment


  • A small percentage of patients develop recurrence of ulna nerve entrapment.  This may require revision surgery and transposition of the ulna nerve