Introduction
When symptoms are not improved with non-surgical measures, surgery is recommended.
The aim of surgery is to remove any structures compressing the nerve and to ensure that the nerve is stable throughout elbow movement
Procedure
Surgery is under general anaesthesia. Surgery takes approx. 20-30 minutes and is performed as a day surgery procedure.
An approximately 6-8 cm incision is made on the inner part of the elbow. The nerve is identified and any soft tissue or bone structures causing compression are removed. The nerve is thus ‘freed up’.
The elbow is taken through movement to ensure that the nerve stays stable in its position. If the nerve is noted to slide in/out of its position, then it is moved to a position beneath muscle/skin where it is stable and not compressed. This is known as a transposition.
The skin is closed with dissolvable sutures.
Recovery
- Day surgery procedure.
- Commence elbow movement immediately.
- Hand physiotherapy may be required.
- Drive within 2-3 days.
- Return to office work within 1 week.
- Return to Manual work within 4-6 weeks.
Results
- 80-90% Good results.
- It may take up to 12 months for sensation to return to normal.
- Strength may take 3 months to return to normal.
- Strength and feeling may not recover fully in very severe cases.
Risks and Complications
These include:
- Incomplete relief of symptoms.
- Scar sensitivity.
- Recurrence of symptoms.
- Nerve instability/subluxation.