Ulnar Nerve Decompression and Transposition
Ulnar nerve decompression is surgical procedure designed to explore the region around the elbow through which the ulnar nerve passes. The ulnar nerve is responsible for the “funny bone” phenomenon when you hit your elbow. Damage to this nerve, usually from some form of trauma or other injury or in rare instances a tumor, can lead to a permanent sensation of numbness or tingling similar to the “funny bone” sensation. Additionally, damage to the nerve can lead to loss of function in the muscles of the hand supplied to the ulnar nerve. Diagnosis of a peripheral nerve injury is usually confirmed by diagnostic tests to evaluate the conduction of electrical impulses through the ulnar nerve and to confirm the neuropathy is isolated to the ulnar nerve.
Usually patients are brought to the operating room for ulnar nerve surgery. Most patients do not require being put fully to sleep with general anesthesia for this procedure. Patients are usually given intravenous sedation medication to keep them resting and comfortable. Local anesthetic in the elbow region is also used to limit pain. Occasionally a nerve block can be applied to the entire arm that will be explored.
A 3-4 inch incision is made along the elbow in between the two bony prominences that are on the same side of the arm as the thumb. The incision is taken deep enough to be able to visualize the ulnar nerve. The nerve is then explored into the upper arm to the point that is passes through the triceps muscle. It is explored in the forearm until it passes through a muscle in the forearm. Once the entire nerve has been explored through this region and is seen to be well decompressed, the overlying connective tissue and skin are closed with stitches.