Cubital tunnel surgery involves decompression of the ulnar nerve as it passes around the elbow joint. The nerve travels through a tight tunnel and can become compressed in this area.
If a patient has compression of the ulnar nerve at the elbow level, a decompression is recommended to prevent further deterioration of the nerve function and to allow some improvement in sensation and muscle function.
The surgery is performed under a general anaesthetic and tourniquet control. An incision is made along the inside of the elbow just behind the epicondyle (the bony prominence that can be felt on the inside of the elbow). The ulnar nerve travels just behind the bony prominence.
The nerve is identified and the overlying tissues are released to make sure that the nerve is completely free of any compression along its course.
In some cases where the nerve is very unstable, it can flick over the bony prominence of the medial epicondyle when the patient flexes and extends their elbow. In these situations, the nerve may be stabilised by transferring it to the front of the elbow.
This involves a longer incision and a more significant dissection. Once the nerve is secured on the front of the elbow, symptoms of irritability should improve.
The ulnar nerve can be slow to recover following decompression and it is recommended that patients seek treatment early, before they lose muscle function in the hand.