After Cubital Tunnel Release

What was done

The ulnar nerve was released from a tight tunnel at the inner side of the elbow (the cubital tunnel) to take pressure off the nerve. In most patients the nerve is left in place (an in-situ decompression). In selected cases, the nerve is moved forward into a new position in front of the elbow (anterior transposition) if it is unstable or specifically compressed in flexion. Your operative report has the exact details; this page covers the typical in-situ decompression.

You have an incision on the inner side of the elbow covered with a soft dressing, and the arm may be in a soft bulky dressing or a sling.

The first 5 days

• Keep the dressing on, clean, and dry.
• Keep the elbow elevated above the level of your heart as much as possible. Propping the arm on pillows while sitting or sleeping is the single most useful thing you can do for swelling and pain.
• Move the fingers, wrist, and shoulder often. Full finger and shoulder motion from day one prevents stiffness.
• Gentle elbow motion is encouraged after in-situ decompression. Do not force the elbow into full extension or full flexion in the first few days, but slow, comfortable motion is fine.
• No lifting more than 5 pounds (about a gallon of milk) with the operated arm.
• If a sling was given, use it for comfort only. It is not meant to keep the elbow bent all day — the elbow should be straightened several times an hour to prevent stiffness.

Day 5–7: dressing comes off

• Remove the dressing about 5 to 7 days after surgery. You can shower and wash over the incision with soap and water; pat it dry.
• Cover the incision with a simple adhesive bandage for a few more days, or leave it open once it is dry and closed.
• No soaking (baths, pools, hot tubs) for 2 weeks after surgery.

Pain and nerve symptoms

• Most patients take over-the-counter pain medicine (acetaminophen/Tylenol and ibuprofen/Advil) for the first several days. Many do not need the prescription pain medicine at all.
• Ice over the dressing for 20 minutes at a time helps with swelling during the first 2 to 3 days.
• Numbness and tingling in the small and ring fingers may improve quickly or slowly, depending on how long and how severe the compression was before surgery. Milder cases often recover within weeks; severe, long-standing cases can take 6 to 12 months or more, and full recovery is not always possible if the nerve was compressed for a very long time.
• A sore or "zinging" feeling along the incision and down the forearm is common for a few weeks as the nerve settles.
• Weakness in pinch and grip is common early on; this is partly from surgery and partly pre-existing. Strength typically improves over 3 to 6 months.

Activity

• Driving: when you have comfortable elbow motion, are not taking prescription pain medication, and feel safe turning the wheel with the arm (usually 5 to 10 days).
• Typing / desk work: right away, in moderation, with breaks.
• Return to light work: most office workers return within 1 to 2 weeks.
• Return to heavy manual work: 6 weeks, after strength has returned.
• Therapy: a few hand therapy sessions are arranged for most patients, focusing on elbow range of motion, nerve gliding exercises, and gradual strengthening.
• Sleeping position: avoid sleeping with the elbow fully bent for the first several weeks. A soft towel rolled into the front of the elbow and wrapped with tape for sleep helps keep the elbow closer to straight.

Follow-up

Come to the office 10 to 14 days after surgery for a wound check and suture removal. We will see you again at 6 weeks to check on nerve recovery and strength.

Related

About cubital tunnel syndrome · Home hand therapy

Questions?

Call your office location for non-urgent questions:

• NYU Langone Laurelton · 646-501-4950
• NYU Orthopedic, Woodside · 929-429-3222
• NYU Orthopedic, Richmond Hill · 718-206-6923
• Jamaica Hospital Ambulatory Care Center (ACC) · 718-301-0720

See our office contact information for addresses and fax numbers.