Cubital Tunnel Syndrome Surgery

If you’re experiencing tingling, numbness, or weakness in your ring and little fingers that’s affecting your hand use, you may have Cubital Tunnel Syndrome. This condition involves compression of the ulnar nerve at the elbow and, if left untreated, can lead to worsening symptoms and reduced hand function.

Mr Rikki Mistry, a highly regarded Consultant Plastic Surgeon specialising in hand and wrist surgery, offers expert evaluation and surgical options to help you regain comfortable, confident use of your hand.

Understanding Cubital Tunnel Syndrome

The ulnar nerve travels from your neck down your arm, crosses behind the medial elbow (the “funny-bone” region) through the cubital tunnel, then passes into the forearm and hand.

In Cubital Tunnel Syndrome, the nerve is compressed or stretched within this tunnel, often when the elbow is bent or subjected to repeated pressure.

Common symptoms include:

• Numbness or tingling in the little finger and half of the ring finger.

• Clumsiness or loss of grip strength, especially when doing tasks involving the hand.

• Worsening symptoms when your elbow is bent for prolonged periods, or when resting on the elbow.

• Conservative treatments (night-splinting, activity modification, nerve-gliding exercises) may help in early or mild cases.

• Surgery is considered when symptoms persist, worsen, or when there is muscle weakness or hand function loss.

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Tailored Care for Every Patient

At your consultation, Mr Mistry will:

• Review your history of symptoms, hand strength and elbow use

• Perform a detailed physical exam, possibly including nerve conduction or EMG tests if needed to assess the ulnar nerve.

• Discuss whether non-surgical options are still viable or whether surgery is now the best choice

• Explain the different surgical techniques (for example in situ decompression vs nerve transposition) and decide which is suitable for your anatomy and severity.

• Walk through the likely outcomes, risks and recovery plan, ensuring the procedure is aligned with your goals and lifestyle

Because each patient’s elbow anatomy, nerve compression severity, and functional goals differ, the treatment plan is customised to you.

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Cubital Tunnel Surgery Procedure

Here’s how the surgery typically works:

1. Preparation and anaesthesia

The surgery is often done as an outpatient procedure, under either local, regional or general anaesthesia.

2. Surgical approach

   • The simplest form is in situ decompression, where the nerve is freed of constricting tissue while staying in its original location.

   • In some cases, a nerve transposition is performed - the ulnar nerve is relocated to a new position in front of the elbow to relieve tension.

   • Occasionally a medial epicondylectomy (removing part of the bone) may be used.

     
     

3. Procedure details

   • A small incision (typically 3–5 inches) is made on the inside of the elbow to access the tunnel.

   • The ligament/roof of the cubital tunnel is cut or released to release the constricted nerve.

   • The nerve is followed up and down the arm to ensure there are no other points of constriction

   • If transposition is used, the nerve is moved and secured in its new location.

   • The incision is closed using dissolving sutures, a bulky dressing applied, and you’re usually able to go home the same day.

     
     

4. Duration

Most procedures take under an hour, depending on complexity.

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Recovery and Aftercare

Immediate post-op: You may wear a soft bandage or elbow splint for a few days to protect the repair.

• Home care: Elevate the arm, apply ice to reduce swelling, keep the dressing clean and dry.

• Early motion: Finger and wrist movements are usually encouraged almost immediately; gradually you begin elbow motion.

• Hand therapy: A physiotherapist may guide nerve-gliding exercises and hand strengthening as the nerve recovers.

• Timeline:

  • Many patients resume light daily activities within 1–2 weeks

  • Grip strength and full hand function may take 4–8 weeks or longer, depending on how damaged the nerve was.

• Outcome expectations: Most patients (~80–90 %) see improvement in symptoms after surgery when done before permanent nerve damage arises.

• What you should watch for:

  • Signs of infection (increasing redness, warmth, discharge)

  • Persistent or worsened tingling/numbness

  • New or worsening hand weakness If these occur, contact your surgeon promptly.

Long-term care: Avoid resting on your elbows, reduce repetitive bending, and follow your therapist’s recommendations to maintain nerve health.

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Why Choose Rikki Mistry

Specialised experience: Mr Mistry brings deep training in hand and microsurgical nerve procedures and remains current on evidence-based techniques for ulnar nerve compression.

• Tailored surgical approach - Whether you need simple decompression or more advanced nerve transposition, the plan is crafted for your specific anatomy and functional needs.

• Focus on function and aesthetics - Surgery is done not just to relieve symptoms, but to optimise your hand strength, dexterity and comfort - while minimising scarring and downtime.

• Comprehensive care - You’ll get detailed pre-operative discussion, personalised aftercare instructions, therapy coordination and follow-up to ensure the best outcome.

  
  

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