Ulnar Nerve Transposition

Ulnar nerve transposition is surgery to relieve pressure on one of the three main nerves (ulnar) in the arm by moving it from behind the elbow to the front. This is done to relieve numbness and tingling in the ring and small finger and tenderness near the "funny bone" (inner elbow).

Understanding the procedure

Most often, the surgery is done around the elbow, but it can be done at the wrist, if that is the place of the compression. Sometimes, the nerve is compressed in both places, so surgery is done at both the elbow and the wrist.

When the nerve is compressed at the elbow, the surgeon makes an incision (cut) at the joint and moves the ulnar nerve from behind the elbow to a new place in front of the elbow. The nerve can either be moved to lie under the skin and fat but on top of the muscle, within the muscle, or placed under the muscle. There are many factors that go into deciding where the nerve is moved. The doctor will recommend the best option.

If the nerve is compressed at the wrist, a zigzag incision will be made at the base of the palm on the little finger side of the hand. The surgeon will open the roof of Guyon's canal to take the pressure off the ulnar nerve. If there is a cyst or another reason for the compression, the surgeon will remove that at the same time.

The procedure is usually done on an outpatient basis or may require an overnight stay in the hospital.

Indications for the procedure

Surgery is recommended when more conservative options like splinting and rest fail to provide relief or if symptoms, such as hand weakness, are present throughout the day.