Ulnar Transposition Surgery

.I am scheduled for Ulnar Transposition Surgery (elbow) in two weeks. I have started doing serious research on recovery times and success rates and I am starting to get cold feet! My main concern is the fact that I have been suffering with this for at least 8-9 years. It has taken me this long to find a Dr.that actually diagnosed the condition and reccomended surgery! I don't have any muscle wasting which is good, my nerve conduction test showed definite problems at my elbow, and my Dr. tells me I am a good candidate for the surgery, but this has been going on for so long how realistic is it that I will recover any sensation and motor function? I am a professional guitarist so this is a major decision for me. I can play now with some slight limitation, but at least I can still play pretty well. My Dr. has told me my recovery time should be around 12 weeks with some P/T and O/T to assist. I am just not sure now though.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

The ulnar nerve may also be referred to as the “funny bone” when tapped or hit. It has several sites of compression along its course – one site being at the elbow. Classically, it may be a truck driver who rests elbow on window/door. It should also be mentioned that with rapid weight gain or weight loss, the ulnar nerve (which causes carpal tunnel syndrome) can be compressed and cause their neuropathies.  

After an ulnar neuropathy is diagnosed, the treatment should be conservative at first in those with mild or intermittent sensory symptoms or in those with symptoms brought about by occupational causes. Modifications should be made to avoid repetitive elbow flexion and extension and direct pressure at the elbow. Elbow protectors have been used.

Overall, it is typically recommended to try conservative measures for at least 3 months before surgery is considered. Have you tried lifestyle modifications? It may be difficult given your occupation. Surgery results can vary from person to person. One prognostic indicator may be the thickness of the nerve at the time of surgery (which is identified on ultrasound).

Recovery can vary as well (which is apparent with poster describing her recovery being 6 weeks). After surgery, physical and occupational therapies are recommended.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[klm3739]

I know everyone heals at different rates and depending on medical status, however, I had ulnar and median nerve transposition of both arms one year apart from each other.  I play piano and at the time was a medical secretary transcribing dictation and lectures so I really needed my hands to work.  My surgery went very well each time.  I actually did no professional PT and used alternating heat and ice, massage and playing the piano (I don't recommend that - just what I was comfortable with)  I was back at work in 6 weeks.  It was a little slow going at first but as the weeks went on of constantly using my hands and arms to do what I usually do (short of lifting anything heavy until cleared by my surgeon), I was fine.  That was in 1988 and 1990.  I still play the piano and I am a paralegal and do a lot of typing and computer work and still have no issues other than a bruising like sensation on the inside of my elbow from time to time.  I was told that I may need to have the surgery redone at some point but right now, it's at a place I can deal with - no real pain or numbness and tingling - just occasional pain (and more if I hit the elbow - like funny bone, b/c of the transposition).  Good luck to you.  I hope this puts you more at ease.

[thelou]

I had a triple bypass on Apr 16th. My right arm must have been in a bad position and the Ular nerve was damaged in my right arm. I have a numb pinky and ring finger. MY cardio doctor says it will heal in time, Well, in the mean time I do not have use of my two mentioned fingers and I am wondering if any one has any ideas, or experience with this type of problem.