Ulnar Nerve Transposition (Cubital Tunnel Release)

Through an incision at the inner elbow, the ulnar nerve is carefully freed from surrounding tissue and moved, or transposed, to a new position in front of its original bony groove, reducing pressure and irritation on the nerve. The procedure typically takes about an hour and is usually day surgery.

Assessment includes examination of hand strength and sensation, alongside a nerve conduction study to confirm the diagnosis and its severity. Standard preoperative steps apply, including fasting and arranging transport home.

A splint supports the elbow initially, with physiotherapy introduced as healing allows. Tingling and pain typically improve first, with strength recovering more gradually over the following months.

Rehabilitation focuses on regaining elbow movement and hand strength through targeted exercises, with the pace guided by comfort and healing. Regular follow-up helps monitor nerve recovery over time, since this can continue gradually for many months.

Risks include infection, and, uncommonly, ongoing or recurrent symptoms if the nerve remains irritated despite the transposition. There is also a small risk of further nerve irritation from the surgery itself, though this is generally temporary.

The aim is to relieve pressure on the ulnar nerve and improve the numbness, tingling and weakness caused by cubital tunnel syndrome. Many patients experience significant relief, particularly of sensory symptoms, with strength recovering more gradually. Outcomes are generally better when surgery is performed before significant muscle wasting develops.

Ulnar nerve transposition relieves persistent compression of the ulnar nerve at the elbow by moving it to a position with less pressure. Recovery of pain and tingling is generally quicker than recovery of strength, and earlier surgery tends to give the nerve the best chance of good recovery.

For help telling this apart from a similar nerve condition at the wrist, see carpal tunnel vs cubital tunnel syndrome.