I am a Consultant Hand and Upper Limb Surgeon and my NHS practice is based at the Brighton and Sussex University Hospital Trust; this includes Haywards Heath Princess Royal Hospital and The Royal Sussex County Hospital.
I specialise in the following areas of Orthopaedics:
Hand, wrist and elbow conditions, injuries (including soft tissue sports injuries) and treatments, including:
Ulnar Nerve Compression / Cubital Tunnel Syndrome
The nerve supplying the little and ring fingers passes behind the funny bone (medial epicondyle) at the elbow. Here it is under a tight roof of tissue, and sometimes muscle, as well as being stretched when the elbow is held in a bent position. If the nerve becomes squashed here it causes pins and needles and even numbness to the ring and little fingers. Sometimes nerve tests may be needed to confirm the diagnosis.
If the symptoms are severe, do not settle during the day or start to cause weakness of the hand, then surgery may be required to release the nerve. If the nerve is not stable in its tunnel after the release, but wants to rise up out over the funny bone when the elbow bends, then it may need to be re-routed to run in front of the bone to take the tension out of it. This would be decided upon at the time of surgery.
The surgery is usually done as a day case operation under a general anaesthetic. A tourniquet is placed on the upper arm and the nerve is released behind the funny bone at the elbow. After the operation a bulky bandage is applied for 10 – 14 days so it slightly restricts elbow movements to allow the wound to heal.
Scar tenderness sometimes occurs and the nerve may take some time to settle. If the nerve has been squashed for a long time it may not recover fully, even after surgery.