Ulnar nerve transposition post op concerns

[JoseeC]

In the past I have had two ulnar nerve compression surgeries. Both were medial epicondylectomy with decompression. After a long period of time between each surgery my symptoms came back. My second surgery he discovered my ulnar nerve was curling up and crushed under heavy scar tissue near the funny bone.

I recently went through my third surgery which was ulnar transposition surgery along with decompression of  my right elbow almost two weeks ago. Once again my ulnar nerve was curled up and crushed under heavy scar tissue near the funny bone. He decompressed it and moved the nerve underneath fat. I think its called subcutaneous transpostion?

With all my surgeries I experienced post op pain that eventually became better. But this time I'm not sure if what I am experiencing is normal with the transposition surgery.  When I woke up in the recovery room I had intense pins n' needles in my little, ring finger and palm of hand below these two fingers. I figured this was due to the fact I just had surgery and due to the type of surgery I had. Over several days these pins n' needles slowly became more intense. I also had a heavy or dead type feeling on top of my hand near the little and ring finger, worse at night.

I'm also experiencing a crushing type sensation, pain in my elbow. Almost like someone is squeezing the life out of my elbow or a large animal is stepping on it. This sensation comes and goes but three days ago it became so intense that I almost fell over. I have a high pain tolerance but this literally made me cry. It is now almost constant.

I did see the plastic surgeon for a follow up a few days ago and brought up the above symptoms. I was told " This shouldn't be occuring because I moved your nerve out of the problem area. " He plans on sending me to a pain clinic and physical therapy.

Is this crushing sensation normal after this type of surgery? And the pins n' needles? Suggestions? Thanks for your help!

[JoseeC]

Thank you Dr. Gross for your help!

I also have a buzzing sensation in the palm of my hand below the little and ring finger. I had this prior to surgery off and on but now it is more steady. Today I noticed this same type of sensation in my wrist (wrist area that is directly below little and ring finger). This is the first time I have experienced the buzzing in my wrist. It is more steady now and increased if I bend my elbow which I try to avoid doing.

With possible too much tension on the nerve after transposition.. is this something that would need to be fixed through another operation?

At my follow up earlier this week, he prescribed a stronger pain medication and also gabapentin to help with nerve pain. It does help somewhat but I can still feel that crushing sensation.

I see the surgeon in three weeks for a follow up.

[Michael L Gross, MD]

The symptoms you describe sound like they are caused by some sort of pressure on the Ulnar Nerve. This could also be the result of too much tension on the nerve after the transposition.  I'm not sure pain management is the way to go at this point.  Bring it to the attention of your surgeon again.