Ulnar Nerve Transposition

[firecop25]

I am post Ulnar Nerve Transpo (sub skin) almost 18 mo.  I currently still have extreme pain in my elbow and numbness in my hand.  The numbness is after say 5-10 minutes of use.  The damage done to the nerve was extensive (burnt noodle the size of a pipe cleaner.  My repeat EMG done a month ago shows normal conduction.  I've been told that my only options are live with it or have a second surgery for submuscular.  He also said possibly to have the head of the ulna modified.  I am a 41 y/o firefighter/paramedic.  This injury occurred 4 years ago when a roof fell on top of my crew.  Will I benefit from either of these procedures?

[MinnieM]

The doctor here answering this may have good advice but I am adding my 2 cents worth .  I am not a doctor.  Ulnar nerve surgery is a very painful surgery and usual in the right hands can be very good....I would look for the VERY BEST hand clinics in the US before I would resort to any more surgery for more options/  This is my thinking and I have been there myself. There are some very good places in the US for a consult.  I am not endorsing this hand clinic but there is suppose to be a very good one in Kentucky.  This is called the Christine Kleinert hand and Micro clinic in Lexington.  I am not sure if Dr. Kleinert is still practicing but I have heard that Dr. Atasoy is very good.  If you can e-mail him or call him, I know he returns calls and e-mails and he may be able to guide you.  You may need a neurosurgeon also of which he may be able to help with this also.  Again, I am NOT endorsing this group but I have heard very good things about them.  Good Luck to you.

[firecop25]

Thanks for your help.  If anyone else has input, I'm open to them.  I currently live int he Chicago area.  My ortho is refering me to Northwestern Memorial.  Any help?

[caliatra]

I had surgery 15 months ago. Guess what pain back, andI even had quit lifting with that arm. Worried about going back in and redoing it behind muscle this time. Auto accidents are not fun!

[Macey1]

Hello!  I have had the ulnar nerve release procedure done on both my left and right elbow.  One was done in Nov 2004 and the other in Jan 2005.  I have not had any of the results I thought I would have from this procedure.  At this point handwriting is very difficult (lots on pain in the outside of my wrist), my elbows are still so tender, my fingers (ring & pinky) are still numb on both hands and now I have pain in my arms I didn't use to have.  A neurosurgeon did this procedure for me.  At this point I am meeting with a new neurosurgeon to see what if anything can be done.  Just today I found out that someone I know is looking to have this procedure done.  They mentioned the transposition procedure and not the release like I had done.  Instead of a neurosurgeon she saw an orthopedic doctor.  Does  anyone know what the difference would be in selecting an othopedic surgeon versus a neurosurgeon? What would be the pros and cons of choosing the right type of surgeon?  I am very nervous about any decisions I will have to make and my future abilities with this condition.  I would gladly invite any of your comments.  I just don't want to have another less than successful procedure.

[elgann]

I had ulnar nerve transposition Dec.29, 2006 and I am still having problems.  It was nightmare pain...worse than kidney stones and my hysterectomy.  Nothing touches that kind of pain.  My main purpose everyday for the first 4 months was to get unconcious.  I didn't take medication during the day but when I got home I did!  The diabetic medications for nerve pain made me mentally confused and cymbalta was really awful.  I still feel like the side of my hand is in a pile of fire ants even though the hand feels cold to the touch.  I really don't know what to do.  I was told the second surgery isn't always successful and I don't think I could deal with the pain I had during the first four months.  I am watching the muscles in my hand waste away and I pick bluegrass guitar with my father who is getting old and freaking out about this as much as I am.  It is what we do and can't anymore....

[jd_painwench]

i just had this done this week, consider myself strong for handling pain but this pain i past natural chilbirth and about up therew/ dry socket pain of dental.  this is hell an this half cast is eating a hole in me, causing compression cube syndrome.   i think being paralyzed in arm/hand was a better option than this repair ... thy also removed a 1/2 dollar sized bone chip  .... not enough pain pills to manage this hell.

[jd_painwench]

can 't type but w/ one hand sorry for typos

[jd_painwench]

also  did not mind the nerve conduction study test  but could only stand 4 of the needles for the EMG part of the study, doc kep pulling  them out and restickin me  and he had swabbed w/ alcohol about 10 spots so i knew i had way more to go but made them stop after they got the ulnar spots... the rest i said they would just have to find a diff test to rule out if it was coming from neck.   but  emg torture is nothing compared to t his post op pain... off the scale    15+ pain...    my advice is to stay in hospital 1st night and get shots or iv pain mgt  before going home on pills

[jd_painwench]

or  better dont get the repair

[weezey]

I am considering having the surgery after the results of an ulnar nerve ultrasound are known.  But you guys are scaring the heck out of me!  I had a spinal fusion in my neck and awoke with severe pain in my right hand.  It was imediately diagnosed as CRPS. After 3 years of treatment and 8 doctors later, MAYO clinic ruled out CRPS and attributed it to some sort of injury.  Now an ulnar nerve transposition is being considered.  After almost 4 years of severe pain I wonder if I'm better off the way I am now!

[bsad11]

do not be afraid of this surgery. i had it went i was 14 years old, and pain was minimal. but i should also mention i had the ANTERIOR transposition, not the subcutaneous. the subcutaneous requires a cut of a muscle so the ulnar nerve can be placed underneath it, while in an anterior, the nerve is "grooved" between the for-arm muscles. the recovery time is quicker and allows for a greater range of motion of the nerve. you will find most football athletes or people with high contact and truma to their elbow joint end up having the subcutaneous because it provides more protection, but the recovery time is a little longer.
    since EMG's were brought up, i'll explain what it is for those who don't know or understand. Electromyography, or EMG, involves testing the electrical activity of muscles. this test is often performed with another test, a nerve conduction study. this is a test that measures the conducting function of nerves. EMG requires a very small needle to be inserted into a muscle that the specific nerve controls. you will not feel the needle and it does not give off an electrical current if you were worried about that. you are then asked to move the muscle causing the muscle to contract, thus the electrical activity of the muscle can be measured. in a nerve conduction study, no needles are required. a pad is placed on the muscle and stimulates the muscle. the test records the time it takes for the specific nerve to fire a reaction for the muscle to contract due to the stimulation. both are very unpainful and provide valuable information concerning yor condition.
  my surgery was outpatient and i had barely any pain. i was in a soft cast for 7 days and jumped right into occupational therapy. they did give me pain meds, but they weren't needed. the recovery went extremely well, and i'm happy to say i'm back to where i was before, if not better, before i had the transposition. the feeling in my fingers was not affected, and my motor skills were regained in occupational. before i knew it, i was doing what i love the most, playing baseball again in 9 weeks!! eventhough i was still limited, i could play light catch and swing the bat 100%. actually, i came back stronger than before.
    you may question my knowledge on this subject because of my young age, but i went through the same questions and the process of weighing out the outcomes. i used much of my down time to research these conditions and am confident in my knowledge of them.

i hope this will help you if you are considering this procedure.  if you have any other questions about what i have mentioned, i would be happy to answer them.

[susie11]

I Had the surgery on Friday pain isnt bad but still My 2 fingers feel numb and part of my hand like before the surgery . I was told this surgery would make this better what happened

[bsad11]

did you have a nerve block? i felt the same way for about 2-3 weeks after. my hand was very sensitive and tingling constantly. they should go away after a while.

[mdc1959]

Well I think I have most of you beat, concerning Ulnar Nerve Transposition surgery.  I had both the Ulnar and the Radial nerve done within a span of 6 months.  And these operations were just over 7 years ago, in some well known Boston Hospitals.  From my stand point, I would not have any surgery if at all possible.  While I did experience some benefits short term, the long term is I am in pain every day, my only solice is to not work for a few days which translates to not writing and not typing on a computer keyboard for 2-3 days and I can actually see the swelling go down on my right arm. Pain is coupled with numbness in small finger and ring finger, never mind the general arm pain I have.  I am right handed and I refuse to hold a cup of coffee in my right hand, for fear of dropping it.  When I food shop I use my left had for grocery bags, and never carry anything more than my car keys in my right hand.  I attribute my issues to over working my right "mousing" hand for many years at a non ergonomically designed work station.  I'm 48 years old and I have pain like a 90 year old.  So do streaching, exercises and ice packs and/or find a new job rather than have surgery if it is at all possible.

Good luck to you all !!

[jstrating]

It has been a year since I had ulnar nerve surgery TWICE on my right elbow and I am still in hell. This all came two years after I broke my arm at the elbow, and a nerve conduction test revealed a severely damaged nerve.  The first surgery was a straightforward submuscular transposition, and afterward I was in so much pain that I couldn't function, nor could I get my elbow to bend beyond 90 degrees.  Well, my doctor could not figure out what was wrong, so six weeks later he went back in.  You think it is painful the first time around, imagine getting a second, more invasive surgery on an already irritated nerve!  I managed to get my most of my range back .... slooooowly .... but to this day still have persistent pain, numbness, weakness and limited function in my wrist and elbow.  I am beginning to develop shoulder issues as a result of overprotecting my arm.  Perhaps the worst part about it is that I am a very healthy 24-year old woman and WAS an athlete.  Before the first surgery I naively believed that it would fix all my problems.  I was totally oblivious to all the risks.  So now I am in medical debt up to my eyeballs, with nothing to show for it.  It is so frustrating.  If you are considering having the surgery, I would recommend discussing every conceivable risk with your physician, ie how badly the nerve is damaged, what placement is best, etc.  I just put blind faith in my surgeon and regret it (fyi, not sure if it makes any difference, but he was an orthopedic surgeon with an upper extremity specialty).  Not that I blame him, but he led me to believe I would get better and I definitely have not.

Sorry for the sob story, but it's rare that I can find some people who can understand what it is like to have your arm taken away from you!

[KENYO20]

JUST HAD ULNA NERVE TRANSPOSITION 8 HOURS AGO. YOU GUYS SCARE ME. ALTHOUGH I NEVER HAD ANY PAIN IN MY ELBOW, I DID EXPERIENCE NUMBNESS IN MY LITTLE AND RING FINGERS. IT WASN'T TOO BAD, BUT THE LOSS OF POWER IN MY GRIP WAS VERY FRUSTRATING. SURGERY LASTED ONLY 22 MINUTES. AWOKE AS THEY WERE LIFTING ME OFF SURGERY TABLE ONTO GURNEY. AFTER AN HOUR, I WAS MOVING MY FINGERS AROUND, AND THERE WAS NO MORE NUMBNESS. WELL, LIKE I SAID, 8 HOURS AFTER SURGERY AND I HAVEN'T EVEN TAKEN AN ASPIRIN. MAYBE I'LL WRITE BACK HERE IN A FEW WEEKS. DR SAVATSKY AT HACKENSACK MEDICAL CENTER, NJ DID THE WORK.

[speedo_reido]

Hey, I had my surgury done 11 days ago and my symptoms are much better. I had no feeling in my fingers before the surgury and now they just tingle. It does hurt worse at night and in the morning, but I know this is just temporary. I have positive expectations for my full and 100% recovery and thats what I will have. Think only healing thoughts, vocally tell yourself and the universe you are grateful and thankful for your healing. Talk to your body and your elbow to heal and recover fully. It's the only way. You are a magnet for the thoughts you put out. Think pain and thats what you'll have. Tell yourself you will be 100% healed and strong within the next two months. What do you have to lose? Let's keep in touch. I can be reached at ***@****. I am going to be healthy and back practicing martial arts within months. The universe says: You wish is my command. Command it to go your way. Get the DVD called "The Secret" on Amazon for $10 and don't buy into any negitive thoughts. Focus on what you want to have happen and not where you currently are. Be grateful and thankful you have such wise surgens on you side. Do you see where I coming from? It's called the law of attraction. Attract what you want for your life...

[kevmalone]

On Labor Day Weekend 2007, I was showering in a hotel and hit my elbow on a soap dish that was elevated in the shower.  I remember thinking to myself that it should hurt, but thanked God silently that it didn't.  The next day, I awoke with numb pinky and ring fingers on my left hand.  Relatives (nurses) suggested I wait before seeing a doctor.  I slept with a soft cast for a few nights but noticed no improvement.  I finally saw my physician 60 days later and he suggested 30 days of prescription strength Advil. No impact. I finally saw a surgeon who refered me to another doctor for the EMG and nerve conduction testing.  (about 30-40 minutes....not painful but uncomfortable)  The EMG doctor said my condition wasn't serious....that it might go away on it's own...he said there wasn't any muscle loss and he recommended I do my best to not flex my left arm. He is going to send my EMG results to my surgeon.  I am not in pain.....I am not kept from doing what I normally do. My little finger and that side of my ring finger are numb. I don't like being damaged.    If I knew surgery would help, I would be all over it. But many of these comments have left me uncertain. Can anyone offer guidance?

[maxi75]

i had ulnar nereve surgery july 07 and after 4mths there was no improvement went back to consultant and was told the muscle that the nerve was attached to had slipped down my arm and nerve now detattched! going for more surgery 29th april to have nerve sewn to skin under arm . has anyone else had this happen and what was the outcome?

[dwhoops]

I had an ulnar nerve transposition Dec 29 06 at 16 years old--best thing ever!  I had numb and tingly fingers all the time but after the surgery nothing.  Recover went very quick and I was playing basketball and throwing shotput in a matter of weeks.  Just make sure you trust your doctor before the procedure and it should be great.  Parkview Musculoskeletal Institute for any chicage people.  Dr. Ferrell or Moran--both excellent!

[dwhoops]

Not to mention i am prob going to have one on the other elbow--submuscular or course

[tmartin121391]

I am almost one week into an ulnar nerve transposition, the kind that is put under the muscle. Still in a splint, and I feel some pain, but nothing unbearable. My surgeon did even more then I could have hoped for. If you are in Kansas, consider Dr. Harry Morris at Advanced Orthopedics.
I'll post once again after my stitches are taken out on December 1st.

[tmartin121391]

Alright, now I'm about 4 weeks post op, and I'm feeling great!
I haven't started strength therapy yet, but I have full range of motion, with only a small amount of pain!

[LillyBeads]

I fell at the grocery store in March 2008.  When the non-slip rug flew out from under my foot, I went up then landed on my leg and hip and as I was falling back  I put my left hand down.  I injured both knees, my hips and back  and my hand.  After about 2 days my wrist was bruised and swollen and my ring & little finger and side of hand was numb and tingly.  After seeing Orthopaedic dr. suggested I wait and see.  After 8 1/2 months the numbness was still there.  I had 2 nerver EMG showing compresson at the wrist and elbow.  I had the ulna nerver decompression with nerve transposition at elbow on December 2, 2008.
I can tell you I have never in my life had that much pain.  It has been 5 months now and my fingers and hand are still numb.  Had another nerve test yesterday and the Neurologist says there is some inprovement.  I do not see where the improvement is because my fingers and hand is still numb as before the surgery.  I have a new symtom though   I have grabbed 3 dishes out of my canbinet on 3 different occassions and have not been able to hold on to them and they have dropped and broke.

How long has your doctors said it would take to see improvement?  My doctor says a year  but you would think I would see some improvement in 5 months.

What is your opinions?