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Posted: 1/7/2006 5:13:25 PM EDT
I'd like to get your take on surgery to correct Cubital Tunnel Syndrome if you've had it.

did you have medial epicondylectomy or ulnar nerve transposition ?


I think it's time for me to go this route as conservative treatment hasn't helped too much.

Of course I'll be working with my MD, but I'd like to get some input from someone whose BTDT.

thanks
Link Posted: 1/7/2006 5:25:39 PM EDT
[Last Edit: 1/7/2006 5:37:41 PM EDT by USMC88-93]
I had it done, couldnt use my pinky or ring finger and was dropping things alot "clumbsy" would be the word for it. I couldnt feel anything in those two fingers and the back of my band. Also my wrist was week and would roll over limp wristed alot.

The day after the surgery It felt like I had a new hand, of course there was pain from the surgery and thearapy with an occupational thearapist. to regain range of motion and strength.

All in all the surgery is well worth it if necessary.

Discuss with you surgeon the options however

there are multiple levels of the surgery, the first just cuts the tendon holding the nerve in its location on the bone. The second cuts the tendon and moves the nerve also removes any restricting scar tissue. The third I believe goes a step further and cuts a channed in the muscle or under the muscle for the nerve to ride it.

Take the last descriptions with a grain of salt I am not a doctor but I play a patient on the internet.

Are you in denver If so I highly recommend Dr Brian at Panarama Orthopedic in golden. They also have several other offices he works out of.

Link Posted: 1/7/2006 5:32:47 PM EDT
Link Posted: 1/7/2006 5:43:10 PM EDT
I perform this procedure on occasion. It is not a very common condition and can be treated non-operatively. It is imperative that the correct diagnosis be made. An EMG/NCT test is done to make sure the compression of the ulnar nerve is at the elbow, at not at the wrist or neck/brachial plexus. Treatment with anti-inflammatories and steroids can alleviate the nerve compression.

That being said, there are 3 main ways to surgically treat the condition:

1)Decompress the nerve in situ without any transposition
2)decompress the nerve and transpose it sub-muscularly
3)decompress the nerve and transpose it sub-cutaneously

In my experience, it is the 3rd procedure that has the least amount of recurrence
Link Posted: 1/7/2006 5:53:42 PM EDT
Thanks for the input so far guys!

Clay, yep. had the EMG done already.

NSAID route only provided temporary solution. and my MD and I are in agreement that its not a long term solution.
Link Posted: 1/12/2006 3:47:54 AM EDT
anyone else able to give some insight ?
Link Posted: 1/21/2006 11:27:37 AM EDT
getting closer to my md apppointment... still accepting input
Link Posted: 1/21/2006 1:37:49 PM EDT

Originally Posted By tc6969:
Mine didnt take so the doctor went back in and cleared the whole pathway for the nerve and then packed it with fat that he borrowed from another part of my hand.

Its been more than a year now and I'm back to about 80% or so of what I used to have.

Better than nothing.

Doctor says it can take quite a while for things to get back to normal.





Well... I hope you don't loose any more function in your arm. Loost ability is a terrible thing.
Link Posted: 2/1/2006 2:35:08 PM EDT
surgery it is.

The procedure I'm going to get is 'submuscular transposition' ( this will also correct
for tendinitis at the same time)
guess I better get psyched up for not using my arm/hand for a while.
Link Posted: 2/1/2006 2:53:06 PM EDT

Originally Posted By RED_5:
surgery it is.

The procedure I'm going to get is 'submuscular transposition' ( this will also correct
for tendinitis at the same time)
guess I better get psyched up for not using my arm/hand for a while.



I had the same thing and all I got to show for it is this:


My fastball went from 90 to two million mph.

Had the surgery in '98 by a Dr. in Lost Angels. Still feels good with an ocasional twinge. I had it in a cast for 3 weeks, but I PT'd it like a foo and it's back to 99.8% normal.
Link Posted: 2/1/2006 3:45:02 PM EDT
[Last Edit: 2/1/2006 4:28:53 PM EDT by USMC88-93]
do all the occupational therapy they prescribe and when they start to stretch your arm back out straight let them. I kind of thought they started my therapy a little early but the earlier the better to break up the scar tissue.

They also wrapped it post op with some tubes that ran to an ice cooler with a motor to circulate cold h20 and avoid swelling. Try filling an ice cooler periodically with one arm a little messy.


Link Posted: 2/1/2006 3:50:01 PM EDT

Originally Posted By USMC88-93:
do all the occupational therapy they prescribe and when they start to stretch your arm back out straight let them. I kind of thought they started my therapy a little early but the earlier the better to break up the scar tissue.
img.photobucket.com/albums/v651/PhotoTWB/ArmSurgerycopy.jpg




how is it feeling now?
Link Posted: 2/1/2006 3:51:00 PM EDT
hmmmm.... how long were you guys out of action?
Link Posted: 2/1/2006 3:52:56 PM EDT

Originally Posted By RED_5:
hmmmm.... how long were you guys out of action?



I was mowing the lawn the next day in a cast

But, I would say 3-4 months to get to doing most things comfortably.

Link Posted: 2/1/2006 3:54:06 PM EDT
[Last Edit: 2/1/2006 3:56:57 PM EDT by USMC88-93]
Its feels great, but I have a little carple tunnel action going on too that I need to have corrected.

How long you are out of work depends on your job.
Pushing a desk mabye 2 weeks but you will still be imobilized
Heavy lifting 8 or 10 weeks to be safe Im sure

This will of course depend on the details of your surgery

My hand felt brand new the next day.

PS Im not a doctor I play a patient on the internet.


you will notice from the two pictures that the nerve may take a slightly different route in your arm
Link Posted: 2/1/2006 4:22:49 PM EDT
Cubital Tunnel syndrome is the second most common compressive neuropathy. IT is common. I perform every variation of the procedures listed above. I perform this type of procedure once or twice a week. There are multiple operative procedures available, and they all work well on mild to moderate neuropathy. For severe ulnar nerve compression, there is debate as to what the ideal surgical procedure should be performed. Prolly want to stay away from a release or medial epicondyle resection for this, and move to a more agressive procedure.

THE ONLY ERROR YOU CAN MAKE, IS TO WAIT TOO LONG TO DO IT. For many reasons, the ulnar nerve does not recover as well as the median nerve (carpal tunnel syndrome).

I am a fellowship trained hand surgeon, and do revision cubital tunnel, and primary cubital tunnel surgery as a regular part of my surgical practice.

BT.
Link Posted: 2/1/2006 4:36:21 PM EDT
I look forward to being 'normal' again.

I can't do a lot of things at the moment.... right now, my arm feels like any other part of your body thats just 'waking up' after its been 'asleep'
Link Posted: 2/24/2006 7:38:25 PM EDT
Well how did it go?
Link Posted: 2/24/2006 8:08:30 PM EDT
not yet but only days away.....
Link Posted: 2/28/2006 3:12:25 PM EDT
well, thanks (or no thanks at all)- to tri-care and some .mil entities no surgery!


the 'system' has gotten so fucked up, it beyond my comprehension.
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