Peripheral Nerve Decompression for Ulnar Nerve Entrapment (Cubital Tunnel Syndrome)
Cubital Tunnel Syndrome represents the second most common compression neuropathy of the upper extremity, occurring where the ulnar nerve traverses the tight retroepicondylar groove and Osborne's ligament at the inner elbow. Repeated elbow flexion stretches and compresses the nerve, causing tingling and numbness in the small and ring fingers, nocturnal waking, dropping of objects, and progressive wasting of the first dorsal interosseous and intrinsic hand muscles (ulnar claw hand).
Surgical Decompression vs. Anterior Transposition
Dr. Vishal Purohit performs thorough nerve releases tailored to individual anatomical pathology:
- In-Situ Decompression: Incising Osborne's ligament and the deep investing flexor carpi ulnaris aponeurosis along an 8–10 cm path, freeing the nerve while preserving its segmental extrinsic blood supply.
- Anterior Transposition (Subcutaneous or Subfascial): Indicated when the ulnar nerve subluxates over the medial epicondyle on elbow flexion or in severe revision cases. The nerve is mobilized and gently relocated anterior to the elbow joint, creating a relaxed, tension-free pathway secured with a fascial sling.
- Internal Neurolysis: Releasing dense fibrotic epineural constrictions under surgical loupe magnification to restore microvascular blood flow to the nerve fascicles.
Arresting Muscle Atrophy and Restoring Grip Function
Decompressing the ulnar nerve halts progressive intrinsic muscle wasting, relieves little-finger paresthesias, and restores pinch strength and fine motor coordination.