I am now one week post-op from my ulnar nerve transposition surgery. I ended up with a lot more surgery than I expected. Although my doctor was honest with me about the fact that he wouldn’t know what type of surgery I would need until he opened my elbow to look, he expected, based on his clinical examination, to be able to do a simple in-situ release procedure. There were no outward signs of nerve subluxation (jumping from one side of the bone to the other), so most likely the nerve just needed a little more space. When I awoke from the anesthesia, however, the first words I heard were, “you had a sub-muscular transposition.”
I had read quite a bit about cubital tunnel syndrome and its treatment options before my surgery, but everything I saw said that if the nerve was subluxing and an in-situ release wasn’t possible, the alternative was a subcutaneous transposition. Basically, they move the nerve to the other side of the arm, but let it ride on top of the muscle. I did see references to the other possibility – cutting the muscle off the bone, sliding the nerve under it, and then sewing the muscle back in place – but it always said something along the lines of, “this is necessary for athletes, such as baseball pitchers, who place extreme demands on their arms.”
I am far from being an athlete. In fact, I am a weakling, and therein lies the problem. Apparently, a subcutaneous transposition doesn’t work when your arms are very thin. So, when the doctor released the nerve and saw it flip-flopping around the epicondyle, he had no choice but to give me the baseball pitcher version of the surgery.
Bottom line, I went in to surgery expecting a week of elbow immobilization and came out facing a month of full arm and wrist immobilization followed by a couple months of physical therapy. I will see the doctor tomorrow to learn more details. In the mean time I am mourning the loss of my summer as I try to learn how to get stuff done in work and life without the use of my dominant hand.