Cubital tunnel syndrome occurs as a result of entrapment of the ulnar nerve in the cubital tunnel in the elbow. This means that the nerve is compressed, causing hand and arm pain that can be debilitating. The precise cause of the entrapment is unknown. Surgery can relieve compression of the entrapped nerve, but cubital tunnel surgery is not without complications.
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According to the Journal of Hand Surgery, 2009, surgical failure is the most common complication of cubital tunnel surgery. Surgical failure is defined as the inability of the surgery to relieve the patient’s symptoms. In most instances, no apparent reason exists for the failure. The symptoms may reoccur immediately after surgery, or a brief period of symptomatic relief may exist before symptoms return either with the same or increased intensity.
Anterior subluxation can occur as a result of cubital tunnel surgery. This means that the ulnar nerve moves away from its normal, resting position when the elbow is bent. However, this can be avoided by not operating too extensively past the point of entrapment, as well as detecting movement of the ulnar nerve during surgery by bending and moving the elbow and observing the nerve’s position.
General Surgical Complications
General complications of surgery can depend on various factors. The most important factor is associated with the patient’s health before the operation. Those patients with a chronic illness such as diabetes, chronic obstructive pulmonary disease and arthritis will have a higher risk of developing complications. Another factor is the surgical skill of the doctor. A doctor less skilled will have a higher chance of evoking complications. While rare, such complications are varied and include accidental ulnar nerve injury, accidental injury to blood vessels, partial or complete numbness in the hand or fingers and prolonged elbow stiffness.
Minor complications of surgery are more common, yet these can be alleviated easily. Patients feel a temporary stiffness in the elbow after surgery, but this resolves with time and therapy. Temporary tenderness and pain also may occur in the elbow, particularly at the site of surgery. Swelling, minor bleeding, minor infection and scar pain also may occur; however, these are temporary. The surgical scar on the skin may also appear abnormal, yet this is not serious or harmful in most cases.
Other complications that are rare and associated with surgery in general include systemic infection or severe infection at the surgical site. An allergic reaction to the anesthesia or medicines, ointments and bandages (such as a latex allergy) may occur. Nausea and vomiting after surgery are not uncommon but are easily treated and temporary. Death is a possibility with any surgery, but this is an extremely low-risk complication.
REFERENCES & RESOURCES
- Journal of Hand Surgery (American): "Review of treatment results for ulnar nerve entrapment at the elbow;" A. Dellon; May 2009
- Hand Surgery: "Cubital Tunnel Syndrome;" Christopher Bainbridge; 2004
- Encyclopedia of Surgery: General Surgery
- Postgraduate Medical Journal: Cubital tunnel syndrome