FESSH prep Compressive neuropathies Postoperative complications and revision surgery
Complications of ulnar nerve decompression
Regarding complications of surgical decompression of the ulnar nerve at the cubital tunnel, which of the following statements are true?
1.Iatrogenic ulnar nerve subluxation can develop after simple in situ decompression at the cubital tunnel if the nerve is unstable preoperatively or if the medial intermuscular septum and Osborne's ligament are not adequately addressed.
2.Persistent numbness after cubital tunnel decompression suggests incomplete release, a missed second site of compression, or pre-existing axonotmetic injury.
3.Persistent pain at the surgical site is uncommon following cubital tunnel decompression.
4.Perineural scar adhesion can restrict nerve gliding after decompression and produce recurrent symptoms despite anatomically adequate release.
5.Revision surgery — typically involving neurolysis and anterior submuscular transposition — is indicated when initial in situ decompression or subcutaneous transposition fails to relieve symptoms and a remediable structural cause is identified.
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