Cubital tunnel syndrome (CTS) is caused by the compression of the ulnar nerve as it passes through a narrow passageway on the inside of the elbow. This nerve controls sensation in the little finger and half of the ring finger, as well as most of the small muscles in the hand. When non-surgical treatments like splinting and anti-inflammatory medications fail to relieve symptoms such as numbness, tingling, or pain, ulnar nerve decompression surgery is recommended. This procedure aims to relieve pressure on the nerve, and understanding the time commitments involved helps patients plan for the process.
Duration of the Surgical Procedure Itself
The actual time spent in the operating room, from the initial incision to the final closure, is short for cubital tunnel surgery. For most patients, the procedure is completed in approximately 30 to 60 minutes.
The specific technique chosen by the surgeon is the main factor influencing the operation’s length. The shortest procedure is typically in situ decompression, where the surgeon simply cuts the ligament and other soft tissues pressing on the ulnar nerve at the elbow. This simple release can be finished in under an hour.
A longer procedure is ulnar nerve transposition, generally taking closer to 60 minutes or occasionally longer. This technique is used when the nerve is unstable or if simple decompression is unlikely to fully resolve the compression. Transposition involves physically moving the ulnar nerve from behind the bony prominence of the elbow to a new location in front of it, requiring more complex dissection and fixation. This time window only accounts for the surgeon’s work and does not include pre-operative or recovery time.
Total Time Spent at the Surgical Facility
The total time a patient spends at the surgical facility on the day of the procedure is significantly longer than the surgery itself, as cubital tunnel release is an outpatient procedure. The overall visit typically ranges from four to six hours from arrival to discharge.
Pre-Operative Preparation
Pre-operative preparation commonly takes between one and two hours. During this time, the patient is admitted, changes into a gown, and meets with the nursing staff and the anesthesiologist. An intravenous (IV) line is started, and a regional nerve block may be administered to numb the arm before the patient is moved to the operating suite.
Post-Anesthesia Care and Discharge
Following the procedure, the patient is monitored in the Post-Anesthesia Care Unit (PACU). This observation period typically lasts from one to three hours, ensuring the patient has recovered safely from anesthesia and that pain is well-controlled. Before discharge, the medical staff reviews post-operative instructions and confirms the patient meets all criteria for going home, such as tolerating fluids and having stable vital signs.
Timeline for Full Recovery and Functional Return
The timeline for full recovery and regaining strength is the longest time commitment, extending far beyond the day of surgery.
Initial Healing (1–2 Weeks)
Initial healing focuses on wound care and controlling swelling for the first one to two weeks. During this period, the arm may be immobilized in a splint or bulky dressing, and patients are advised to keep the hand elevated to minimize swelling.
Rehabilitation and Activity Return
The rehabilitation phase begins after initial wound healing, with sutures or dressings typically removed around 10 to 14 days after the operation. Patients can return to light activities of daily living and desk work within a few days to two weeks. Patients must avoid lifting, pushing, or pulling anything heavier than one pound for at least four to six weeks to protect the surgical site.
Physical or occupational therapy starts with gentle range-of-motion exercises, progressing to strengthening activities around six weeks post-surgery. Complete functional return, allowing for strenuous activity, heavy lifting, and sports, is expected between three and six months. The ulnar nerve heals very slowly, and full resolution of symptoms, particularly chronic numbness and tingling, may improve for up to 12 to 18 months following the operation.