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Medical Questions: Carpal Tunnel Surgery / Ulnar Surgery

I am a court reporter who had carpal tunnel surgery and anterior submuscular transposition. My carpal tunnel symptoms have resolved but now I have ulnar neuropathy. Should my surgeon have performed the most aggressive ulnar surgery in existence at the same time as my carpal tunnel release or should she have waited to see if my symptoms improved after just the release?

A: Medical experts who have addressed questions like this said that ulnar surgery should not be done simply because the surgeon is already performing a carpal tunnel release and can more easily do a ulnar nerve surgery at that time.

An ulnar transposition should only be done in certain situations: when the patient has a strong Tinel’s sign at the elbow, weakness in the muscles controlled by the ulnar nerve and loss of sensation in the area controlled by the ulnar nerve.

Experts also said that transposition is quite aggressive and should usually only be done if the ulnar nerve seemed to dislocate when the patient bends the elbow. Ulnar nerve surgeries require large incisions and should not be done through a small incision such as is done with endoscopic carpal tunnel releases.


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