- Type
- Open nerve decompression
- Anaesthesia
- General + regional block
- Day surgery
- Yes
- Sling
- Comfort sling, 3–5 days
- Return to desk job
- 1 week
- Return to manual work
- 4–6 weeks
What it is.
Cubital tunnel release is the surgical decompression of the ulnar nerve at the elbow. The operation removes the points of compression that produce the numbness, tingling and weakness of cubital tunnel syndrome. Despite its relatively modest scale, it is one of the most reliably satisfying operations in upper-limb surgery — particularly when performed before significant motor weakness has developed.
How it is performed.
Under general anaesthesia with a regional block, a 5–6 cm incision is made on the inside of the elbow, behind the medial epicondyle. The ulnar nerve is carefully identified and traced from above the elbow into the forearm. Every point of compression is released:
- Proximally — the arcade of Struthers and the medial intermuscular septum.
- At the elbow — the cubital tunnel retinaculum.
- Distally — the fascia of flexor carpi ulnaris (the FCU arcade).
The nerve is left in its native bed (simple in-situ decompression). Anterior transposition — moving the nerve in front of the elbow — is reserved for the minority of patients in whom the nerve is unstable, deformed by previous trauma, or compressed by bony anatomy that cannot be addressed by simple release.
Recovery.
Week 1
- Comfort sling for 3–5 days.
- Active range of motion of the elbow from day 1.
- Return to a desk job within the week.
Week 2–6
- Wound check at 10–14 days; sutures removed if not absorbable.
- Heavier activity introduced.
- Return to manual work at 4–6 weeks.
Months 1–6
- Numbness and tingling improve gradually as the nerve recovers.
- Established weakness recovers incompletely; this is why earlier surgery is preferred.
Rehab protocol
A written, procedure-specific rehabilitation protocol is provided to your physiotherapist on the day of surgery. View the recovery roadmap for the full five-phase journey, or visit For Physiotherapists to request protocols directly.
Frequently asked questions.
Will my numbness fully go away?
Mild to moderate cubital tunnel — particularly without established weakness — has the best chance of full recovery. Severe long-standing cases with muscle wasting often have residual numbness even after a successful release.
Why isn't the nerve always moved in front of the elbow?
Most patients are well treated by simple in-situ decompression — a smaller operation with fewer complications and equivalent results in straightforward cubital tunnel. Anterior transposition is reserved for selected anatomies.
How long off work?
Desk job within a week. Manual work at 4–6 weeks.
Will I have a scar on my elbow?
Yes — a 5–6 cm scar on the inside of the elbow, behind the medial epicondyle. It fades over 6–12 months.
References.
- Bartels RHMA, et al. Surgical management of ulnar nerve compression at the elbow. J Neurosurg. 1998;89(5):722–727.
- Macadam SA, et al. Simple decompression versus anterior subcutaneous transposition for the treatment of cubital tunnel syndrome. J Hand Surg Am. 2008;33(8):1314–1324.