Treatment and Prognosis

Conservative treatments are most successful when paraesthesia is transient and caused by malposition of the elbow or blunt trauma.

NSAIDS also are useful adjuncts to relieve nerve irritation.

Conservative treatment should be carried out for 6-12 weeks, depending on patient response.

Indications for surgery

Surgery may be indicated where there is:

• No improvement in presenting symptoms after 6-12 weeks of conservative treatment
• Progressive palsy or paralysis
• Clinical evidence of a long-standing lesion (e.g. muscle wasting, clawing of the fourth and fifth digits)

Surgical therapy

Surgical therapy of ulnar nerve entrapment depends on the site of compression. Surgical therapy at the elbow can be either decompression in situ, or decompression with anterior transposition.

Prognosis

With appropriate decompression performed in a timely manner, the result should be a return to normal function.

If decompression in situ is performed appropriately, return to normal function is almost immediate.

With transposition of the nerve following decompression, postoperative immobilisation and the rehabilitative process, three to six months may pass before normal function is achieved.