64719 Neuroplasty and/or transposition; ulnar nerve at wrist

Name of the Procedure:

Neuroplasty and/or Transposition of the Ulnar Nerve at the Wrist
Common name(s): Ulnar Nerve Release Surgery, Ulnar Nerve Transposition, Wrist Neuroplasty

Summary

Ulnar nerve transposition and neuroplasty at the wrist is a surgical procedure aimed at relieving pressure on the ulnar nerve, which can cause pain, numbness, or weakness in the hand and fingers. The surgery involves either relocating the nerve to a less compressed location or releasing it from surrounding tissues.

Purpose

It addresses ulnar nerve entrapment at the wrist or Guyon's canal syndrome. The goal is to reduce pain, improve function, and prevent further nerve damage.

Indications

• Numbness or tingling in the ring and little finger
• Weakness in the hand
• Persistent pain at the wrist or hand
• Diagnostic tests indicating ulnar nerve compression

Preparation

• Fasting usually required 6-8 hours before surgery
• Adjustment of any medication as advised by the doctor
• Pre-operative diagnostic tests such as nerve conduction studies or MRI

Procedure Description

1. The patient is generally given local or general anesthesia.
2. A small incision is made at the wrist.
3. The surgeon identifies the ulnar nerve and releases it from the surrounding tissues or relocates it to a less restrictive place.
4. The incision is then closed with sutures.
5. A sterile bandage is applied.

Tools: Surgical scalpel, retractors, sutures, and sometimes microsurgical instruments.
Anesthesia: Local or general.

Duration

Approximately 1-2 hours.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic or Neurosurgeon
• Surgical Nurse
• Anesthesiologist

Risks and Complications

• Infection
• Bleeding
• Scarring
• Nerve damage
• Persistent symptoms or incomplete relief

Benefits

• Relief from pain and numbness
• Improved hand function
• Prevention of further nerve damage
• Benefits usually noticeable within a few weeks post-surgery

Recovery

• Keep the wrist elevated and immobilized for a few days
• Pain management with prescribed medications
• Avoid heavy lifting or strenuous activities for several weeks
• Follow-up appointments for suture removal and progress evaluation

Alternatives

• Physical therapy
• Anti-inflammatory medications
• Steroid injections
• Bracing or splinting Pros and Cons: Non-surgical options provide relief without surgery but may be less effective for severe compression.

Patient Experience

During: Minimal to no pain due to anesthesia, some pressure or tugging sensations possible. After: Mild to moderate pain managed with medication, temporary swelling, or discomfort. Full recovery with increased function generally occurs within a few months.