When is surgery indicated for ulnar neuropathy?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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More specifically, indications for surgery for ulnar nerve entrapment include the following:

  • No improvement in presenting symptoms after 6-12 weeks of conservative treatment

  • Progressive palsy or paralysis

  • Clinical evidence of a long-standing lesion (eg, muscle wasting or clawing of the fourth and fifth digits)

If a fracture of the hook of the hamate is noted in the wrist, cast immobilization or splinting is required for 4-6 weeks. Surgery is indicated if symptoms progress during this time. On the other hand, as swelling subsides, pressure on the nerve may abate and symptoms may disappear. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also valuable for reducing swelling in the tunnel.

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