Post-surgery driving instructions
After Surgery Instructions for Cubital Tunnel Syndrome
Cubital Tunnel Syndrome, or ulnar neuropathy of the elbow, is a common condition causing numbness in the small and ring fingers and weakness in the hand. If this condition does not respond to non-surgical treatment, or is severe enough, surgery may be indicated. The surgery involves a cubital tunnel release. In some instances an additional procedure called a medial epicondylectomy may be added.
- A soft dressing covered by an ace wrap is worn for the first week. This dressing is kept clean and dry. A large plastic bag is worn over the dressing for showers. Dressing gloves used by hunters or vet gloves can work well. Garbage bags can also be used. The bag can be held in place with tape or rubber bands.
- It is important to elevate the extremity as possible for the first 3 to 4 days after surgery. This means trying to keep the elbow between the ceiling and the heart. It is difficult to do this while walking, but the extremity can be placed on pillows while sitting down. For sleeping, the arm can be placed over a pillow on the chest, on pillows out to the side, or on pillows in front of you while sleeping on the opposite side. We do not recommend the use of slings, instead recommending that the shoulder be kept moving.
- In most cases, a local anesthetic will be injected into the operative area at the end of the surgery to provide pain relief for the trip home. This medicine usually lasts 8 hours, but has been known to last as long as several days in a few patients. Pain medicine will be prescribed, and should be used as needed. This is a narcotic medicine, so patients should not drive, operate machinery, or use alcohol while taking this medicine. The pain medicine should only be used as needed, and Tylenol or Advil can be used between doses or instead of the pain medicine as pain resolves.
- Finger motion should be done periodically, trying to stretch the fingers and then bend them as far as the dressing allows. Light activity, such as picking up books or plates, is encouraged this first week. Some elbow motion will be possible in the soft dressing, but should not be forced.
- Ice can be applied over the operative area if needed because of discomfort. The ice should be kept in a plastic bag so that the dressing remains dry, but some of the cold will be able to penetrate the dressing.
- A plastic splint made before surgery is applied immediately after surgery if the medial epicondylectomy is performed in addition to the cubital tunnel release. This splint is worn full-time for the first week.
- At the first post-surgical appointment, the padded dressing will be changed to a smaller dressing. This dressing can be changed as needed at home. The sutures will be left in place this 2nd week, but showering without a cover is permitted. The dressing can be removed before the shower, and the soap and water can run over the surgical site. The sutures should not be held underwater, such as in a bath or hot tub. After the shower, the sutures can be cleaned with peroxide or alcohol if desired, and a new dressing applied.
- Light activity is continued the second week, including light lifting or light typing. Elbow motion is possible, but again should not be forced and should not be done to the point of causing pain.
- If a plastic splint was applied in surgery it is removed for showering the second week, but worn full-time otherwise.
- Sutures are removed at the second office appointment two weeks after surgery. 3 days after the sutures are out, a dressing is no longer needed, and the extremity can be soaked as in a bath or hot tub if desired. Also after 3 days, lotion should be massaged into the operative incision twice daily for 3 to 5 minutes. Any kind of hand lotion can be used, such as Vaseline Intensive Care lotion.
- Range of motion exercises should be done 2 or 3 times a day to regain motion of the elbow. The exercises should be gentle stretching exercises, not done fast or forcefully.
- Strengthening exercises by squeezing a soft ball or grip strengthener can also be done 2 or 3 times a day.
- In cases where the plastic elbow splint was used, the splint is now worn gradually less. It is not necessary to sleep with the splint on, and it can be removed for light activities initially. The splint is usually no longer required for any activity by 6 weeks after surgery.
Work Related Patients:
If the surgery is done under workman’s compensation, work activities are restricted for the first 6 weeks in order to protect the surgical area and avoid potential problems.
- For the 1st 2 weeks, the operated arm is not to be used at work. If the employer has one-handed work, that can be started 2 or 3 days after surgery as long as narcotic pain medicines are not being used. It is usually a good idea to establish before surgery whether your employer has one-handed work or not.
- At the 3rd week, light activity with the operated arm is started and a lifting restriction is also utilized. Impact tools such as screw guns are restricted. The plastic splint is worn for 4 more weeks at work if a medial epicondylectomy was performed.
- Full work without restriction is usually started at the 6th week after surgery.
If you have problems or questions, please call the office for help. Whenever possible, call during normal business hours (8 AM to 5PM, Monday through Thursday and 8 AM to 3 PM Friday).