Radial Tunnel Release Info Consent
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Why this operation has been suggested
Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. We usually try non-operative care first and consider surgery when that has not given enough improvement.
The radial nerve travels through a stretch of tissue where several separate structures can compress it. This operation releases those pressure points to relieve pain and restore function. We recommend this when conservative treatment fails to help.
Before the operation
Please do not eat or drink for seven hours before your surgery. This allows us to bring your operation forward if the schedule runs early. Your surgeon will tell you exactly which medicines to stop. Please arrange a lift home and wear comfortable clothing. Bring a list of all your current medications. We use imaging like X-rays, MRI, or ultrasound to plan the procedure. Most patients do not need blood tests or an anaesthetic review. If you have other medical conditions, you may need these checks. Your surgeon will advise you if they are necessary for your specific case.
On the day
You present to the hospital's surgical admissions unit, where you are checked in and prepared for theatre. You meet the anaesthetist to discuss your care plan. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.
You are then taken into the operating theatre, where the operation is performed. You wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery.
What the operation involves
Your surgeon makes a single cut over the front of your forearm, just below the elbow crease. This is an open approach, meaning we look directly at the area rather than using small keyhole cameras. We do not use incisions on the back of the elbow.
The radial nerve runs through a stretch of tissue where several separate structures can press on it. These pressure points include the edge of a muscle, a fibrous band, or a small group of crossing blood vessels. We carefully move these structures aside to free the nerve from all the areas that might be squeezing it. We examine the entire length of this path to ensure no tight spots are missed.
Once the nerve is fully released, we close the skin. We place a fine self-adhesive mesh over the wound first to hold the skin edges together. Then, we paint a liquid skin adhesive over the mesh. This sets to seal the whole thing as one piece. The mesh and adhesive stay in place for roughly one to two weeks. They then lift and peel away by themselves, so there is nothing to be taken out.
After the operation
You will wake up in the recovery ward with a soft dressing on your forearm. We provide pain control to keep you comfortable. This is usually a day case, so you can expect to go home the same day, although occasionally patients stay overnight. Please ensure someone stays with you for the first 24 hours. You do not need a brace or cast for this operation. Your wound is covered by a simple dressing that we will change at your follow-up. You can usually return to driving within two to three weeks, once any post-op splint is off and pain has settled enough to hold the wheel and react quickly. Patients in a splint must NOT drive. See Driving after upper-limb surgery for more details.
Recovery
You will have a soft dressing over your incision. We do not use rigid braces, casts, or hinged supports for this procedure. Your arm may feel sore and swollen in the first few days. This is normal. Keep your hand elevated above your heart when resting to help reduce swelling. Over-the-counter pain relief usually manages the discomfort.
Your rehabilitation is guided by hand therapy, not physiotherapy. We work with Ruby Doolan at Extend Rehabilitation. Ruby is a hand therapist who directs your exercises and makes any splint you might need. You will not see a physiotherapist for your recovery care. Ruby will teach you gentle movements to keep your wrist and fingers mobile. These exercises help prevent stiffness while the nerve heals.
You can return to driving once the splint is off and pain settles enough to hold the wheel and react quickly. This usually happens within two to three weeks, but it depends on your comfort. Patients in a splint must not drive. You can resume light home tasks as movement returns and grip strength improves. Your timeline may differ; your surgeon and hand therapist will guide you based on how you heal.
What can go wrong
Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.
You might notice pain, swelling, or redness around the elbow or forearm. These signs can point to a deep infection. This is a serious problem that needs immediate attention. If you see spreading redness or feel a deep, throbbing pain that simple painkillers do not ease, contact the clinic right away.
Some patients experience changes in sensation or strength in the hand and wrist. You might feel numbness, tingling, or weakness when trying to lift your wrist or fingers. These symptoms suggest irritation or injury to the radial nerve. In many cases, this is temporary and improves on its own. However, if you notice sudden weakness or persistent numbness, bring it up at your next review. Your surgeon will check your nerve function to decide if further treatment is needed.
A rare condition called superficial thrombophlebitis can occur. This involves inflammation of a surface vein in the forearm. You might feel a tender, cord-like lump under the skin near the incision. While uncommon, it can sometimes entrap a small nerve branch. If you feel a new, tender lump or notice increased redness along a vein, let your team know. They can assess whether this is causing any nerve symptoms.
In some cases, the bone may fail to heal properly, known as a nonunion. You might notice persistent pain or instability at the fracture site. Conversely, there is a small risk of deeper infections that require more intensive treatment. If your pain worsens after initially improving, or if you develop a fever, seek medical advice promptly.
Recovery from nerve-related issues varies. For some, symptoms resolve within three months. For others, it may take up to five months. Spontaneous recovery is common for many radial nerve injuries. If your symptoms do not improve as expected, your surgeon may discuss other options like tendon transfers. These procedures can help restore function if the nerve does not heal on its own.
The complications table on this page lists typical rates if you want the specifics.
When to call us
Call us if you have fever, increasing wound redness or discharge, sudden severe pain, calf swelling or shortness of breath. Go to emergency if you lose sensation or cannot move your limb. We need to check these signs quickly. Do not drive if you are in a splint. You can usually drive within two to three weeks once the splint is off and pain settles enough to hold the wheel and react quickly.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Radial Tunnel Syndrome page.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Radial Tunnel Syndrome page.
