Elbow & Hand Surgery

Carpal tunnel syndrome occurs when one of the main nerves supplying the hand, the median nerve, is excessively compressed by the transverse carpal ligament, which makes up the roof of the “carpal tunnel”. Carpal tunnel syndrome may result in numbness in the first three fingers as well as pain and clumsiness in the hand. In mild to moderate cases, carpal tunnel syndrome may effectively be managed with bracing and/or injections. In refractory or severe cases, a carpal tunnel release is performed, which has a very high success rate of alleviating patients’ symptoms, a fast recovery and a highly cosmetic scar that typically can be barely seen after it has fully matured.

Similarly, cubital tunnel syndrome is an entrapment of the ulnar nerve that occurs at the inside of the elbow. This typically presents with pain and numbness that primarily affects the 4th and 5th finger of the hand. If non-operative of cubital tunnel syndrome fails, operative management, which involves a release of the ulnar nerve at the inside of the elbow, has a high success rate.

Pain at the outside or inside of the elbow is frequently caused by lateral or medial epicondylitis, respectively. These conditions are also known as tennis or golfer’s elbow. The sssmajority of patients will experience resolution of their symptoms with non-operative management consisting of medications, physical therapy, injections and/or bracing. In cases where the pain persists despite extensive non-operative a surgical release and debridement of the affected area may be necessary.

Please see below a list of some common elbow and hand surgeries Dr. Horner performs.

Elbow

• Distal biceps repair
• Ulnar nerve decompression
• UCL reconstruction
• Lateral epicondylitis (tennis elbow) release/debridement
• Medial epicondylitis (golfer’s elbow) release/debridement

Hand

• Carpal tunnel release
• Trigger finger release
• Ganglion cyst excision

Dr. Horner has also published extensive research on elbow and hand surgery. Below is a list of peer reviewed journal articles and book chapters by Dr. Horner on this topic.

1. Ann W, Akhter S, Horner NS, Aljedani A, Khan M, Alolabi B. Outcomes and Complications of Distal Humeral Hemiarthroplasty for Distal Humeral Fractures. Shoulder & Elbow. In press.
2. Hildebrand A, Zhang B, Horner NS, Alolabi B, Khan M. Indications and Outcomes of Radial Head Excision: A Systematic Review. Shoulder & Elbow. 2019. In press.
3. Liu EY, Hildebrand A, Horner NS, Athwal GS, Khan M, Alolabi B. Heterotopic ossification after total elbow arthroplasty: a systematic review. J Shoulder Elbow Surg. 2019;28(3):587-595.
4. Coughlin RP, Gohal C, Horner NS, Shanmugaraj A, Simunovic N, Cadet ER, Bedi A, Ayeni OR. Return to Play and In-Game Performance Statistics Among Pitchers After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review. AJSM. 2019;47(8):2003-2010.
5. Coughlin RP, Lee Y, Horner NS, Simunovic N, Cadet ER, Ayeni OR. Increased pitch velocity and workload are common risk factors for ulnar collateral ligament injury in baseball players: a systematic review. JISAKOS. 2018;4(1):41-47.