Surgery and HNPP

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As has been stated under treatment, surgery for carpal tunnel syndrome may be tried. Surgery to move the ulnar nerve in the elbow should be avoided.

Unfortunately, having HNPP does not make one immune to other problems and diseases in life. One can still get the flu or have a car accident or develop a hernia in need of repair. If surgery is needed for any reason (gallbladder, appendix, etc.) the entire surgical team needs to be alerted to the HNPP diagnosis. Surgery for anyone increases the risk of nerve damage, from lying still. Individuals with HNPP are at a much greater risk. Knowing about the susceptibility to pressure palsies can help the surgical team avoid causing them by positioning you to avoid pressure palsies.

First, the surgeon needs to know that you have HNPP and will need to have special positioning during surgery. Make absolutely sure that you communicate this to him or her. Next, you need to make sure that everyone you are seeing or talking to about your surgery knows that you need special positioning too. This includes the nurse who takes your history, the preoperative room nurse, the operating room nurse, the nurse anesthetist and most importantly the anesthesiologist (doctor of anesthesia).


A generic letter to the surgical team has been developed and successfully used to tell the surgical team exactly what kind of positioning will help prevent pressure palsies. Feel free to print this letter and take it with you when you have surgery. This puts in writing what you need and can help minimize any mistakes.

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