Simultaneous Upper Limb Multi-Nerve Decompression: Economic, Reliable & Safe

Purpose Patients presenting with multiple nerve compression syndromes of the upper limb may benefit from a comprehensive surgical approach. Evidence regarding simultaneous decompression of three or more sites, particularly around the elbow, remains limited. This study described a single-stage, symptom-guided technique addressing multiple entrapment sites and reported clinical outcomes. Methods A retrospective consecutive series of 12 patients (13 upper limbs) was analyzed between November 2023 and July 2025. Inclusion criteria required ≥ 3 clinically confirmed nerve compression sites, absence of neurological comorbidities, and simultaneous decompression of all symptomatic sites within one surgical session. Diagnostic evaluation included clinical examination, electrodiagnography for carpal and cubital tunnel syndromes, and Hagert’s triad for lacertus and radial tunnel syndromes. Outcomes included QuickDASH, VAS for pain and numbness, strength, and return-to-work time. Results All procedures were completed successfully under regional anesthesia with no intra- or postoperative complications. Each limb underwent decompression of at least three nerves (median, radial, ulnar, and/or carpal tunnel). QuickDASH and VAS scores improved markedly, and all patients returned to work between postoperative days 15 and 21. No recurrence or residual symptoms were observed at last follow-up. Conclusion Simultaneous multi-site nerve decompression is a safe and effective approach for selected patients with complex upper-limb compression syndromes. This technique provides rapid functional recovery with minimal morbidity and may be a valuable alternative to staged surgery.