This elbow surgery case involves a sixty-six-year-old patient who underwent a right total elbow arthroplasty. During the procedure, the ulnar nerve was severely damaged. The surgical note reports that the ulnar nerve was transposed to the anterior side of the medial epicondyle. This signifies there was some direct manipulation to the nerve site. The patient underwent a second surgery to attempt to relieve inflammation, numbness, and pain. During this procedure, the subsequent treating surgeon found that the ulnar nerve to be displaced to the posterior side of the epicondyle. There was also significant scar tissue formation with severe ulnar neuropathy from compression of the nerve at the elbow. The surgeon claims to have constructed a tunnel and secured the nerve in place to prevent migration. However, there was no reference of this in the operative report.