Good morning,

I suspected you were going to tell me as much on your daughter's story. I was wondering about that ulnar nerve, it is easily compromised due to its position. It is a red flag for me that your daughter's pain is so highly localized. It sure sounds like something is going on in there with the pain and/or popping. I would never advocate for or against surgery. That is a very personal decision. I DO advocate for exhausting the possibilities and getting the absolute best professionals available. I harp quite a bit about nerve injury because of personal experience with one that required a 3.5 hour repair under microsope by a peripheral nerve plastic surgeon. This was after other doctors told me nothing was wrong. That surgery made the difference in my whimpering on the couch all day and now having a life. My CRPS came from another procedure sadly needed later further down on the same foot. I stand firmly, LOL by my ankle nerve repair.

By all means get a consult! But get it with the best person for the job. This may require travel. Most general surgeons are not versed in nerve and may not have the expertise to give a valuable opinion. Nerve injury and or compression is best found by someone trained in peripheral nerve. The scratch collapse test is invaluable and found my injury when it did not show on either MRI or nerve conduction study. The surgeon in the video, Dr, Susan Mackinnon is the chief of plastics reconstruction at Washington University, they have a really incredible program. I think if you called and spoke with her assistant they would be happy to give you names of graduates of their fellowhip program and where those doctors have gone. The two surgeons I consulted with before my procedure trained there.
Nerve conduction study is a good place to start. I did have reduced signal which though still in normal range was an indicator things were not quite right.

Sometimes Physical Medicine and Rehabilitation doctors with extensive training on ultrasound can also find a nerve compression or injury. Even a skilled chiropractor may be of some utility.

Here are some resouces

http://nerve.wustl.edu The program at Washington University in St. Louis. Lots of great info on types of injury and compression. Entrapment does not always mean surgery, sometimes therapy , hydrodissection or injections can address compression, But you have to find it first.

A fascinating article with cute after photo of girl under covers with her cat after surgery to address her CRPS II of many years duration. Kinda throws central sensitization on its head.
http://rsds.org/wp-content/uploads/2015/02/2014-Nerve-resection-Crush-relocation-CRPSII.pdf

https://vimeo.com/78033661 This is of the Scratch Collapse Test. This test is able to locate an injury or compression point with great specificity.

Here is Dr. Chopra, a highly regarded CRPS specialist who is conservative and encouraging. The video is two hours long but gives great info on treatment, specifically addresses kids at one point. He also is very adament about ruling out nerve entrapment and specifically mentions casts as a source of nerve scarring.

http://www.youtube.com/watch?v=s3LKhOZ8mAM

To me running down the surgical consult is about peace of mind. I know as a parent you won't rest until you've moved heaven and earth to help your child. Never rely on doctors saying there is nothing else to be done unless you really feel it in your heart. Everyone else may give up way before you do. Be relentless. You don't want nagging doubts and you don't want to find out down the line that there were possibilities and options. Surgery is never ideal but sometimes it makes the difference in gaining the potential to heal. If it comes to that there are precautions that can be taken. I pray you find whatever it is that will bring restoration to your daughter soon! Please feel free to PM me if you need info or hit a wall on finding resources.

Sending extra Healing Love, Littlepaw