Carpal Tunnel Surgery
What is Carpal Tunnel Syndrome?
The carpal tunnel is a passageway through the wrist carrying tendons and one of the hand's major nerves. Pressure may build up within the tunnel because of disease (such as rheumatoid arthritis), injury, fluid retention during pregnancy, overuse, or repetitive motions.
The resulting pressure on the nerve within the tunnel causes a tingling sensation in the hand, often accompanied by numbness, aching, and impaired hand function. This is known as carpal tunnel syndrome.
Carpel tunnel syndrome can cause tingling, numbness, or a dull ache in the shaded area shown in this illustration.
The surgeon makes an incision from the palm to the wrist, providing access to the tissue that's causing pressure on the nerve.
A section of tissue is cut, relieving pressure on the nerve and restoring feeling and function to the hand.
In some cases, splinting of the hand and anti-inflammatory medications will relieve the problem. If this doesn't work, however, surgery may be required.
Carpal Tunnel Release Surgery
Your plastic surgeon makes an incision from the middle of the palm to the wrist. He or she will then cut the tissue that's pressing on the nerve to release the pressure. A large dressing and splint are used after surgery to restrict motion and promote healing. The scar will gradually fade and become barely visible.
Carpal tunnel release can be performed as an endoscopic procedure, with only one or two small incisions on the palm. Using a tiny fiber optic camera attached to a monitor, your surgeon can see the underlying structures and perform the operation. In other cases, the operation is done using an “open technique” with a limited incision in the base of the palm. With this technique, your surgeon can directly see all structures that will be operated on.
During surgery, you may be asleep under a general anesthetic or awake under a sedative and a local anesthetic, which numbs the wrist. You should feel no pain during the procedure and be able to go home within a few hours of surgery.
After Carpal Tunnel Release
Someone will need to drive you home and during the initial recovery period and help you with daily activities, as your wrist movements will be restricted. The results of the surgery will depend in part on how long the condition has existed and how much damage has been done to the nerve. For that reason, it's a good idea to see a doctor early if you think you may have carpal tunnel syndrome.
A splint may be worn for several days after surgery, along with a bandage. Expect some swelling, bruising, and minor pain after the surgery, which can be managed with ice packs, cold compresses, and a pain medication prescription. Avoid lifting anything for at least two weeks after the surgery.
The doctor will remove your stitches within two weeks. This procedure can relieve pain and numbness and improve strength, but it might completely restore your muscle strength. Improvement varies from patient to patient, partly depending on how long they have experienced carpal tunnel syndrome.
In some severe cases, recovery and improvement will take a few weeks or even several months. Your surgeon will instruct you on steps to prevent recurrence of the syndrome.
Complications are unusual with carpal tunnel release surgery, but there is a possibility for nerve injury or failure to eliminate carpal tunnel symptoms.