Carpal tunnel decompression

Carpal Tunnel Decompression is a surgical procedure aimed at relieving symptoms of carpal tunnel syndrome, a condition characterized by numbness, tingling, and weakness in the hand and arm. The surgery involves cutting the transverse carpal ligament to reduce pressure on the median nerve, which runs through the carpal tunnel in the wrist. This article provides an overview of the procedure, including indications, techniques, recovery, and potential complications.

Indications

Carpal tunnel decompression is typically recommended for patients who have not responded to conservative treatments such as wrist splinting, nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroid injections. It is also indicated for patients experiencing severe symptoms that interfere with daily activities or for those with evidence of nerve damage.

Techniques

There are two main techniques for performing carpal tunnel decompression: open carpal tunnel release and endoscopic carpal tunnel release.

Open Carpal Tunnel Release

In the open technique, a surgeon makes an incision in the palm of the hand over the carpal tunnel and cuts through the transverse carpal ligament to relieve pressure on the median nerve. This method allows direct visualization of the treatment area but may result in a longer recovery period and more postoperative pain compared to the endoscopic technique.

Endoscopic Carpal Tunnel Release

The endoscopic technique involves making one or two small incisions in the wrist or hand and using a camera-equipped device (endoscope) to see inside the carpal tunnel. The surgeon then cuts the transverse carpal ligament with special instruments passed through the endoscope. This minimally invasive approach typically results in less pain and a quicker recovery time.

Recovery

Recovery from carpal tunnel decompression varies depending on the surgical technique used and the individual patient. Most patients experience a significant reduction in symptoms following surgery, although complete recovery can take several months. Physical therapy may be recommended to restore wrist strength and flexibility.

Complications

As with any surgical procedure, carpal tunnel decompression carries risks. Potential complications include infection, nerve damage, and incomplete relief of symptoms. Scar tissue formation can also lead to recurrent symptoms in some cases.

Conclusion

Carpal tunnel decompression is a highly effective treatment for carpal tunnel syndrome, especially in patients who have not benefited from conservative measures. Both open and endoscopic techniques have their advantages and potential drawbacks, and the choice of procedure depends on various factors, including the surgeon's experience and the patient's specific condition.