Carpal tunnel surgery

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Carpal Tunnel Surgery is a medical procedure aimed at treating Carpal Tunnel Syndrome, a condition characterized by numbness, tingling, and weakness in the hand and arm. The surgery is designed to relieve pressure on the median nerve in the wrist, which is responsible for the symptoms of this condition. This article provides an overview of the types of carpal tunnel surgery, the preparation, the procedure itself, recovery, and potential risks.

Types of Carpal Tunnel Surgery[edit | edit source]

There are two main types of carpal tunnel surgery: Open Carpal Tunnel Release Surgery and Endoscopic Carpal Tunnel Release Surgery.

Open Carpal Tunnel Release Surgery[edit | edit source]

In open surgery, a surgeon makes a single large incision in the palm of the hand over the carpal tunnel and cuts through the ligament to free the nerve. This traditional method allows the surgeon a direct view of the treated area but may result in a longer recovery period.

Endoscopic Carpal Tunnel Release Surgery[edit | edit source]

Endoscopic surgery involves making one or two smaller incisions in the wrist or palm, through which a tiny camera (endoscope) is inserted. The camera guides the surgeon in cutting the ligament. This method typically results in less pain post-surgery and a quicker recovery.

Preparation for Surgery[edit | edit source]

Patients may undergo several diagnostic tests, including Electromyography (EMG) and Nerve Conduction Studies, to confirm the diagnosis of carpal tunnel syndrome and determine the severity. Preoperative preparation also involves discussing any medications the patient is taking and potentially stopping certain medications that could increase the risk of bleeding.

The Procedure[edit | edit source]

Both types of carpal tunnel surgery are usually performed on an outpatient basis under local anesthesia, meaning the patient is awake but the area being operated on is numbed.

During Open Surgery[edit | edit source]

The surgeon makes an incision in the palm, exposes the transverse carpal ligament, and then cuts it to relieve pressure on the median nerve. The skin is then stitched back together.

During Endoscopic Surgery[edit | edit source]

The surgeon makes one or two small incisions and inserts an endoscope to visualize the transverse carpal ligament. Special instruments are used to cut the ligament, after which the incisions are closed with stitches or tape.

Recovery[edit | edit source]

Recovery varies depending on the type of surgery and the individual. Generally, patients may experience pain and discomfort in the wrist and hand, which can be managed with medication. Physical therapy may be recommended to restore wrist strength and flexibility. Most patients can return to normal activities within a few weeks, although full recovery may take several months.

Risks and Complications[edit | edit source]

As with any surgery, there are potential risks and complications, including infection, nerve damage, stiffness, and pain at the scar site. There is also a small risk that the symptoms of carpal tunnel syndrome may not be relieved or could return after surgery.

Conclusion[edit | edit source]

Carpal tunnel surgery is a common and generally effective treatment for carpal tunnel syndrome, especially in cases where nonsurgical treatments have failed to provide relief. Patients considering surgery should discuss the potential benefits and risks with their healthcare provider to make an informed decision.

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Contributors: Prab R. Tumpati, MD