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Carpal tunnel

Carpal tunnel syndrome is a progressive condition caused by compression of a median nerve in the wrist, leading to its severe pain and weakness. Carpal tunnel release is a surgical procedure, performed to treat this condition when everything else fails. Leaving this condition untreated for long can cause permanent damage to the median nerve leading to loss of function of the hand.

Carpal tunnel release surgery is advised in conditions that include

  • Constant pain associated with numbness, muscle weakness, or atrophy
  • Symptoms for more than 6 months and no response to non-surgical methods
  • Progressive deterioration of hand functions

There are two types of surgeries for carpal tunnel syndrome for one or both hands:

1.     Open Carpal Tunnel Release Surgery

2.     Endoscopic or “Keyhole” Surgery

Facts & Figures:

  • Sir James Paget first mentioned the median nerve compression at the wrist following a distal radius fracture in 1854. In 1880, James Putnam presented a series of patients suffering from pain and paresthesia in the median nerve distribution. Being the most common surgery of the hand and wrist, approximately 260,000 carpal tunnel release operations are performed each year.

    As per the National Center for Health Statistics,47% of these cases considered to be work-related. This condition is responsible for the highest number of days lost among all work-related injuries. Also, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel.

Advantages

  • High success rate with a good prognosis of the surgery. Almost 80-90% of patients resume daily activities post-surgery with restored normal function and increased strength of the hand.
  • It is a quick outpatient procedure, safe, and uncomplicated, with the patient returning home immediately.

Disadvantages

  • Patients may lose the full range of motion of the hand and wrist after surgery.
  • Chances of recurrence of symptoms following open release are up to 20%

Preoperative Preparation

  • Undergo all physical diagnostic tests, blood, and urinalysis
  • Seek medical consultation regarding medicine doses and how to take them.
  • Any smoking or drinking habit must be informed about immediately.
  • Plan for absence from the office. Get help for mundane tasks at home until complete recovery.
  • Avoid eating or drinking anything after midnight before surgery.

Post operative care

  • The wrist needs to be kept wrapped in a bandage and a splint for about 1-2 weeks post operatively. Follow the gradual rehabilitation program of physical therapy to regain strength and flexibility of the hand, wrist, and forearm.
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