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    Carpal tunnel release

    What is a carpal tunnel syndrome?

    Carpal tunnel syndrome  is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. This pressure may cause numbness, tingling, weakness, and other problems in your hand.

    What are the symptoms of carpal tunnel syndrome?

    Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger, including:

    • Tingling or numbness. You may experience tingling and numbness in your fingers or hand, especially your thumb and index, middle or ring fingers, but not your little finger. This sensation often occurs while holding a steering wheel, phone or newspaper or, commonly, waking you from sleeping. The sensation may extend from your wrist up your arm.
    • Many people “shake out” their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.
    • You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are controlled by the median nerve.

    Why is a carpal tunnel surgery needed?

    If symptoms haven’t improved after several weeks to months of nonsurgical treatment, surgery is considered to be the right option. Surgery can help relieve symptoms or make them go away for good. Surgical treatment involves severing the flexor retinaculum to reduce pressure on the median nerve.

    How does the procedure work?

    Carpal tunnel release

    Carpal tunnel surgery can usually be done on a day case basis. The most common surgery for relieving carpal tunnel symptoms involves cutting the transverse carpal ligament to relieve pressure on the median nerve in the wrist. The operation may be done using an endoscope, a thin flexible telescope that is inserted into a small incision. Images are transmitted to a screen, allowing the surgeon to see inside the wrist.

    In a more traditional, open operation, a longer cut is made in the palm of the hand. The endoscopic repair leaves a smaller scar, and usually allows people to get back to their usual activities more quickly. Most people receive regional anesthesia before this surgery.

    What are the benefits and risks of the surgery?

    Benefits

    • Decrease pain
    • Decrease nerve tingling
    • Decrease numbness
    • Restore muscle strength

    Risks

    Risks that can be related to any surgery include allergic reaction to medications, bleeding, and infection. Risks related to carpal tunnel release surgery include:

    • Injury to a blood vessel
    • Return of pain and numbness in the hand
    • Injury to the median nerve or the nerves that branch off it (very rare)

    Am I a good candidate for carpal tunnel surgery?

    If you have persistent signs and symptoms suggestive of carpal tunnel syndrome, especially if they interfere with your normal activities and sleep patterns, it is recommended to consult your doctor who can suggest the most appropriate treatment for you.

    How should I prepare for the carpal tunnel release surgery?

    • Follow the instructions exactly about when to stop eating and drinking. If your surgeon told you to take your medicines on the day of surgery, take them with only a sip of water.
    • Before you come in for your surgery, do not apply lotions, perfumes, deodorants, or nail polish.
    • Do not shave the surgical site yourself.
    • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

    What shall I do after a carpal tunnel surgery?

    Your wrist is wrapped in a bandage after surgery. The stitches are removed about two weeks later. There are differing opinions on how long you need to rest your hand, it largely depends on individual cases and the surgeon’s preference. It is often recommended to immobilize it for a while by wearing a splint. So there is usually nothing wrong with moving your hand the day after surgery and putting a little strain on it. Heavy lifting and major strain should be avoided for several weeks to give the wound a chance to heal properly.

    Why is regular check-up important after the surgery?

    A post-operative follow-up appointment should be made in 10 to 14 days after the surgery when the incision will be inspected and the sutures will be removed. It is always important to follow your surgeon’s instruction during the post-operative care period.

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