Endoscopic Carpal Tunnel Release

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition often experienced by people who use their hands repetitively in day-to-day activities, such as desk workers, musicians or assembly line workers. Other people at higher risk of developing carpal tunnel syndrome include:


• Women between 40 and 60 years of age
• Pregnant women
• Anyone who experiences rapid weight gain
• People with certain types of arthritis

Carpal tunnel syndrome is caused by compression of the median nerve at the wrist, which results in hand numbness, loss of dexterity, muscle wasting and decreased functional ability in the hand.

Some people naturally have a smaller carpal tunnel than others, which can eventually lead to problems. In many cases the underlying cause cannot be found and in other cases there is a combination of factors. Other causes include:

• Arthritis – arthritis, especially rheumatoid arthritis, can cause inflammation and swelling.
• Pregnancy – hormones associated with pregnancy cause general fluid retention, which can compress the nerve. Carpal tunnel syndrome triggered by pregnancy usually goes away soon after birth.
• Wrist Fractures – bone fragments from wrist fracture can irritate the tenosynovium or reduce the viable space in the carpal tunnel.
• Repetitive Strain Injury – tendons in the carpal tunnel can become irritated and inflamed by awkward postures and repetitive hand movements.

Common symptoms 
:

• Pain in hand and/or arm, particularly at night
• Pain darting from wrist
• Numbness
• Tingling
• Pins and needles
• Weakness of the hand

Diagnosis may involve:

• Medical history review
• Physical examination
• Nerve conduction study
• MRI
• X-ray

The procedure

The procedure is usually performed under general anaesthetic. The endoscope is passed through a small incision in the wrist (single-portal technique). During endoscopic carpal tunnel release surgery, the transverse carpal ligament is cut to release pressure on the median nerve and relieve carpal tunnel syndrome symptoms.

The surgery is often performed as day surgery and requires only small incisions. Recovery varies, depending on the incision size and the patient’s overall health.

Post operative care

You may be able to go home on the day of your surgery but you will need a responsible adult to stay with you for 24 hours after anaesthesia and it’s likely you will need some help around the house for a day or two.

Cold packs applied at regular intervals can help reduce post-operative swelling.

If you have any increased swelling, redness or heat in the days following surgery, please contact the rooms immediately as these symptoms could indicate infection.

Prognosis

Most people who have carpal tunnel surgery find that their symptoms are relieved and do not come back.

If you have a severe case of carpal tunnel syndrome, surgery can help with the symptoms but you may still feel numbness, tingling, or pain every so often. Pain around the surgery site may linger for some months.

The recovery from endoscopic carpal tunnel surgery takes a varying amount of time – anywhere from several weeks to several months, depending on the severity of the condition.

If the nerve has been compressed for a long period of time, recovery may take even longer.