Carpal Tunnel Surgery

Minor Hand Surgery

Carpal tunnel syndrome is essentially a pinched nerve in the wrist. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. 


Causes 

  • Swelling of the lining of the flexor tendons, called tenosynovitis
  • Joint dislocations
  • Fractures
  • Arthritis
  • Fluid retention during pregnancy 

Signs and symptoms 

  • Pain
  • Numbness
  • Tingling
  • Weak grip
  • Occasional clumsiness
  • Tendency to drop things

The numbness or tingling most often takes place in the thumb, index, middle and ring fingers. The symptoms are usually felt during the night but may also be noticed during daily activities such as driving or reading a newspaper. In severe cases, sensation and strength may be permanently lost. 


Diagnosis 

A detailed history including medical conditions, how the hands have been used, and any prior injuries is important in diagnosing carpal tunnel syndrome. An x-ray may be taken to check for arthritis or a fracture.


What is Carpal Tunnel Surgery?

Carpal Tunnel Surgery involves making a cut along the front of your wrist and the palm of your hand to release the tight ligament (flexor retinaculum) that is squashing the nerve.

The procedure lasts approximately 20 to 30 minutes and is performed as a day case under local anaesthetic, this means you will be awake during the procedure and can usually go home approximately 1 hour after the procedure is completed.


Treatment Options

  • Changing patterns of hand use (helps reduce pressure on the nerve)
  • Keeping the wrist splinted in a straight position (helps reduce pressure on the nerve)
  • Wearing wrist splints at night (helps relieve symptoms that interfere with sleep)
  • Steroid injections into the carpal tunnel (helps reduce swelling around the nerve)

If you decide not to have surgery initially you will be contacted approximately 6 weeks after your initial appointment to determine what improvement in your symptoms has been experienced. Further treatment options will be discussed and agreed.

When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Pressure on the nerve is decreased by cutting the ligament at the top of the tunnel on the palm side of the hand.