Carpal Tunnel Release Surgery: A Path to Pain Relief

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Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of
the hand, becomes compressed at the wrist. This condition can cause pain, numbness, and weakness in the hand and fingers. When nonsurgical treatments don't provide relief, carpal tunnel release surgery may be necessary.

What is Carpal Tunnel Release Surgery?

Carpal tunnel release surgery involves cutting the transverse carpal ligament to reduce pressure on the median nerve. There are two main surgical techniques:

  1. Open Carpal Tunnel Release: The surgeon makes an incision in the palm of the hand to access and cut the transverse carpal ligament.
  2. Endoscopic Carpal Tunnel Release: This minimally invasive technique involves one or two small incisions. A camera and special instruments are used to cut the ligament.

Important Anatomic Structures

  • Median Nerve: A crucial nerve running down the arm into the hand, controlling sensations to the palm side of the thumb and fingers, and motor functions to some of the hand muscles.
  • Carpal Tunnel: A narrow passageway in the wrist, formed by carpal bones and the transverse carpal ligament, through which the median nerve and flexor tendons pass.
  • Transverse Carpal Ligament: A thick, fibrous band forming the roof of the carpal tunnel, which is cut during the surgery to relieve pressure on the median nerve.
  • Flexor Tendons: Tendons that run through the carpal tunnel and control finger movements.

Steps in Performing Carpal Tunnel Release Surgery

  1. Preoperative Preparation: The patient's arm is positioned on an arm board, and the wrist area is sterilized. A tourniquet is applied to control bleeding.
  2. Incision: For open surgery, a small incision is made in the palm of the hand. For endoscopic surgery, one or two small incisions are made near the wrist.
  3. Exposure: In open surgery, the transverse carpal ligament is directly visualized and carefully cut to release pressure on the median nerve. In endoscopic surgery, a camera is inserted, and the ligament is cut using specialized instruments.
  4. Closure: The incisions are closed with sutures, and a sterile dressing is applied.
  5. Postoperative Care: The patient is monitored in recovery, and instructions are provided for wound care, wrist immobilization, and physical therapy.

Benefits of Carpal Tunnel Release Surgery

  • Symptom Relief: Most patients experience immediate relief from pain and numbness.
  • Enhanced Hand Function: Surgery often leads to improved grip strength and hand function.
  • Minimally Invasive Option: The endoscopic approach offers quicker recovery and less scarring.

Recovery and Results

After surgery, patients may need to wear a wrist brace and engage in physical therapy. Full recovery typically takes several weeks, but most patients return to normal activities within a few months.

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