THIS POST IS PART OF THE ULTIMATE GUIDE TO HAND, WRIST AND ELBOW INJURIES
Carpal tunnel syndrome is a common condition that causes pain, numbness and tingling in the hand and arm. Carpal tunnel syndrome occurs when the carpal tunnel becomes narrowed and the median nerve is squeezed or compressed as it travels through the wrist. Over time, it can lead to nerve damage and worsening of symptoms.
Occasionally, surgery is necessary to treat carpal tunnel syndrome. Endoscopic carpal tunnel surgery is the most common treatment for carpal tunnel syndrome patients who need surgery.
What is endoscopic carpal tunnel surgery?
Endoscopic carpal tunnel surgery is minimally invasive decompression of the median nerve at the wrist. A fiber optic camera is used to see the carpal tunnel and median nerve. The roof of the carpal tunnel is released from the inside of the hand through a one-centimeter incision on the wrist.
When would a patient need this procedure?
Patients who have carpal tunnel syndrome with numbness and tingling in the hands and fingers, night pain and weakness would benefit most from the procedure.
What does this procedure consist of?
During the endoscopic carpal tunnel surgery, the patient can choose to be awake or under anesthesia. Local anesthetic is injected at the wrist. A one-centimeter incision is made in the wrist to introduce a five-millimeter fiber optic camera.
The carpal tunnel ligament is visualized with the scope and the transverse carpal ligament is released with a microscopic blade under direct visualization. The incision is then closed with one stitch and a soft bandage is applied to the wrist. Both sides can be done at the same time.
What are the benefits of this surgery?
This surgery is usually less painful and carries less risks than the open or mini open carpal tunnel releases. The scar on your wrist is less noticeable than an incision on the palm and less symptomatic. This incision heals faster, which means less time off work. Typically there is no need for hand therapy post-operatively.
What are the potential outcomes?
After endoscopic carpal tunnel surgery, the numbness resolves, sensation in the fingers is restored and grip strength increases. The recovery is gradual over 6 to 12 weeks. Patients have no post-op restriction. Driving is possible the day after surgery. Patients are typically back to light work within in a week and heavy lifting after a month.
To determine if you need carpal tunnel surgery, confirm the correct diagnosis via a physical exam by a hand specialist and an EMG.
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