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carpal tunnel decompression

Alternative Names
CTD, carpal tunnel release

Definition
Carpal tunnel decompression is a surgical procedure that helps to relieve the symptoms of carpal tunnel syndrome. In carpal tunnel syndrome, the median nerve in the wrist is compressed, or squeezed, and often is irritated. This causes numbness and pain in the fingers and hand. Carpal tunnel repair relieves the compression of the median nerve.

Who is a candidate for the procedure?
Carpal tunnel decompression is done when other treatments for carpal tunnel syndrome, such as rest, splinting, and physiotherapy, have failed to improve the symptoms. If a person has symptoms for more than 4 months, surgery is often considered.

How is the procedure performed?
Carpal tunnel release is usually done as day surgery in an outpatient setting. A local injection is used to numb an area of the palm of the hand. A 5 centimetre incision is made to free the carpal tunnel ligament from the median nerve. This relieves the pressure on the median nerve, which has caused the numbness and pain associated with carpal tunnel syndrome. An endoscopic release is a less invasive form of surgery. This procedure uses an endoscope, a small fibreoptic camera, to look into the carpal tunnel through a small incision in the wrist. A small tube, or cannula, is placed along side the median nerve. Through this cannula, a special knife is inserted to free the carpal tunnel ligament from the median nerve.

What happens right after the procedure?
After the carpal tunnel release:
  • a bulky gauze dressing will be applied
  • the affected hand will be elevated to decrease swelling
  • anti-inflammatory medication, such as brufen or naprosyn, may be given to decrease swelling and discomfort
  • the person will be able to eat right after surgery
  • the person will be discharged from the day surgery centre within a few hours
What happens later at home?
Once the person is discharged:
  • the hand should be kept elevated for 48 hours to prevent swelling
  • ice could be applied for 20 minutes every 2 hours during the first 48 hours
  • the person should avoid heavy lifting until cleared by his or her surgeon
  • the symptoms should begin to improve within the next few weeks
  • finger and wrist exercises should be done according to the surgeon's instructions
What are the potential complications after the procedure?
Complications of carpal tunnel release include:
  • nerve damage
  • infection
  • scarring
  • pain
Author:
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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