Carpal Tunnel Repair

Alternate Names
CTR
carpal tunnel release



Definition of Carpal Tunnel Repair

Carpal tunnel repair (now called "carpal tunnel release" ) 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 and often is irritated. This causes numbness and pain, and sometimes weakness in the fingers and hand. Carpal tunnel release relieves the compression of the median nerve.

Who is a candidate for the procedure?

Carpal tunnel release is needed when other treatments for carpal tunnel syndrome - rest, splinting, and physical therapy - have failed to relieve 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 in a same-day surgery setting. A local anesthetic is used to numb an area on the palm of the hand. A 2-inch incision is made to release the tight band (carpal tunnel ligament) that is putting pressure on the the median nerve.

An endoscopic release is a less-invasive form of surgery. This procedure uses an endoscope, a small fiber-optic camera. The surgeon uses it to look into the carpal tunnel through a small incision in the wrist. A small tube, or cannula, is placed alongside 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 surgery, the patient will be kept in the surgery recovery room for a few hours. He or she can expect the following:

• The affected hand will be elevated to decrease swelling.
• Anti-inflammatory medicine such as ibuprofen (i.e., Motrin) may be given to decrease swelling and discomfort.
• A bulky gauze dressing will be applied.
• He or she will be able to eat right after surgery.
• He or she will be discharged from the same-day surgery center within a few hours.

What happens later at home?

After discharge, the individual will be given instructions for ways to relieve pain and swelling. These include:

• applying ice for 20 minutes every 2 hours during the first 48 hours
• avoiding heavy lifting until given the OK by the healthcare professional
• changing the dressing daily
• doing finger and wrist exercises according to the surgeon's instructions
• elevating the hand above the level of the heart for 48 hours to prevent swelling

The pain of carpal tunnel syndrome should clear up within the first 2 weeks after surgery. Full recovery of function and sensation to affected areas may take several weeks or months.

What are the potential complications after the procedure?

Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic. Specific complications of carpal tunnel release include nerve damage, scarring, and pain.