Tunnel Syndrome Surgery
There are three main nerves travelling down the arm
to the hand. One of these, the median nerve, is responsible
for most feeling in the hand (apart from the little
finger). The median nerve travels through a narrow tunnel,
the carpal tunnel, as it passes from the wrist into
the palm of the hand. If the carpal tunnel becomes too
narrow, then pressure on the nerve develops and the
symptoms of carpal tunnel syndrome appear. Learn more
about Carpal Tunnel Syndrome in the "Anatomy
and Causes" section of this web site.
Open carpal tunnel surgery is considered
- Symptoms are still present after a long period
of nonsurgical treatment. Some experts recommend that
surgery not be considered until after at least a year
of nonsurgical treatment.
- Severe symptoms (such as persistent loss of feeling
or coordination in the fingers or hand, or no strength
in the thumb) restrict normal daily activities.
- There is damage to the median nerve (shown by nerve
test results and loss of hand or finger function),
or a risk of nerve damage.
- Tumours or other growths need to be removed.
open carpal tunnel release surgery, the transverse carpal
ligament is cut, which releases pressure on the median
nerve and relieves the symptoms of carpal tunnel syndrome.
An incision is made at the base of the palm of the hand.
This allows the doctor to see the transverse carpal
ligament. After the ligament is cut, the skin is closed
with stitches. The gap where the ligament was cut is
left alone and eventually fills up with scar tissue.
Open carpal tunnel release surgery is usually done under
local anaesthetic as an outpatient same-day surgery.
What are the Outcomes?
Most people who have surgery for carpal tunnel syndrome
have fewer or no symptoms of pain and numbness in their
hand after surgery. The overall success rate for either
endoscopic or open surgery is more than 95%. However,
after open surgery, recovery may be slower, and there
may be some pain in the wrist and hand.
In rare cases, the symptoms of pain and numbness may
return (the most common complication), or there may
be temporary loss of strength when pinching or gripping
an object, due to the cutting of the transverse carpal
If the thumb muscles have been severely weakened or
wasted away, hand strength and function may be limited
even after surgery.
What are the Risks?
The risk and complication rates of open surgery are
very low (about 5%). There is a small risk that the
median nerve or other tissues may be damaged during
surgery. There are also the risks of any type of surgery,
including possible infection and risks of general anaesthesia.
However, most open carpal tunnel surgery is done with
local anaesthesia or regional block, rather than general
here to download an Information Sheet on Carpal Tunnel
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