Each year over 350,000 people in America undergo a carpal tunnel release. Carpal tunnel syndrome entails one of the most significant work absence causes every year in the US.
The open carpal tunnel surgery is done to relieve median nerve pressure, reducing the pain from the syndrome. Typically patients regain normal sensation to the fingers and hands.
The surgery is done as an outpatient. The open procedure is done through a small incision between one and two inches in the palm to expose the transverse carpal ligament, which is the structure just over the carpal tunnel.
Between the median nerve and the overlying transverse carpal ligament, a metal guide is situated. The surgeon cuts on top of the metal guide through the ligament. This allows more breathing room for the median nerve, which allows it to regenerate and improve sensation and motor function.
Once the ligament is cut, the incision is closed with sutures, a splint is applied to the wrist, and the patient is usually allowed to go home as soon as the anesthetic wears off. Within a couple weeks, patients often begin hand therapy to regain lost strength and for effective pain control post-operatively.
The endoscopic technique is also performed on an outpatient basis. It is designed to create less pain and scarring from traditional open surgery and tries to provide for a shorter recovery.
The incision is smaller than the open surgery and a metal guide is inserted above the median nerve, similar to the open technique. At this point the surgeon inserts a video camera which sends images to a television monitor in the operating room. The surgeon can visualize the inside of the wrist and hand.
Using the monitor, the surgeon transects the transverse ligament, reducing the median nerve pressure. The camera is removed, and the wound is sutured. A wrist splint may be put on and hand therapy may be started within a week or so to help with wrist and hand strength.
A few studies have evaluated endoscopic versus open carpal tunnel surgery. The endoscopic procedures appears to provide faster pain relief and recovery along with quicker improvement of functional abilities. Long term results between the two procedures are no different.
Both open and endoscopic methods have shown overall equal effectiveness in relieving carpal tunnel symptoms. It is unclear of the increased expense of endoscopic surgery makes the usage appropriate for its modest benefits.
The open carpal tunnel surgery is done to relieve median nerve pressure, reducing the pain from the syndrome. Typically patients regain normal sensation to the fingers and hands.
The surgery is done as an outpatient. The open procedure is done through a small incision between one and two inches in the palm to expose the transverse carpal ligament, which is the structure just over the carpal tunnel.
Between the median nerve and the overlying transverse carpal ligament, a metal guide is situated. The surgeon cuts on top of the metal guide through the ligament. This allows more breathing room for the median nerve, which allows it to regenerate and improve sensation and motor function.
Once the ligament is cut, the incision is closed with sutures, a splint is applied to the wrist, and the patient is usually allowed to go home as soon as the anesthetic wears off. Within a couple weeks, patients often begin hand therapy to regain lost strength and for effective pain control post-operatively.
The endoscopic technique is also performed on an outpatient basis. It is designed to create less pain and scarring from traditional open surgery and tries to provide for a shorter recovery.
The incision is smaller than the open surgery and a metal guide is inserted above the median nerve, similar to the open technique. At this point the surgeon inserts a video camera which sends images to a television monitor in the operating room. The surgeon can visualize the inside of the wrist and hand.
Using the monitor, the surgeon transects the transverse ligament, reducing the median nerve pressure. The camera is removed, and the wound is sutured. A wrist splint may be put on and hand therapy may be started within a week or so to help with wrist and hand strength.
A few studies have evaluated endoscopic versus open carpal tunnel surgery. The endoscopic procedures appears to provide faster pain relief and recovery along with quicker improvement of functional abilities. Long term results between the two procedures are no different.
Both open and endoscopic methods have shown overall equal effectiveness in relieving carpal tunnel symptoms. It is unclear of the increased expense of endoscopic surgery makes the usage appropriate for its modest benefits.
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