 carpal tunnel release: This is the standard surgical technique for this condition.
An incision is made in the palm over the carpal tunnel and the transverse
carpal ligament is released. This operation has an excellent success rate and a
relatively low complication rate. It can be performed under local anaesthetic
instead of a general anaesthetic.
Endoscopic carpal tunnel release:
This is a minimally-invasive procedure where a small
incision is made at the front of the wrist. A camera is inserted allowing a
view of the carpal tunnel from inside. The transverse carpal ligament is then
released from below. This procedure has a smaller scar and is associated with
quicker return to function than an open procedure. However, there is a slightly
high complication rate reported with this operation, and it cannot be performed
under local anaesthetic alone.
What to expect after the operation:
Carpal tunnel release is performed as a day-only procedure.
A bulky dressing will be applied to the surgical site in the operating room.
For open procedures, this dressing should be kept on and dry until the post-operative appointment.
For endoscopic procedures, this bulky bandage can be taken
off one or two days after the operation. An underlying waterproof dressing will
be in place and should be left in place. At this stage the hand may start getting wet
under running water. Within a few days of the operation you would usually visit a therapist to
start some exercises. It is important that
you follow instructions to get the wrist and hand moving, and for wound care.
The immediate operation pain will subside within
weeks and patients can usually return to full duties within 3-4 weeks for
endoscopic procedures and 6-8 weeks for open procedures. Some milder aching
pain (known as pillar pain) will remain for up to 9 months.
Patients usually find that some symptoms, such as tingling
and waking at night, resolve within several days of the operation. Other
symptoms, such as numbness and weakness, can take a year to resolve, and
sometimes never resolve in severe disease. Muscle wasting almost never fully
There is no difference in final outcome when comparing open
versus endoscopic carpal tunnel release after 12 months.
What are the risks of surgery?
Complications from carpal tunnel surgery are uncommon. The usual risks are:
- nerve, tendon or blood vessel damage
- Ongoing pain. It is common to get some mild to moderate soreness in the palm for 9 months following surgery.
- Ongoing numbness. This takes up to 12 months to recover and may be permanent in severe disease.
- Ongoing weakness. This takes up to 12 months to recover and may be permanent in severe disease
- Complex regional pain syndrome
- The symptoms may recur in future.