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Endoscopic Carpal Tunnel Release
Carpal Tunnel Syndrome is a common condition where a nerve (the median nerve) is compressed or squeezed as it passes through the wrist into the hand. This nerve typically provides sensation to the thumb, index, and middle fingers, and these digits usually get numb and ‘tingly’ when the nerve is compressed. Symptoms are often worse at night, and patients complain of ‘shaking out’ their hands to wake them up. Advanced cases can cause significant and permanent loss of muscle strength and sensory loss. The treatment for persistent cases is surgery, or a Carpal Tunnel Release.
The roof of the carpal tunnel is made of a thick broad ligament, called the transverse carpal ligament. Dividing this ligament increases the volume of the carpal canal, and releases the pressure on the nerve.
Most carpal tunnel release surgery is done with an open incision in the palm. This incision is made through skin, fat, connective tissue, and muscle, just to get down to the transverse carpal ligament. This ligament is then cut, completing the surgery. The other tissues are then repaired. This is usually a very successful procedure, although scar tenderness is not uncommon.
It is now possible to release the transverse carpal ligament, and thus perform a carpal tunnel release, without a large incision. Using an arthroscope, a patient can now have an Endoscopic Carpal Tunnel Release. The advantages of this procedure are that it is often done under local anesthesia only, with just one or two tiny quarter inch incisions in the wrist. Usually no splint is required, and motion is started immediately. Bandages are removed after a few days, and a patient may return to full activities as tolerated. Both sides can be done at the same time, as well.
Both open and endoscopic carpal tunnel releases get the job done, and have equally good long-term results. Many patients prefer an endoscopic release because it hurts less, and returns them to work and function sooner.
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