Carpal tunnel release is an outpatient procedure performed to relieve pressure on the median nerve and reduce the symptoms of carpal tunnel syndrome. This procedure can help restore muscle strength and dexterity, and is typically performed on patients who have had persistent symptoms that do not respond to conservative treatment methods.
Carpal tunnel release can be performed endoscopically or through an open procedure. Both types offer different advantages to the doctor and patient, and should be considered after a thorough evaluation of the patient's individual condition. Open carpal tunnel release involves a two inch incision in the middle of the palm and gives the surgeon a better view of the treated area with less risk of accidentally damaging nerve tissue. Endoscopic carpal tunnel release involves two tiny incisions and offers patients less post-operative pain and the ability to return to work more quickly.
Patients can return home the same day, but may need prescription pain medication at first to manage the pain from the procedure. The hand may be kept in a splint for the first few weeks after surgery in order to protect the wrist while it heals. Although patients may continue to experience carpal tunnel symptoms after this procedure, most report that symptoms are significantly reduced after carpal tunnel release.
Carpal tunnel syndrome is a common condition involving numbness, pain, and tingling in the wrist, hand, and fingers. It occurs when pressure is put on a nerve in the wrist, called the median nerve, which controls motor function in the thumb. This pressure is most often caused by thickening of a ligament on the palm side of the wrist, called the transverse carpal ligament. The exact reason why this ligament thickens is unknown. It is thought to be a combination of the person’s anatomy, physiology, and external stresses experienced by the hand and wrist.
Carpal tunnel syndrome can be diagnosed by history and physical exam and confirmed with a nerve conduction study. It can often be effectively treated with non-surgical therapies such as wrist splints. In specific circumstances, corticosteroids injections can be used for treatment. In cases where pain and numbness persist, surgery may be necessary to relieve pressure on the nerve.
Dupuytren's contracture is a hand deformity caused by the gradual shortening and thickening of the connective tissues (palmar aponeurosis) within the palm.
Dupuytren’s contracture is a genetically inherited disorder. The exact mechanism as to how Dupuytren’s contracture occurs is unknown; however, it is known that there are multiple genes that are involved. This characteristic makes its presentation and behavior different in every individual.
For many people, Dupuytren’s contractures present as thickening of the palmar aponeurosis tissue, are non-progressive, and true contractures do not occur. Observation is recommended for these patients.
In other cases, Dupuytren’s contractures are progressive. In these situations, invasive intervention is recommended. This can be done with injectable medication, collagenase (Xiaflex), or by surgical release/removal of affected tissue.