Carpal Tunnel Syndrome
Problem
- Numbness and tingling affecting the thumb, index, middle and ring fingers
Cause
- Compression of the median nerve as it passes through the carpal tunnel at the level of the wrist.
Diagnosis
- Characteristic night time waking with numbness
- Characteristic distribution of numbness in the hand
- Sometimes wasting of the thenar (thumb) muscles in the hand
- Positive Tinnels (tapping) and Phalens (compression tests
- Nerve Conduction Tests can confirm the diagnosis if needed.
Treatment
Non Op
- Night splinting
- Steroid injection for temporary relief
Op
- Open – LA with sedation or GA
- 4cm Incision
- Release of the transverse carpal ligament
- Skin Closure
Endoscopic – GA
- Using an endoscope to divide the ligament between the smaller incisions
- Same long term results as open
- Slightly earlier return to work than Open
- Bilateral procedure possible
Potential Complications
- Infection, Haematoma
- Wound sensitivity
- Pillar pain (thenar and hyperthena areas)
- CRPs (exaggerated pain response from the nerves)
Post Op Care
- Day surgery
- Keep fingers moving, – elevation
- Debulk bandage at 5 days
- Review at one week and six weeks
- Return to desk work at 10 days
- Return to manual work at one month