Carpal tunnel

Carpal tunnel syndrome is a medical condition that occurs when the median nerve in the wrist is compressed or pinched as it passes through the carpal tunnel, located in the wrist area. The carpal tunnel is a narrow passage through which nerves and tendons travel to the hand and fingers. When the nerve is compressed in this tunnel, it can cause pain, numbness, and tingling in the hand and fingers. Symptoms of carpal tunnel syndrome may include pain, tingling, or numbness in the thumb, index finger, middle finger, and part of the ring finger that connect to the median nerve. Pain in the hand or forearm, sensitivity to cold or heat, weakness in the hand, and loss of sensitivity in the hand and fingers may also occur. Carpal tunnel syndrome can be treated with conservative methods such as wearing a wrist guard or performing therapeutic exercises. In more severe cases, surgical intervention may be necessary to relieve pressure on the nerve and improve hand and finger function.

When is surgery indicated?

Surgery for carpal tunnel syndrome is typically considered when symptoms do not improve or worsen despite conservative therapies like wearing a wrist guard or engaging in therapeutic exercises. Surgical intervention may also be recommended if there is nerve damage or if there is a risk of permanent nerve damage. There are different types of surgical procedures that can be used to treat carpal tunnel syndrome, with endoscopic or open surgery being the most common. In endoscopic surgery, the surgeon uses a small endoscope that is inserted into the carpal tunnel to relieve pressure on the nerve. In open surgery, the surgeon accesses the carpal tunnel through an incision on the palm and relieves pressure on the nerve. The final decision on whether surgery is necessary for carpal tunnel syndrome always depends on the individual case and must be made in consultation with a physician.

How is the surgery performed?

Carpal tunnel surgery can be performed using various methods depending on the doctor's preference and the severity of the patient's condition. However, in the most commonly applied method of open surgery, the procedure is performed as follows:

1. Before the surgery, the patient is given local or general anesthesia. The physician will determine which type of anesthesia is best for each patient.
2. The surgeon makes a small incision (usually about 2-3 cm) on the palm above the carpal tunnel.
3. After opening the skin and subcutaneous tissue, the surgeon separates the tissues to reveal the carpal tunnel.
4. The surgeon carefully cuts the tight ligaments surrounding the carpal tunnel to relieve pressure on the nerve.
5. After relieving the pressure, the surgeon carefully stitches the skin and subcutaneous tissue and covers the operated area with a bandage.
6. The patient is usually discharged home on the same day.

After the surgery, the patient will have several weeks of limited use of the hand while the wound heals. Physical therapy and exercises may also be necessary to assist in the rehabilitation of the hand and improve movement and strength.