The carpal tunnel is a narrow, tunnel-like structure in the wrist. The bottom and sides of this tunnel are formed by wrist (carpal) bones. The top of the tunnel is covered by a strong band of connective tissue called the transverse carpal ligament.
Carpal tunnel syndrome is numbness, tingling, pain and weakness in the hand that is caused by pressure on the median nerve in the wrist. Some people may have pain in their arm between their hand and their elbow.
Carpal tunnel release is surgery to treat carpal tunnel syndrome. This surgery is recommended when there is static numbness, muscle weakness, or atrophy, and when night-splinting no longer controls intermittent symptoms of pain in the carpal tunnel.
Carpal tunnel release surgery is used to reduce the pressure on the median nerve in the wrist. This is done by cutting the ligament that forms the top of the carpal tunnel. Cutting this ligament relieves pressure on the median nerve. Any other tissue (such as a tumor) that may be putting pressure on the median nerve can also be removed during surgery.
Conditions associated with carpal tunnel syndrome, or that appear to put the individual at higher risk for developing the condition include:
- Certain Thyroid Conditions
- Arthritis, Especially Rheumatoid
- Previous fractures or injuries
- Conditions Involving Hormonal Changes
- Cigarette Smoking
- Numbness, tingling, and pain in the hand
- An electric shock-like feeling mostly in the thumb, index, and long fingers
- Strange sensations and pain traveling up the arm toward the shoulder
- Stiffness in the fingers when get up in the morning
- Pain in the forearm between the elbow and wrist
Surgery is usually recommended for cases of CTS, when other treatments have failed to relieve symptoms.
During surgery the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist. A local anaesthetic is used to numb the hand and wrist.
- Open carpal tunnel release surgery: In open surgery, the surgeon will make a single cut (3 to 4cm long) near the base of the palm. Surgeon will then divide the carpal ligament to relieve pressure on the median nerve. The surgeon will close the cut in your skin with stitches.
- Keyhole carpal tunnel release surgery: The surgery involves two small cuts (about 1 to 2cm long) in your skin. The first cut will be on the inside of the wrist and the second will be in the palm of the hand than insert small instruments and a tube-like telescopic camera through the cuts in the wrist. Surgeon will then divide the carpal ligament to relieve pressure on the median nerve. The surgeon will close the cuts in the skin with stitches.
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