Carpal tunnel release is a surgical procedure for the treatment of carpal tunnel syndrome (CTS). A carpal tunnel is the narrow channel formed by the carpal bones and the carpal ligament. It normally contains the median nerve which innervates the muscles of the middle and index fingers, thumb and a small portion of the ring finger. Carpal bones are small bones found in the wrist and the carpal ligament is a sheet of tissue connecting the carpal bones together. In carpal tunnel release, the carpal ligament is often cut to free the median nerve from pressure.
When tissues around the median nerve become swollen due to inflammation or other causes, compression of the median nerve usually occur, resulting in CTS. Some factors may increase an individual's risk for developing carpal tunnel syndrome. These include thyroid problems, arthritis, pregnancy, obesity and smoking.
Symptoms of CTS include tingling, numbness, pain in the hand which sometimes radiates to the arm and shoulder, and weakness of the hand. Medical treatment is usually given, such as corticosteroids and anti-inflammatory drugs. Splinting and occupational therapy are also included in the management of CTS. When these interventions do not provide relief of symptoms, a carpal tunnel release is frequently necessary.
Diagnosis of CTS often involves physical examination of the hands. Electromyography, which is a tool for evaluating the health and electrical activity of the muscles and nerves, is also an essential diagnostic tool frequently done in patients with CTS. The test, taking about 30 to 60 minutes, measures the muscle activity with the use of a small pin or needle inserted in the muscle.
An orthopedic surgeon, a doctor specializing in the treatment related to disorders of the musculoskeletal system, is usually the one performing carpal tunnel release. Patients are administered with either a general anesthesia, where the patient is put to sleep during the whole procedure, or a regional block, where only the affected arm experience loss of sensation during the procedure.
The surgeon usually makes a small cut on the palm of the affected hand to visualize the carpal ligament and other tissues in the wrist. Making sure that the median nerve is out of the way, the surgeon then cut the carpal ligament to free the nerve from compression. The wound is then stitched closed and a bulky dressing is applied.
Patients can usually go home after the procedure. They are often instructed not to do any pinching and gripping activities for at least six weeks. Complications from carpal tunnel release may include infection, pain from the wound, and weakness of the hand.
