Carpal Tunnel Release
what is carpal tunnel release surgery?
Carpal tunnel release surgery is a surgical operation used to relieve and treat symptoms associated with carpal tunnel syndrome (CTS), such as numbness, pain and tingling in your hand. It is typically performed when all other non-surgical treatments have been exhausted. If symptoms do not improve through non-surgical measures such as steroid injections, a carpal tunnel release may be indicated.
How does carpal tunnel release surgery work?
A local anaesthetic is injected into the wrist to numb the area, which may initially sting. A small incision is then made in the hand, and the roof of the carpal tunnel is cut so that it removes pressure on the median nerve. The small incision will then be sutured using dissolving stitches and a dressing will be applied. The procedure will only take around 15 minutes.
The local anaesthetic will prevent any immediate post-operative pain but the hand and fingers may remain numb for around 6 hours and in some cases a little longer. Before the anaesthetic wears off you should take regular pain relief for 24-48 hours.
carpal tunnel release recovery
Keep the hand elevated at all times for the first 48-72 hours to prevent swelling and stiffness in the fingers. It is important that you do not walk around with your hand dangling by your side, and that you do not sit with your hand held in your lap. Continue to exercise the hand and to perform light activities.
You will be discharged with a dressing which should remain in place for the first 48-72 hours following the operation. Following this the outer dressing can be removed. There will be a sticky plaster covering the wound under the dressing. If this is completely clean, you can leave it where it is. If it has some blood on it, which is completely normal, remove the plaster, wipe the wound clean and apply a fresh sticky plaster. You should have a fresh plaster inside your bandages.
Look out for any redness or tenderness in the area around the wound which might indicate an infection. Keep the hand clean and dry for the first 10 days as it is important to not get the wound wet, until the stitches have dissolved. You will be seen in clinic 10-14 days following your operation, and you should keep the wound covered until then.
You can return to driving after 1 week as long as you are comfortable, you have regained full finger movements and are in complete control of the vehicle.
after the stiches dissolve
As the wound heals, you will be left with a small scar on your palm. This will be firm to touch and possibly tender for 6-8 weeks. This can be managed by massaging the scar firmly with a moisturiser. Massaging the scar will also help desensitise the area.
If you experience any problems with scar massage, hand function or rehabilitation, please make an appointment to see your hand therapist.
You may find initially that your grip is slightly weaker than before. This will gradually improve over 3-6 months following the operation.
Long-term prognosis
The pins and needles in the fingers should resolve quickly. However, the numbness can take much longer to recover, and this may be related to how long you have had carpal tunnel syndrome. For example, the longer this numbness has been present the longer it will will take to go away. For some people, if the numbness has been profound and the muscles of the hand have already wasted the sensation may not return.
The One Team Specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist
