Carpal tunnel surgery is one of the most common surgeries performed in the U.S. Two basic types of this surgery exist: open release and endoscopic release. Like any surgery, each poses potential complications, some of which are associated with surgery in general and others with the specific type of carpal tunnel release surgery. The severity of the complications ranges from soreness to severe drug reactions.
Types of Surgery
The carpal tunnel surgery procedure is technically called carpal tunnel release surgery because the transverse carpal ligament is severed to release pressure on the median nerve. Severing the ligament can be achieved by one of two methods: open release surgery or endoscopic release surgery. All of the complications discussed here apply to both procedures, although according to a 2006 report in the British Medical Journal, the complication rate in endoscopic release surgery is lower.
Major Complications
Severity of complications most often depends on the general health of the patient. Many patients are already compromised by other health conditions and any surgery increases the risk of complications in them. Other major complications are independent of the patient's overall condition.
The major complications include:
1. Reaction to anesthesia
2. Allergy to medications
3. Surgical damage to the median nerve
4. Surgical damage to the blood vessels of the hand
5. Numbness in the fingers and hand
6. Severe infection at the surgery site
7. Prolonged stiffness of the hand and fingers
8. Ineffectiveness of the procedure, and continued pain and other symptoms
9. Death, which is a potential complication of any surgical procedure
Minor Complications
Minor complications are more common than major ones, yet with careful attention they will resolve quickly and permanently.
The minor complications include:
1. Temporary stiffness in the hand and fingers
2. Pain and tenderness at the surgery site
3. Minor infection
4. Bleeding at the surgery site
5. Swelling
6. Abnormal or painful scarring
7. Allergy to oral medication, bandages and ointments
8. Nausea and vomiting
Increased Risk Factors
A multitude of factors may increase the risk of complications. The primary factors are:
1. Over age 50
2. Severe symptoms before surgery
3. Diabetes
4. Chronic obstructive pulmonary disease
5. Heart disease
6. Having hemodialysis
7. Alcohol or drug abuse
Decreased Risk Factors
Factors contributing to a more favorable outcome, with fewer complications, include:
1. Good overall health
2. Under age 50
3. Having surgery within three years of diagnosis
4. Good preoperative grip strength
5. Having symptoms primarily at night
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