Open release carpal tunnel surgery generally is a safe procedure and represents the major surgical procedure performed on the hand in the United States. The surgery can be performed under general anesthesia or with a regional anesthetic. In either case, there can be problems associated with this surgery varying from a minor or temporary incident to a permanent or life threatening situation.
Nerve Injury
Nerve injury is one of the most serious problems after carpal tunnel surgery. Although rare, sometimes a major nerve like the median nerve can be inadvertently nicked or even cut completely. Depending on the degree of nerve injury, this results in complete or incomplete sensory and motor loss -- including grip strength loss -- in the fingers and part of the hand.
Scar Formation
The body can form scar tissue inside the carpal tunnel in response to open release surgery. Scarring produces adhesions, which inhibit tendons from gliding smoothly. Subsequently, the hand and fingers can become numb and painful. This causes pain while moving the wrist joint, causing the patient to move the joint less and less. The result is freezing of the joint. Physical therapy, including range of motion maneuvers helps to minimize this problem.
Sensation and Strength
Open carpal tunnel surgery may result in loss of sensation and weakness in the hand and fingers. This includes loss of grip strength. These problems may be slight or profound. Also, they may be only temporary, lasting weeks to months. However, it is not uncommon for these problems to be permanent. There generally also is some loss of sensation on the skin area around the incision, which may last months or even years.
Pain, Stiffness, Tenderness
These are not uncommon problems after open carpal tunnel surgery. The pain and stiffness in the hand and wrist can persist for weeks to months. Tenderness around the incision site also can be lasting. Physical therapy including stretching exercises and range of motion maneuvers are beneficial. Also, gently massaging the wrist and incision site can bring about relief.
Return of Symptoms
Not all surgeries are successful. Some reports indicate that almost half of surgical patients are unsatisfied with their results. This is primarily due to return or persistence of symptoms. Generally, the more prolonged or severe the symptoms were before surgery the more unsatisfactory the results.
Infection
It is rare to have a serious infection of the incision site after surgery. Systemic infections are even rarer. In either case, infections can be treated effectively with oral or intravenous antibiotics.
References
- "Journal of Hand Surgery"; Patient-reported outcome after carpal tunnel release; M. Leit, et.al.; May 2004
- "The Journal of Hand Surgery"; Surgery after Carpal Tunnel Release; N. Stuz, et. al.; February 2006
- "The Journal of Hand Surgery"; Maine carpal tunnel study; J. Katz; July 1998
- "Journal of the British Society for Surgery of the Hand"; Long-term results of carpal tunnel release; M. Nancollas, et. al.; August 1995
- "Arthritis and Rheumatism"; Predictors of Outcomes of Carpal Tunnel Release; J. Katz, et.al.; May 2001
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