Carpal tunnel syndrome is a condition characterized by pain and numbness in the hand. It affects the area in the wrist called the carpal tunnel, which is a small opening with bones called carpal bones on the tunnel floor and a ligament on the tunnel ceiling. The ligament in the carpal tunnel can thicken, which can cause pressure on the median tendon, which passes through the tunnel, and some of the muscles that pass through it. This pressure can cause pain and numbness in the hand. Surgery can be performed to cut the ligament and relieve pressure, and there are two main procedures for performing this type of surgery. The procedures are open-release surgery and endoscopic surgery.
Open-Release Surgery
In open-release surgery, a large incision is made to allow surgeons to see the carpal tunnel directly instead of having to view it through a camera. The procedure may performed with the patient under either local or general anesthesia. A tourniquet is sometimes applied to reduce the amount of blood flowing to the hand.
The incision made during open-release surgery starts in the middle of the palm and extends toward the wrist, sometimes into the wrist. The surgeon then cuts the ligament of the carpal tunnel, enlarges the tunnel, and closes the incision. This is typically an outpatient procedure.
Endoscopic Surgery
Instead of the one large incision of open-release surgery, endoscopic surgery employs one or two small cuts, allowing surgeons to insert an endoscope with a small camera on the end so they can see the carpal tunnel. A local anesthetic is injected into the palm, and a tourniquet may be used. Using the endoscope and other medical tools, the surgeon cuts the carpal tunnel ligament and enlarges the tunnel. This is also typically an outpatient procedure.
Recovery
With either procedure, patients may be asked to wear a splint for up to two weeks to protect the wrist. The Mayo Clinic points out that some surgeons do not require the splint after the endoscopic procedure. After either procedure, nothing heavier than 11 pounds should be lifted for two months.
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