Carpal tunnel release surgery is a procedure that's performed to treat the condition known as Carpal Tunnel Syndrome. This condition results from persistent pressure exerted upon the major nerve that passes over the palm side of the wrist, the median nerve, from bone and ligament tissues within the wrist. The condition arises from many factors, including trauma, pregnancy and overuse/repetitive stress activities.
The surgery itself, which is typically very successful in reducing if not eliminating symptoms, is considered a rather minor procedure. But carpal tunnel release surgery comes with its own risks and potential for complications.
Infection
As with any surgical procedure that involves cutting through the skin and other tissue layers, there's an ever-present risk of infection. This is mainly due to the presence of bacteria on the human skin which, as long as it remains external to the body, usually poses no problems. Once microorganisms are introduced into the tissues below the surface, the risk for propagation of these bugs increases dramatically.
Infection can be caused by the normally occurring bacteria on the skin, improper surgical sterile technique and a patient's diminished immune system.
Worsening of Pain
No one wants to hear that a recommended surgical procedure designed to achieve the highest level of beneficial outcomes could actually make one's problem worse. Though this is an extreme rarity, it's a risk nevertheless. Symptoms can be worsened in terms of incision pain, pain radiating into the fingers, and pain in the palm of the hand. If injury to the nerve occurs during surgery, it could leave the patient with long-lasting pain, numbness and tingling.
Nerve Injury/Damage
In addition to any long-term injury or damage that can be inflicted upon the median nerve from longstanding pressure from too tight of a canal, injury and damage to the nerve from the surgical procedure is a legitimate risk factor and must be understood before proceeding.
Damage and injury from the surgical instrumentation, depending upon the type of carpal tunnel surgery performed, can cause injury and even permanent damage to the nerve if proper care protocols aren't employed.
Incomplete Ligament Release
The ligament that crosses over the top of the carpal tunnel above the nerve is called the transverse carpal ligament. Occasionally, this ligament can become thickened due to overuse, repetitive stress or trauma, and contributes heavily to narrowing the tunnel. This puts pressure on the nerve.
The open carpal tunnel procedure--in which an incision is made and the structures are seen under direct vision--remains the benchmark for this condition. But many minimally invasive and endoscopic approaches have been developed and are in wide use.
One potential problem with procedures that offer limited visibility is incomplete release of this ligament, leaving behind a band of thick tissue that can continue to put pressure on the nerve.
Recurrence of Symptoms
For all of its successes, the carpal tunnel release procedure cannot guarantee against the potential for recurrence of symptoms. One potential reason for a recurrence of symptoms is a return to undesirable activities--such as the use of pneumatic or air-powered impact guns that are commonly found on automobile production lines--that caused the problem in the first place.
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