Management Team

Carpal Tunnel Release

Overview

Carpal tunnel release is an arthroscopy procedure to treat carpal tunnel syndrome where the surgeon releases the transverse carpal ligament in the wrist, which covers the median nerve, to decrease pressure on the nerve or decompress the nerve.

This nerve decompression procedure is usually recommended for patients who are in advanced stages of carpal tunnel syndrome and have not shown improvement following non-surgical interventions.

Preoperative preparation

The decision for surgery is made following extensive clinical examination and a thorough discussion between the patient and surgeon. Before the surgery:

  • Few blood tests are required before the procedure to assess the patient’s general condition
  • Anti-inflammatory medications and blood thinners are stopped 5–7 days before the surgery

Surgery

This arthroscopy procedure can be performed as a daycare procedure or might require 1-day admission depending on the condition. The patient is admitted a few hours before surgery and the duration of fasting required is determined by the surgeon. The procedure is done as follows:

  • Local anaesthesia (axillary block or a wrist block) or general anaesthesia is administered
  • Small incisions (around 1 inch) are made at the palmar aspect of the wrist, and the transverse carpal ligament (covering of the carpal tunnel) is cut completely to relieve the pressure (decompress) on the median nerve
  • All aspects of the nerve are examined to assess adequate release
  • If deemed suitable by the treating surgeon, the surgery can also be done using an endoscope (keyhole surgery).

Postoperative care

  • Medications for pain
  • Wound care
  • Ice packs to reduce swelling
  • Hand elevation in the first few days to minimise swelling
  • Physical therapy and rehabilitation
  • Avoiding strenuous activities involving the hand and wrist for 2-4 weeks

Arthroscopy procedures are generally safe but potential complications include: 

  • Tissue or nerve damage
  • Infection
  • Stiffness and weakness of joint

Most patients experience significant relief from pain, numbness, and tingling after surgery. Improvement in hand strength and functionality is typically gradual with full recovery taking several weeks to months. Patients can usually resume light activities within 1–2 weeks, while full recovery may take 6–12 weeks, depending on the complexity of the surgery and the patient's adherence to postoperative care.

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