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CARPAL-TUNNEL-SYNDROME REPAIR

General Information

DEFINITION--Cutting the transverse carpal ligament, the fibrous tissue extending across the wrist.

BODY PARTS INVOLVED--Transverse carpal ligament; median nerve and surrounding fibrous tissue; wrist joint.

REASONS FOR SURGERY--Relief of pain or numbness caused by compression of the median nerve.

SURGICAL RISK INCREASES WITH

  • Obesity.
  • Smoking.
  • Poor nutrition.
  • Recent illness.
  • Alcoholism or chronic illness.
  • Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
  • Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Hand surgeon, general surgeon, orthopedist or plastic and reconstructive surgeon.

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS

  • Before surgery: Blood and urine studies; x-rays of wrist; nerve-conduction tests (See Glossary).
  • After surgery: Blood studies.

ANESTHESIA

  • Local anesthesia by injection, sometimes a regional block.
  • General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

  • A tourniquet is applied above the wrist to prevent bleeding in the surgical area.
  • An incision is made in the underside of the wrist.
  • The transverse carpal ligament is located and cut, releasing the compressed median nerve.
  • The skin is closed with fine sutures, which usually can be removed about 10 days after surgery. Absorbable stitches are not removed.
  • A bandage is applied, and a splint is used to hold the wrist in position. In some instances, the stitched wound may be left uncovered.

POSSIBLE COMPLICATIONS

  • Excessive bleeding.
  • Surgical-wound infection.
  • Inadvertent injury to blood vessels or nerves.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 1 month for recovery from surgery.


Postoperative Care

† Apply non--prescription antibiotic ointment to the wound before applying new bandages.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

    being, resume daily activities, including work, as soon as you are able.

  • Resume driving 1 week after returning home.

DIET---No special diet.


Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

  • You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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