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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