carpaletunnelrelease

Carpal tunnel release is a surgical procedure to relieve pressure on the median nerve within the carpal tunnel of the wrist. The operation decompresses the nerve by cutting the transverse carpal ligament, enlarging the tunnel and reducing compression of the median nerve. It is typically performed to treat carpal tunnel syndrome when symptoms persist despite conservative treatments such as splinting, medication, or injections, or when electrodiagnostic testing confirms median nerve impairment.

Two main techniques are used. Open carpal tunnel release involves a small incision in the palm to expose and divide the transverse carpal ligament directly. Endoscopic carpal tunnel release uses one or two small incisions and a camera to guide the division of the ligament from inside the tunnel. Both approaches aim to achieve decompression while minimizing disturbance to surrounding structures.

Preoperative evaluation includes a clinical history and examination, with tests such as nerve conduction studies to document median nerve involvement. The choice of technique depends on patient factors and surgeon preference. Potential risks include injury to the median nerve or its branches, vascular injury, infection, scar sensitivity (pillar pain), stiffness, and incomplete symptom relief. Rare complications may include persistent numbness or weakness and complex regional pain syndrome.

Recovery varies by technique and patient. Most individuals can begin light activities within days and gradually resume normal tasks over weeks. Full recovery and improvement in numbness or night-time symptoms may take several weeks to months, with occupational or hand therapy sometimes recommended to optimize function and scar healing.

Outcomes are generally favorable, with many patients experiencing relief of daytime numbness and nocturnal symptoms. While most improve, a minority may retain some symptoms or require additional treatment.