FREQUENTLY ASKED QUESTIONS
Q. Fasting before Operation?
A. Nothing to eat or drink at least 6 hours before the operation.
Q. Anaesthetic?
A. General anaesthetic, arm block or local anaesthetic can be used.
Q. Duration of Operation?
A. About 30 minutes.
Q. Pain?
A. Very little. Usually, local anaesthetic is administered at the time of surgery. You will be given oral pain relief to take home with you.
Q. Will I be in a plaster after the operation?
A. No. If done with the endoscope, there will be no plaster and the bandage may be removed in 2 days and the wound dressing removed after 5 days. Open releases will be in bulky dressing for a week and a wound dressing for 2 weeks.
Q. When can I return to sport or heavy labour?
A. After endoscopic release, many people return to sport or heavy duties within a week. The wound can get wet immediately as the dressing is waterproof. Open releases must wait until after suture removal.
CARPAL TUNNEL SYNDROME
WHAT IS IT?
The carpal tunnel is an arch of bones in the wrist, which is converted into a tunnel by a strong carpal ligament, which connects each side of the bones. Through this tunnel run the tendons that move your fingers and thumb and a major nerve that provides sensation in most of the fingers and strength to the thumb.
If the size of the tunnel is reduced (as when the wrist is flexed) or the contents swell, the pressure in the tunnel increases. The first structure to be affected is the nerve, which is very sensitive to pressure.
If left for many months, permanent damage can be done to the nerve, leading to loss of muscle strength and fingertip sensation.
Close-up Showing Compression of the Median nerve
WHAT CAN BE DONE?
If the problem is identified early, it can often be resolved with injections or splints.
However, if the problem has persisted over many months, or is present day and night, an operation to relieve the pressure may be required. This can be performed via a small incision using an endoscope, or through a full, open incision.
WHAT ARE THE RESULTS OF OPERATION?
Usually, pain and waking from the nerve compression is relieved immediately. The finger numbness and pins and needles may be slow to recover, as this requires the nerve to heal. Muscle wasting may not recover, but should not worsen after surgery.
Endoscopic releases have very low risks (comparable with open releases, in the hands of an experienced surgeon), and are less painful and return to work is earlier. Both hands can be operated on at the same time, with much less inconvenience.
After endoscopic carpal tunnel release, often patients can return to desk duties the next day, and have returned to heavy manual work within a week. Using the hands after this surgery actually speeds up the recovery process.
