Carpal tunnel surgery

Carpal tunnel syndrome is a pathology of the hand and wrist caused by compression of the median nerve as it passes through the wrist. This compression can cause pain, tingling and loss of sensation in the first 3 fingers, as well as hand weakness. Several factors can contribute to this condition, including repetitive activities, chronic diseases such as diabetes, and physiological conditions such as obesity or pregnancy. Diagnosis is usually confirmed by a clinical examination and an electroneuromyogram (nerve conduction study) performed by a neurologist.

Carpal tunnel release is recommended for patients with persistent pain symptoms, particularly at night, despite conservative treatment (night rest splints and infiltrations). Patients with neurological disorders on clinical examination (numbness or weakness) and electrophysiological abnormalities on ENMG are ideal candidates for carpal tunnel surgery.

Preparation for carpal tunnel surgery begins with an assessment of your general health with your surgeon, as well as your history and current medication. It is recommended that you stop smoking and follow specific instructions before the operation. Dr. Bejic will provide you with detailed information on the management of medications, particularly those that could affect blood coagulation (blood thinner).

Carpal tunnel surgery is performed on an outpatient basis at the Leman Hand Clinic, with rapid overall management (less than 2 hours). After a locoregional anaesthetic by Dr. Bejic, surgery is performed via a 2-3 cm mini-incision at the heel of the hand, opening the carpal anterior annular ligament and decompressing the median nerve. The flexor synovitis is removed to free the nerve. The procedure takes 15 to 20 minutes. After receiving post-operative instructions and a snack, the patient can return home.

Like all surgical procedures, carpal tunnel surgery carries general risks: infection, bleeding and algodystrophy (swollen, red and painful limb with hypersudation). Specific complications include painful scarring for several weeks and persistent pain in highly inflammatory forms, requiring anti-inflammatory treatment.

However, these complications are very rare, and the vast majority of patients recover very well with no major problems. It is important to follow the post-operative instructions provided by your hand surgeon to minimize these risks and ensure optimal healing.

Recovery from carpal tunnel surgery varies, but most patients can return to light activity within a few days. Full recovery with resumption of normal activities can take from a few weeks to a few months. Rehabilitation by an occupational therapist is proposed in certain cases, depending on the patient’s progress and needs. It is important to follow your surgeon’s advice regarding care of the carpal tunnel scar, to avoid infection and promote rapid healing.

Results are generally very satisfactory. Most patients experience a quick relief of finger tingling, enabling them to sleep again without being awakened by painful symptoms, and to gradually resume their daily activities. Hand grip strength recovers after 3 months.

Carpal tunnel surgery brings a significant improvement in quality of life. Recovery of finger sensitivity and strength depends on the age and severity of median nerve compression during carpal tunnel surgery. Sometimes, nerve recovery is not complete.