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Cosmetic SiteEndoscopic Carpal Tunnel Release
What is Carpal tunnel syndrome?
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Carpal tunnel syndrome is a situation in which a nerve is compressed in the
wrist. The affected nerve, the median nerve, passes down the forearm through
a tunnel in the wrist. When it becomes tight in this tunnel either due to acute
injury, a culmination of multiple minor injuries, or the effects of normal
wear and tear, aging, and possibly arthritis, the nerve begins to dysfunction.
This causes numb tingly feelings in the thumb, index, and long fingers and
perhaps part of the ring finger. It may cause aching in the palm and forearm.
In severe cases, the muscles of the thumb will wither and the sensation in
the involved fingers will be decreased. In some cases, a specialized test called
a nerve conduction velocity is ordered to evaluate for the disease and its
severity.
What are the treatment options?
The treatment in all but more severe cases is to wear splints for the wrist
that prevent acute flexion and extension. These are usually worn while the
patient sleeps so that they do not interfere during their day‑to-day
activities. Medications that fight inflammation are also used sometimes.
For failure of conservative measures, surgical options are entertained. The
endoscopic release is a newer technique that has been widely used for about
ten years now, at least in our practice. We were some of the first physicians
in Kansas City to use the procedure and have quite an extensive experience
with the endoscopic method. In this operation two small incisions are made,
one at the wrist and one in the palm. The apparatus is placed in position.
The apparatus is about half to two-thirds the diameter of a pencil and contains
a knee arthroscope. This device gives us a picture on a television screen.
Using the device we visualize the band that forms the tight roof to the carpal
tunnel and using tiny instruments under direct visualization from the camera
we divide the band in two. This band opens up, decreases the tightness in the
carpal tunnel, and heals back again leaving a larger tunnel.
As with most all hand and upper extremity surgeries, patient compliance with
postoperative therapy is key to maximizing results.