Endoscopic Carpal Tunnel Release
Carpal Tunnel Syndrome (CTS) while becoming increasingly well known is often not well understood. Treatments for CTS are highly successful, but early diagnosis is very important to achieve the best results and avoid permanent damage.
CTS afflicts over 2.5 million Americans every year. The carpal tunnel is a space in the center of the wrist where the median nerve and nine tendons pass from the forearm into the hand. A very strong ligament forms a roof over the tunnel. When swelling occurs in the carpal tunnel, pressure is put on the median nerve, which supplies most of the fingers and thumb with feelings and movement. When pressure becomes great enough to compress the nerve, Carpal Tunnel Syndrome may occur.
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Symptoms
Common symptoms of CTS are numbness or tingling felt in the thumb, index, middle and ring fingers. Pain may be present in the fingers, hand and wrist that may extend up into the shoulder. Symptoms frequently occur at night and may be noticeable while performing daily activities. A weakening of the grip may become apparent along with a tendency to drop objects.
Causes
Repetitive use of the hands can cause swelling in the carpal tunnel. Activities that involve grasping, squeezing, or clipping may also be associated with the problem. Some medical conditions such as rheumatoid arthritis have bee found to be an actual cause of CTS. Other conditions such as hypothyroidism and diabetes may cause only symptoms of CTS.
Treatment
Conservative treatment options for CTS include:
- Reducing activities that cause continuous exertion or repetitive use of your hands.
- Keeping your wrist in a neutral position.
- Wearing wrist splints at night.
- Anti-inflammatory medication taken orally or injected into the carpal tunnel.
When symptoms are severe or do not improve with non-surgical treatments, surgery may be performed to enlarge the carpal tunnel by cutting (releasing) the ligament to allow more room for the median nerve.
Traditional open surgery and endoscopic surgery are two options for patients with CTS. During traditional open carpal tunnel surgery, an incision is made through layers of skin, fat, fascia, and muscle to identify and divide the transverse carpal ligament.
A new endoscopic procedure is now available as an alternative to traditional open carpal tunnel surgery. The procedure is performed using a device called the 3M Agee Carpal Tunnel Release System. It allows the release of the carpal ligament through a small incision at the base of the wrist. A small endoscope and camera project an "inside view" of the carpal tunnel onto a video monitor. The surgeon watches the screen and is able to precisely cut the ligament with a blade, simply by pulling a trigger.
Endoscopic Carpal Tunnel Release
Both open and endoscopic carpal tunnel surgery have the same goal - to ease the pressure on the median nerve by dividing the ligament and enlarging the carpal tunnel.
The main benefit of endoscopic vs. open surgery is a significantly shortened recovery period. Although individual results may vary, most patients return to normal daily activities within days after endoscopic surgery and return to work earlier that those who undergo the open method. Recovery of hand strength following open surgery can take weeks or even months while the palm heals.
There is less pain and scarring with the endoscopic procedure. Only a very small scar, concealed in a wrist crease, remains after healing.