Hand Surgery

Carpal tunnel release

Hands are often overlooked when they are functioning correctly, but when a debilitating condition like carpal tunnel syndrome arises, great care must be taken to treat them properly and to help restore function. The Plastic Surgeons at Niche Plastic Surgery have undergone specialised hand surgery training.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway in the wrist formed by small bones and a strong band of connective tissue. Within this fortified channel runs the median nerve and the flexor tendons that bend the fingers and thumb. Because the bones and tissue form a rigid boundary around the carpal tunnel, it is limited in its ability to expand in size.

Carpal tunnel syndrome develops when the median nerve becomes compressed within the tunnel. This can occur if the tunnel becomes narrowed or if tissues surrounding the flexor tendons swell, crowding and compressing the nerve.

What are the Symptoms of Carpal Tunnel Syndrome?

People affected by carpal tunnel syndrome may experience numbness, weakness, tingling, burning and pain in the fingers, hand, wrist or forearm. Many carpal tunnel sufferers report that their fingers feel swollen, although little or no swelling is apparent, and become difficult to use. Others notice weakness or decreased grip strength that makes it challenging to perform manual tasks.

Symptoms typically start gradually and become progressively worse. During the day, symptoms often occur when holding something or performing a task that requires the wrist to be bent for a prolonged period. At night, it is common to be awakened by symptoms after sleeping with flexed wrists. Moving or shaking your hands can sometimes help relieve your discomfort.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome usually arises from a confluence of factors. Repetitive hand and wrist motions may aggravate the tendons in the wrist and trigger swelling that compresses the median nerve. Activities that cause the wrist to maintain a position of extreme flexion or extension may also place pressure on the nerve. Heredity factors may also play a role, as well as pregnancy and certain health conditions. People working in any industry can be affected, but it is especially common in jobs that require repetitive wrist motions such as typing, sewing or manufacturing.

What is Carpal Tunnel Release Surgery?

Mild cases of carpal tunnel syndrome can be improved with rest, splinting, medication and occasionally steroid injection. In more severe cases, a surgical carpal tunnel release is required. Surgery is typically recommended when a patient’s symptoms are severe and persist despite attempts at conservative treatment.

Carpal tunnel release at Niche Plastic Surgery is performed as an open procedure, in hospital as a day case. An incision is made in the wrist and a portion of the ligament that makes up the carpal tunnel roof is divided. This decreases pressure in the tunnel, reduces swelling and allows nerve recovery to the fingers. After surgery the ligament fuses with more room for the median nerve to pass through.

What are the Risks of Carpal Tunnel Release Surgery?

Risks & Potential Complications for Carpal Tunnel Release Surgery include:

  • Scarring: Visible scars on the wrist or palm.
  • Infection: Risk of infection at the incision site.
  • Nerve Injury: Damage to the median nerve or other surrounding nerves.
  • Persistent Symptoms: Continued symptoms if the nerve has been significantly damaged.
  • Stiffness: Postoperative stiffness or reduced wrist strength.
  • Complex Regional Pain Syndrome (CRPS): A chronic pain condition that can develop after surgery.
  • Recurrence: Symptoms may return over time.

How Effective is Carpal Tunnel Release Surgery?

Most patients find their symptoms improve after undergoing carpal tunnel release. Surgery can provide relief from pain and numbness when other treatments, including splinting or repeated corticosteroid injections, prove ineffective. The length and extent of recovery from the procedure vary from patient to patient. Your outcome is dependent on a number of factors, including the adequacy of the surgery, the extent of any muscle wasting or nerve damage, your job and the presence of other conditions that affect hand or wrist, such as arthritis or tendonitis. Occasionally carpal tunnel syndrome can return, though recurrence following surgery is rare.

Who Should Consider Carpal Tunnel Release?

Early diagnosis of carpal tunnel syndrome that leads to treatment is ideal. If the condition is identified while symptoms are mild, nonsurgical treatments including splinting, lifestyle changes and corticosteroid injections can be effective short term solutions. Carpal tunnel release is the best treatment option if you are experiencing intense numbness, tingling or pain, or if you are experiencing a debilitating loss of function in your hand. Surgery may also be recommended to prevent ongoing irreversible damage in long-standing cases of carpal tunnel syndrome when muscle wasting has occurred.

Call us to Discuss Your Carpal Tunnel Release Treatment Options

Left untreated or unsuccessfully treated, carpal tunnel syndrome can worsen and take a severe toll on your professional and personal life. Niche Plastic Surgery is a provider of hand surgery in Melbourne. Our plastic and reconstructive surgeons use their extensive experience to offer treatment options for minimising pain and restoring function to your hands and wrists. To schedule a consultation, please contact Niche Plastic Surgery on 9853 9705.