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“Carpal tunnel release” is the surgical procedure performed for the treatment of Carpal tunnel syndrome to relieve the pressure on the median nerve. This widens the tunnel, creates more space for the nerve and thus releases the pressure on the nerve. The procedure can be performed using two different techniques open carpal tunnel release or endoscopic carpal tunnel release. In both the procedures the transverse carpal ligament that covers the tunnel is cut and both are aimed at relieving the pressure on the median nerve.
Carpal tunnel is a narrow passage, about an inch wide, surrounded by wrist bones. A nerve called median nerve passes through this tunnel. The nine tendons called flexor tendons also travel through the carpal tunnel. The nerve and the tendons are responsible for bending of fingers, index, middle and ring finger and thumb. The muscles at the base of the thumb are also controlled by these nerves. The covering of the tunnel is formed by string band of connective tissue and because of the stiff nature of the tissue it does not stretch much. Thus, the tunnel helps in protecting the nerve. Sometimes, the carpal tunnel gets narrowed or there is swelling of the tissue that surrounds the flexor tendon. This creates pressure on the median nerve causing symptoms of carpal tunnel syndrome. Certain positions for prolonged period of time and certain repetitive movements of hand can cause the condition.
In most patients with this condition the symptoms develop gradually over a period of time and in the initial stage they may be mild and on and off. As the condition progresses the symptoms may be severe, more frequent and may persist for longer period of time. Generally activities involving bending of wrists initiate the symptoms.
Diagnosis of the condition is made on the basis of
Carpal tunnel syndrome is an orthopaedic condition. An orthopaedic surgeon, a plastic surgeon or a neurosurgeon performs the surgical treatment for the condition. The stages may be initial stage and advanced stage.
There are surgical and non-surgical treatment options for treatment of carpal tunnel syndrome.If the condition is diagnosed in initial stage then non-surgical treatment can relieve the symptoms.
If non-surgical treatment fails to improve the symptoms then surgical treatment is the option. Having constant numbness and wasting of thumb muscles can cause irreversible damage to the median nerve. If pressure on this nerve is not taken off it can cause nerve damage. Surgery can prevent the damage. The decision of surgical treatment depends on the severity of symptoms.
In most patients the surgery is carried out on outpatient basis. This means the patient is discharged after the surgery or on the same day; hospital stay is not required. Anaesthesia may be local or general. In local anaesthesia only hand and arm becomes numb. In general anaesthesia patient is asleep during the procedure. In some cases light sedative may be given to the patient.
Carpal tunnel release is the name of the surgical procedure performed. This can be done in two different ways open carpal tunnel release or endoscopic carpal tunnel release.
The results of both the surgeries are similar. Each procedure has its own advantages. The selection of procedure depends on the condition and the doctor explains it to the patient.
As there can be complications with any other surgery carpal tunnel release surgery can also cause complications like bleeding, infection and nerve aggravation or injury. Certainly, doctors take utmost care to completely avoid or minimize them.
Outcome of the surgery is excellent in most patients. In most patients symptoms improvesoon after surgery. However, recovery may take longer time. It depends on severity of condition, patient’s age, general health and time period of symptoms. It may take several months to one year for complete recovery. There are conditions in which recovery may be slow like arthritis, tendonitis and long standing cases of carpal tunnel syndrome in which there is severe loss of sensation and wasting of muscle around the thumb base. Recovery may be partial in such patients.
Though very rare the condition, carpal tunnel syndrome may reoccur. In such cases additional treatment or surgery is possible.
If the symptoms are severe or the non-surgical treatment like lifestyle changes, immobilization, medications, and alternate therapies are not useful then definitely you are the perfect candidate for carpal tunnel syndrome surgery. Also if the muscles of your hand and wrist have become weak due to worsening of the condition then also surgical treatment can reverse your condition.
There will be some pain, stiffness and swelling after the surgery and this is perfectly normal. Minor pain and discomfort may be there in the palm for few weeks to few months. After surgery generally it takes 2-3 months to get grip and pinch strength.If condition of median nerve is poor before surgery case then it can take 6-12 months.
Success Rate of carpal tunnel surgery in terms of improvement of symptoms is about 90% and little less than 90% patients can do the jobs they were doing previously. You also can join your previous work after surgery.
Surgery for carpal tunnel syndrome helps in relieving the symptoms and prevents permanent nerve damage.
The cost of carpal tunnel syndrome surgery in India is less than 1/20th as that in USA, less than 1/4th as that in Mexico. The cost of this surgery is cheaper in Thailand (approx. ¼.5th of India) and Singapore (approx. 4/5th of India) as compared to India.
India has highly skilled and professional orthopaedic surgeons’ and world class hospitals. We at MedcureIndia have association with such institutes and work in collaboration with them with the vision to provide best treatment to each patient across the globe at most affordable cost.
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