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OAS Health Blog

New Carpal Tunnel Syndrome Management

August 2, 2013

Carpal tunnel Syndrome (CTS) is a condition of the hand that causes numbness in the fingers and a painful ache in the hand and wrist. Symptoms may occur after or during activities and can frequently occur at night. Numbness, tingling, burning and weakness are all common complaints.

At the middle of the wrist there is a space created by the bones of the hand and a thick ligament called the transverse carpal ligament. Passing through the space to the fingers is a major nerve (median nerve) and nine tendons. When there is swelling in the carpal tunnel, pressure will build and compress the median nerve. In most cases the cause of this condition is unknown, but swelling can be associated with diabetes, thyroid problems, arthritis, fractures and fluid retention secondary to pregnancy. Repetitive motion that involves grasping and squeezing of the hand can also aggravate symptoms.

Treatment will initially be oriented towards decreasing the swelling by eliminating repetitive motions, wearing night splints or using non steroidal anti-inflammatory drugs (NSAIDS).

When conservative treatment fails surgical treatment is then recommended. Previous surgical treatments involved an open operative procedure in which an incision of 4cm is made in the crease of the palm. The incision is carried down through skin, fat and connective tissue until the transverse carpal ligament is seen. The ligament is then incised to release the pressure on the median nerve. Sutures are used to close the wound and a splint is applied. This procedure is effective but patients do have another option that involves a much quicker recovery and rehabilitation. It involves a smaller scar (1cm) which avoids deep cutting in the palm and lessens post operative pain.

Orthopaedic Associates of Stamford is Pleased to offer Endoscopic Carpal Tunnel Surgery. During Endoscopic surgery a small camera is mounted on a surgical instrument called Smart Release CTRS created by Micro-Aire. The device is inserted through a small incision into the carpal tunnel and a video monitor allows the surgeon to precisely release the transverse carpal ligament. This is performed using a small retractable blade without opening up the entire palm. This results in effective treatment with less post operative pain, minimal scar and allows patient to resume normal activities in a quicker period of time.

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