When a patient is planning to under carpal tunnel surgery, there are several types of surgeries available. These include traditional open release, mini-open release, and endoscopic release. Hand surgeons continue to debate the pros and cons of each technique. The various techniques have been compared in scientific studies, and the long-term results and complication rates are similar between the procedures. Less-invasive techniques result in less pain in the short-term than the traditional open approach. The most important aspect of the procedure is releasing the transverse carpal ligament while avoiding complications. Surgeons use the procedure that has worked well in their hands, which they know they can perform safely.
I have used the limited-open carpal tunnel release since 2010. This involves an incision in the palm measuring about an inch long. The surgery can be performed as an outpatient with local anesthesia (numbing medicine) and oral Valium. Most patients treated with this technique do not require an anesthesiologist. At the end of surgery, soft bandages are placed to protect the incision, and I ask patients to change the bandage in 3-5 days. Afterwards a small bandage can be used to cover the incision site until it is fully healed. I advise patients to use their hand lightly over the next 2-3 weeks and “let pain be your guide” on gradually increasing activities. Stitches are removed in the clinic about 10-14 days post-op. After surgery, most patients are pleased with the improvement in the numbness and painful tingling symptoms. Surgical-site pain and scar tenderness gradually decrease over a few weeks. Most patients regain function and range of motion on their own without formal hand therapy.
See picture below of a patient of mine who underwent carpal tunnel release 6 weeks ago on the right hand and 2 weeks ago on the left. Please call the Raleigh Hand Center at 919-872-3171 if you would like to be evaluated by a hand and arm specialist in Raleigh, NC