Carpal Tunnel Surgery

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Carpal tunnel syndrome is a very common condition that results from compression of the median nerve at the wrist. It can occur for a variety of reason, the most common being swelling and inflammation in the fixed space around the nerve at the wrist. This can occur with age, injury, or from overactivity.

The most common symptoms include:

  • Numbness and tingling in the fingers
  • Pain
  • Waking at night due to discomfort

How does surgery work?

Carpal tunnel surgery involves freeing up the nerve from all fibrous bands at the wrist, where it is commonly compressed. This typically takes Dr. McInnes about 10 minutes of operative time and is done in the hospital under local anesthetic only. Most patients have no discomfort during the procedure, aside from the brief discomfort of the needle to anesthetise the area. After surgery they will have their hand wrapped with a tensor bandage over a dressing. Patients usually take this off after 5 days, and switch to a Band-Aid with a thin layer of polysporin.

What does surgery entail?

Like most Canadian plastic surgeons, Dr. McInnes performs carpal tunnel surgery almost every week. Patients come in the minor treatment area of the hospital 30 minutes prior to their procedure to get their paperwork done and then have their surgery under local anesthetic.

Consultation Process

Most patients are seen in the office first and subsequently booked in for their surgery in the hospital. Depending on the referring physician, your understanding of the procedure, and if you are able to complete the pre-operative checklist, your surgical consultation may be booked for the same day as your procedure, but this is rare. If this is the case, there is a possibility your surgery will be deferred if additional information is required (eg. X-rays, MRI) or if Dr. McInnes suspects a different diagnosis.

What can I expect after my surgery?

In short, patients can expect some mild/moderate discomfort at their surgical site after surgery. Most patients get sufficient pain control with Tylenol and Advil after surgery, and no antibiotics are routinely prescribed. Patients are advised to keep their hand elevated for the first few days after surgery. They will have a tensor dressing that is left on for about 3-5 days, before switching to a Band-Aid. It is common to have an achy feeling in the wrist after surgery. This usually lasts for a few weeks, but can last longer, up to 2-3 months. It is equally important to keep your fingers moving so they don’t get stiff.

How long do I need to be off work?

This varies depending on the patient and their occupation. Most patients require 2-3 weeks off from their job. Some go back much earlier, often on modified duties. Patients who perform heavy manual labour type jobs may require more time off work, such as 4 weeks.

Risks

  • Infection
  • Wound dehiscence
  • Persistent aching around surgical site
  • Decreased grip strength (usually mild)
  • Stiff fingers/wrist
  • Injury to median nerve