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Carpal Tunnel Surgery

Open Release
Open release carpal tunnel surgery is the traditional procedure used to correct carpal tunnel syndrome. This surgery consists of making an incision up to two inches in the wrist and then cutting the carpal ligament to enlarge the carpal tunnel. Open carpal tunnel release is generally done under local anesthesia on an outpatient basis, unless there are unusual medical considerations.
 
Endoscopic
Endoscopic carpal tunnel surgery may allow faster functional recovery and less postoperative discomfort than traditional open release surgery. The surgeon makes two incisions (about ½" each) in the wrist and palm, inserts a camera attached to a tube, observes the tissue on a screen, and cuts the carpal ligament (the tissue that holds joints together). This two-portal endoscopic surgery, generally performed under local anesthesia, is effective and minimizes scarring and scar tenderness, if any. One-portal endoscopic surgery for carpal tunnel syndrome is also available.
 

Risks With Carpal Tunnel Surgery

As with all medical procedures, some risks are involved in carpal tunnel surgery (see Complications of Carpal Tunnel Release). These risks may involve:
 
  • Nerve damage
  • Infections
  • Allergic reactions
  • Complications in people who have diabetes.
     
Nerve Damage
The median nerve typically runs just underneath the transverse carpal ligament. After it passes through this ligament, it tends to branch off into many smaller nerves. Each of these branches allows for a certain function to occur.
 
Your doctor is well aware of these variations in nerve branch locations, and the techniques used during carpal tunnel surgery maximize the protection of the median nerve and its branches. However, because of these variations, in rare instances, it is possible to cut this nerve or its branches during the surgery. This can result in loss of feeling or strength in the palm, thumb, or fingers.
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