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WHAT IS CARPAL TUNNEL SYNDROME?
Carpal Tunnel Syndrome is due to compression of a nerve in the base of the hand. The nerve goes through a tunnel in this region and is accompanied by the various tendons which move the fingers. The nerve is relatively crowded at the best of times and if it is crowded and pressed upon too firmly this produces pain and tingling in the hand and weakness of some muscles in the hand.
WHAT DOES THE OPERATION INVOLVE?
An incision is made on the palm of the hand near the wrist. It is usually about two or three centimetres long (about one inch). The wall of the carpal tunnel is released, releasing the pressure on the nerve. The wound is repaired with stitches which dissolve and do not require removal. The operation is usually done under a general anaesthetic in hospital provided that the patient is generally fit and healthy and has someone staying at home with them the night following the operation. They will not need to remain in hospital overnight.
The rate at which people heal following their surgery varies. In most people the hand is able to be used for light work within a week or so following surgery and usually returns to almost completely normal by about the sixth week. However on occasions the wound can remain painful and uncomfortable for much longer than this and on occasions discomfort in the hand can persist for as long as six months or so.
WHAT ARE THE RISKS INVOLVED? The operation itself is relatively minor and is not usually associated with major problems, although sometimes problems can occur. Like any wound on the body it is possible to develop an infection in the wound although this is uncommon. It is possible that some of the nerves or tendons in the hand may be damaged in the operation. It is rare for this to occur but when it does occur the resulting disability can sometimes be severe. Carpal Tunnel Release requires a general anaesthetic. Generally speaking anesthetics are safe these days but rarely problems can arise. Occasionally heart attacks or strokes can be triggered by this but this is rare and usually only occurs in people who are otherwise susceptible to this happening. There are a number of other potential complications which may occur and which may also be serious but the likelihood of these occurring is low.
WHAT HAPPENS AFTER THE OPERATION?
After the operation the hand is bandaged with cotton wool and a firm bandage over the top of the cotton wool. Although this prevents much movement in the wrist it makes the hand much more comfortable by preventing the movement around the cut. The bandage is usually wrapped on firmly in order to steady the hand but if it seems too tight it may be safely loosened so that the pressure on the hand is comfortable.
The pain in the hand afterwards is usually troublesome for the first day or so and usually requires pain killing drugs such as Panadeine or Aspalgin. The hand will generally be more comfortable if it is kept elevated higher than the heart.
The fingers often swell following Carpal Tunnel surgery. This is more likely to occur if the bandages are too tight of if the hand is left dangling. Frequent movement of the fingers will also help to control the swelling.
The fingers should be moved as much as possible following carpal Tunnel surgery in order to prevent stiffness in the fingers and in order to decrease the amount of swelling.
HOW QUICKLY CAN I START TO USE THE HAND AGAIN?
Generally speaking the hand will be too sore to use for any strenuous activity for the first week or so. However providing the pain is not unduly severe it will be quite safe to use the hand for light activities such as eating drinking doing up buttons etc during the first week. Once the wound has healed after the first week or so tasks requiring greater strength may be attempted. Generally speaking it is safe to use the hand for anything as long as the pain is not too severe. Most people will recover full use of the hand within the first six weeks.
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