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Carpal Tunnel Surgery - Overview

Carpal tunnel surgery is a procedure performed in order to eliminate the symptoms caused by the compression of the median nerve in the hand. This medical condition is rather painful and it may also affect normal functions of the hand. The carpal tunnel is located at the foundation of the hand. The median nerves run through the carpal tunnel. Any irritation or swelling of the tendons which run through this tunnel together with the median nerve cause its compression and consequent symptoms of the disease. The surgery is the last resort for all the patients who simply cannot benefit from conservative treatment.

The surgery is rather successful. However, certain factors may interfere and reduce the chances for success. The surgery may not be so effective in elderly patients, patients with severe preoperative symptoms, patients engaged in heavy manual labor (for example manipulating with vibrating tools), patients with very poor nerve conduction results prior the surgery, patients suffering from terminal renal failure who are on hemodyalisis, alcoholics and patients with poor mental status.

Complications after Carpal Tunnel Surgery

Even though this surgical procedure is considered very successful there are several complications and the very treatment modality may fail. The most common postoperative complications include nerve damage which features with tingling sensations and numbness, infection, excessive scarring, pain in the operated area, stiffness of the wrist, incomplete release of the ligament and loss of some wrist strength. Numbness is usually temporary but it may also be permanent complication of the surgery. Furthermore, pain may bother patients only for several months after the surgery and there is also a chance of permanent pain which only points to failure of the procedure. If the pain lingers the patients may require being re-operated. Loss of some wrist strength affects approximately 10 % of all patients. This complication particularly bothers people whose jobs require high amounts of force to the hands and wrists.

Surgical Failure and Recurring Symptoms

External or internal necrolysis is performed in severe cases of scarring. The surgeons may severe the nerve responsible for pain. Unfortunately, necrolysis prolonges the recovery time, and it also increases necessity for repeated surgeries. Necrolysis is most commonly performed in patients who show no signs of recovery three months after the surgery.

Recurrent carpal tunnel syndrome may be treated with muscle flaps and fatty tissue taken from other parts of the body. These structures are implanted at the site of the nerve injury. The flaps provide with the development of new blood vessels and they represent the basis for nerve regrowth.

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