Complications after carpal tunnel surgery

Carpal Tunnel Surgery: An Overview

Carpal tunnel surgery is a surgical procedure performed in order to eliminate the symptoms caused by the compression of the median nerve in the hand. This medical condition, called carpal tunnel syndrome, 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, carpal tunnel syndrome. Carpal tunnel syndrome is typically treated with a combination of exercises and rest, and surgery is the last resort for all patients who simply cannot benefit from conservative treatment.

The surgery has rather high success rates. 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 in patients who have undergone carpal tunnel surgery include nerve damage. This complication causes tingling sensations and numbness, much like carpal tunnel syndrome itself. 

Infection, excessive scarring, pain in the operated area, stiffness of the wrist, incomplete release of the ligament and loss of some wrist strength are further complications or side effects of carpal tunnel surgery. Numbness is usually temporary but it may also be a permanent complication of the surgery. Furthermore, pain may bother patients only for several months after the surgery and there is also a chance of chronic pain which only points to failure of the procedure. If the pain lingers, a patient may require a further operation to correct the issue. 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.

Carpal Tunnel Surgery: Surgical Failure and Recurring Symptoms

External or internal necrolysis is performed in severe cases of scarring. The surgeons may sever (cut) the nerve responsible for pain in these cases. Unfortunately, necrolysis prolongs 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.