Carpal Tunnel Release

Pre-Operative Preparation

Median nerve conduction delay at the level of the wrist should be shown on electromyographic studies/

Anaesthesia

General, local or regional anaesthesia. A tourniquet is applied to obtain a bloodless field and a malleable lead hand may be used to stabilise the hand.
Incision: Is curved from the ulnar border or palmaris longus tendon, where it crosses the wrist crease to extend into the midpalm

Procedure

  • The incision is deepend until the flexor retinaculum is reached.
  • Care is taken not to injure the superficial palmar branch of the median nerve.
  • The middle of the fibrous flexor retinaculum is divided longitudinally. Great care is taken not to injure the median nerve which may be protected with a dissector.
  • The retinaculum is fully divided to release the nerve and it may also require freeing from adhensions.
carpal_tunnel

Closure

The skin only is closed & the hand is dressed in the position of function.

Postoperative management

Start hand physiotherapy early.

Main Postoperative Complications

Nerve damage or failure to release the median nerve sufficiently.