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CARPAL TUNNEL/DEQUERVAIN'S RELEASE
In carpal tunnel release surgery, the goal is to divide the transverse carpal ligament in two. This is a wide ligament that runs across the hand. It forms the roof of the carpal tunnel, and when the surgeon cuts across it (i.e., in a line with the ring finger) it no longer presses down on the nerve inside, relieving the pressure.
The two major types of surgery are open carpal tunnel release and endoscopic carpal tunnel release. Most surgeons historically have performed the open procedure, widely considered to be the gold standard. However, a growing number of surgeons now are offering endoscopic carpal tunnel release.
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| The carpal tunnel protects the median nerve and flexor tendons that bend the fingers and thumb. |
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| Carpal tunnel syndrome is caused by pressure on the median nerve traveling through the carpal tunnel. |
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| The ligament is cut during surgery. When it heals, there is more room for the nerve and tendons. |
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Open surgery involves an incision somewhere on the palm about an inch or two in length. Through this incision the skin and subcutaneous tissue is divided followed by the palmar fascia and ultimately the transverse carpal ligament. Endoscopic techniques involve one or two smaller incisions (less than half inch each) through which instrumentation is introduced including a synovial elevator, probes, knives and an endoscope used to fully visualize the underside of the transverse carpal ligament. The endoscopic methods do not divide the subcutaneous tissues or the palmar fascia to the same degree as the open method does.
All of the surgical options (when performed without complication) typically have relatively rapid recovery profiles (weeks to a few months depending on the activity and technique), and all usually leave a cosmetically acceptable scar.
DEQUERVAIN'S RELEASE
While a Carpal Tunnel Release procedure is being performed, if a surgeon notices inflammation and irritation of the tendons at the base of the thumb he or she may choose to also perform a DeQuervain's Relase. The goal of surgery is to open the compartment (covering) to make more room for the irritated tendons. Normal use of the hand usually can be resumed once comfort and strength have returned. Your orthopaedic surgeon can advise you on the best treatment for your situation.
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| De Quervain tenosynovitis of the first extensor compartment. |
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| Finkelstein test. Arrow indicates location of pain when test is positive. |
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| Surgery opens the sheath over the inflamed tendons. |
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CONDITIONS TREATED BY CARPAL TUNNEL/DEQUERVAIN'S RELEASE
SYMPTOMS TREATED BY CARPAL TUNNEL/DEQUERVAIN'S RELEASE
Difficulty gripping things
Pain on the thumb side of the wrist
Swelling on the thumb side of the wrist
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