Hand Surgery

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

 

CARPAL TUNNEL SYNDROME

What is Carpal Tunnel?

Carpal bones of wrist were aligned to form a groove-shaped bed by their  sequence. The transverse ligament is lined at the top of that groove shape structure to cover and form carpal tunnel. The flexor tendons of the hand and median nerve passes through this tunnel.

What causes Carpal Tunnel Syndrome?

Carpal tunnel disease, a result of compression of the median nerve in the carpal tunnel at the wrist.

What  causes the compression of median nerve in Carpal Tunnel?

Some professionals like secretary, computer specialists,  and musicians have overloadinf on their wrists. It is known that overloading and repetative trauma at the wrist level cause transverse carpal ligament thickening. Thickened transverse ligament puts pressure on median nerve. Tenosynovitis of the flexor tendons and gangions in the carpal tunel may also increase the pressure in carpal tunnel. It also causes carpal tunnel syndrome. Carpal tunnel disease is also more common in patients with diabetes mellitus disease, hypothyroidism, gout and rheumatic diseases.

What are the symptoms of Carpal Tunnel Syndrome?

In Carpal tunnel disease, severe numbness and pain in the hands are the most important findings. Pain is felt worse particularly at night. Patients often express that they usually need to shake hands because of pain. Occasionaly pain may spread arm and shoulder. In advanced cases, patients may drop objects from their hands easily because of decrease in grip strength

How is diagnosis of Carpal Tunnel Disease made?

Carpal tunnel disease is diagnosed with physical examination and laboratory tests diagnosis, along with patient’s complaints. Upon Physical examination, the median nerve dermatome numbness, lack of sensation, tinnel sign over median nerve at the wrist level can be seen. EMG is performed for a definitive diagnosis in almost all cases.

What is the treatment of Carpal Tunnel?

The early stages of carpal tunnel wrist brace and pain killers can be successful. Intermediate and advanced stages of disease, treatment of carpal tunnel requires surgery.

How is the surgical treatment of carpal tunnel syndrome?

Open surgical treatment of carpal tunnel is performed with an open incision. Transverse carpal ligament is cut and the median nerve freed in the tunnel. Carpal Tunnel  Endoscopic surgery become popular in recent years.  Carpal Tunnel surgery does not require general anesthesia. Regional block or regional anesthesia would provide succesful carpal tunnel surgery. Patients were discharged on the same day.

About the author

Prof.Dr. Seref Aktas