Open Carpal Tunnel Decompression
WHAT YOU NEED TO KNOW:
Open carpal tunnel decompression is surgery to take pressure off of the median nerve in your wrist. This is done through an incision on your palm that may extend to your wrist.
WHILE YOU ARE HERE:
Before your surgery:
- Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
- Local anesthesia: This injection is put into the skin of your palm. It is used to numb the area and dull your pain. You may still feel pressure or pushing during surgery.
- Regional anesthesia: This medicine is put into an IV in your arm. A pressure cuff is first put around your arm. After the cuff is tightened, the medicine is put into the IV. The cuff keeps the medicine in the arm so you will not have pain.
- Your hand will be placed on a table, cleaned, and covered with a sheet. A cuff called a tourniquet may be put around your upper arm to decrease bleeding during your surgery.
During your surgery:
- Your caregiver may do a regular open carpal tunnel surgery or a limited open carpal tunnel surgery. During regular open carpal tunnel surgery, your caregiver will make an incision on the palm of your hand. This incision may extend to your wrist. If your caregiver does a limited open carpal tunnel surgery, then he only makes incisions on your palm. Your caregiver uses special tools to help him see and protect the nerve.
- Your caregiver will cut the carpal ligament to release pressure on your nerve. The carpal ligament is a band of tissue that connects joints in your wrist. If the tissue covering the nerve is thick, your caregiver may decide to remove it. He may also remove scar tissue or anything else that may be pressing on your carpal tunnel nerve. The incisions are closed with stitches and covered with bandages. Your caregiver then takes off the tourniquet.
After your surgery:
Your caregiver may put a splint on your wrist to keep it from moving. You will be taken to a room where you will stay and rest until you are fully awake. Your caregiver may ask you to move your fingers soon after your surgery. Do not try to get out of bed until your caregiver says it is okay.
- Movements: Your caregiver may give you exercises for your hand and wrist. These may include range of motion exercises where you move your fingers up, down, or sideways. Do not use your wrist to pull or lift anything heavy until your caregiver says it is okay.
- Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.
- Elevate: Your caregiver may tell you to raise your arm at different times during the day. Raising your arm may help decrease your pain.
- Ice: Your caregiver may want you to put ice on your wrist and hand. This may help decrease your pain and swelling. Do not sleep with the ice pack on your wrist. Always follow your caregiver's instructions for how long to use an ice pack.
- Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- You may get an infection. Your skin may bruise. A thick, painful scar may form where you had surgery. You may get a trigger finger where your fingers are locked in a bent position. Surgery may cause long-term numbness or weakness in your fingers, hand, or wrist. Your symptoms may not go away, and you may need surgery again.
- Without surgery, the symptoms of your CTS may get worse. You may not be able to work or do things you normally do. The muscles in your hand controlled by the compressed nerve may become smaller. You may not be able to feel or move your wrist.