Carpal tunnel syndrome

This is the most classic procedure for carpal tunnel surgery, and it is still the most commonly performed worldwide. The surgeon makes an incision in the palm of the hand (approx. 3 to 4 cm long) over the carpal tunnel ligament. The surgeon carefully opens the ligament so that the middle nerve is no longer pinched. The surgeon then closes the skin with some sutures. You will be given a hand bandage. After surgery, you may move your hand immediately.

The hand surgeons at Maria Middelares are highly experienced in this minimally invasive surgical technique. With this less invasive method, a small hole is made in the skin of the wrist crease. The carpal tunnel ligament is then opened from the inside (using a camera) with an endoscopic blade. Afterwards, the skin should not be closed with sutures. The wound heals on its own after a few days. After surgery, you may move your hand immediately. This technique is characterised by a very rapid recovery of the patient.

This technique is the least invasive of the three surgical techniques. The procedure is done through a minimal incision in the wrist crease, which requires no sutures afterwards. However, not everyone is eligible for this type of surgery. This can be discussed with your physician during the consultation.

On the day of your admission, come to the hospital at the appointed hour having fasted and sign in with your identity card via one of the e-kiosks in the atrium (entrance hall).

You get a ticket via the e-kiosk with a tracking number on it that is shown on the digital screens in the waiting area. A staff member will complete your file and you will receive an identity bracelet with your last name, first name and date of birth. After that, your admission will continue through the OR reception lounge.

You will be prepped for surgery in the operating facilities. The procedure is usually done under local anaesthetic. The anaesthetist will visit you to administer this. Feel free to ask any further questions you may have about the anaesthesia or the procedure.

After the procedure, you will be taken to our pleasant recovery lounge. The nurse will checks your vital parameters while you rest and recover from the surgery. This procedure promotes a quick and smooth discharge, allowing you to leave the hospital easily.

A compression bandage or cast may be applied to prevent excessive swelling. If the above advice does not help, you can loosen the elastic bandage or remove the hand bandage. The elastic bandage in an open cast can also be loosened.

The post-operative hand bandage will absorb any potential bleeding. Elevating the hand and applying ice can also help. Anti-inflammatory medication is possible, but it must be taken in consultation with your physician.

This complication occurs very rarely, but it occurs more frequently in smokers and diabetics. Contact your physician or the A&E in case of sharply increasing pain, fever (>38.5°C), a festering wound or increasing and spreading redness.

Very rarely, a temporary loss of sensation in the fingers may occur.

• Open carpal tunnel release: in 0.49% of patients
• Endoscopic carpal tunnel release: in 0.19% of patients

You had an incision of approx. 3 to 4 cm in length on the palm of your hand. This was closed by sutures and covered with a hand bandage.

You may leave this hand bandage in place until your first follow-up appointment.

The sutures should be removed 12 to 14 days after your procedure. You can contact your GP for this.

You can shower after your first check-up with a water-resistant patch.

The procedure is performed with a minimal incision of about 1 cm. The incision is made following Langer's skin lines, which ensures minimal scarring.

This incision is left open and covered with a hand bandage. The advantage of this is that any post-operative bleeding can be naturally absorbed by the bandage, and there will be no need to remove sutures.

Your bandage may remain closed until your first check-up, after which it will be replaced with a waterproof plaster. This plaster can remain in place for up to 10 days after the procedure and should only be replaced if it becomes soiled or comes loose.

If there is increasing redness or persistent wound fluid, or if you have concerns about your wound, contact the Orthopaedic Secretariat or your GP for a wound evaluation.

It is very important to move your fingers and thumb as normally as possible after the procedure. To do this, close your hand completely with the fingers pushed into the bandage. Afterwards, stretch the fingers again.

This ensures good circulation and has a beneficial effect on pain. It is normal for this to feel stiff for the first few hours and days after your procedure.

Nerve gliding exercises should be performed to prevent nerve adhesion in the post-operative scar tissue.

A good exercise involves stretching the arm and bringing the hand back until you feel the nerve stretch into the fingers. Simultaneously turn your head to the other side for maximum stretching.

As mentioned earlier, rapid mobilisation is crucial to your rehabilitation. Still, there are some limitations, namely combined forceful bending movements of the wrist and fingers. These can cause a sharp pain because the flexor tendons can get caught between the split carpal ligament.

An example of this movement is carrying a heavy shopping bag or intimate hygiene after going to the toilet. For these tasks, it is best to use your other hand.

These movements should be avoided for 4 weeks.