Wrist Problems Solved at Nebraska Hand and Shoulder Institute

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Endoscopic vs. Open Carpal Tunnel Release Pictures 

Carpal tunnel volume increases about 25% with carpal tunnel release surgery. So the net effect of carpal tunnel release surgery is to take pressure off the median nerve by widening the carpal tunnel. The endoscopic technique does so with less tissue damage because only two layers (transverse carpal ligament and deep palmar aponeurosis) rather than four layers are released.

Nebraska Hand and Shoulder  vs  Nebraska Hand and Shoulder
Image showing the minor incisions used with the scope procedure.    The open carpal tunnel release that requires an extended period of recovery.

 

Traditional open surgery releasing four tissue layers, when only the transverse carpal ligament and the deep palmar aponeurosis are causing the problem, is a little bit extreme. Regardless of the size of the incision, traditional open carpal tunnel release ("filet-of-wrist") done by an incision in the palm of the hand tends to keep a person off the job or in a diminished capacity for 6 to 12 weeks or more. Open carpal tunnel release has been associated with many side effects including sympathetic dystrophy or complex regional pain syndrome (CRPS), an unappealing visible scar, wound separation, pain from damage of the palmar cutaneous nerve, and recurrence.

CTRC a Division of NHSI, PC

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