Open Carpal Tunnel Surgery

Open carpal tunnel surgery relieves pain caused by carpal tunnel syndrome - essentially a pinched nerve in the wrist. When non-surgical treatment options, such as such as bracing, anti-inflammatories, and corticosteroid injections, do not improve the symptoms of carpal tunnel syndrome, a carpal tunnel release may be performed to take the pressure off the nerve. There are two main techniques to accomplish this, open and endoscopic.  Although Dr. Donnelly performs both, his preference is the open approach.  He favors the open technique because it allows him to visualize the nerve, which decreases the risk of injury and confirms complete release.

Carpal tunnel release is one of the most common hand surgeries performed. It has been rated as one of the most satisfying and successful as well.  The surgery itself takes 10-15-minutes and is performed on an outpatient basis. Surgery can be done with the patient completely awake using a technique called wide-awake local anesthesia no tourniquet (WALANT), which involves just numbing the hand prior to the surgery.  Traditional sedation anesthesia can also be used.

How is open carpal tunnel surgery performed?

After local anesthesia is administered and the patient is comfortable, an open carpal tunnel release is performed using the following steps:

1. The surgeon strategically makes a less than 1-inch incision over natural skin lines on the palm to minimize visible scarring after surgery.
2. Surgical instruments are used to access and view the carpal tunnel ligament and the pinched nerve.
3. The ligament is carefully cut releasing the pressure off the nerve.
4. The incision is closed using sutures and a special suturing technique to limit wound complications.

After the incision is closed, a soft dressing is placed over it and a bandage is wrapped around the wrist. In most cases, there is no need for a hard splint or cast after surgery.