Carpal tunnel syndrome (CTS)

Overview
Operation: 30-60 minutes
Anesthesia: local anesthesia
Duration of stay: day clinic or inpatient 1 night
Suture removal: after 14 days
Healing time: 2 weeks

Carpal tunnel syndrome describes a narrowing of the hand median nerve (nervus medianus) in the carpal tunnel inside the carpal bone. The most common carpal tunnel syndrome occurs between the ages of 50 and 60. The constricted nerve causes great pain over time and restricts the quality of life of patients in many areas. Like most nerve compression syndromes, however, carpal tunnel syndrome can be treated very well surgically. The earlier the treatment, the higher the chance of complete recovery of the affected nerves. Dr. Matiasek has many years of experience in the field of microsurgical plastic surgery and is looking forward to helping you regain more zest for life.

What are the symptoms of carpal tunnel syndrome?

Carpal tunnel syndrome describes a narrowing of the hand median nerve (nervus medianus) in the carpal tunnel inside the carpal bone. The most common carpal tunnel syndrome occurs between the ages of 50 and 60. The constricted nerve causes great pain over time and restricts the quality of life of patients in many areas. Like most nerve compression syndromes, however, carpal tunnel syndrome can be treated very well surgically. The earlier the treatment, the higher the chance of complete recovery of the affected nerves. Dr. Matiasek has many years of experience in the field of microsurgical plastic surgery and is looking forward to helping you regain more zest for life.

What are the symptoms of carpal tunnel syndrome?

The carpal tunnel syndrome initially manifests itself as a feeling of numbness in the area of the first three fingers or a tingling sensation in the wrist area. The complaints usually first appear at night and only become apparent during the day over time. Eventually, as the damage progresses, there is persistent pain in the wrist, which can radiate into the arm. The pain can get so bad that people can no longer even hold a cup. It is therefore essential to start treatment for carpal tunnel syndrome as early as possible. If the disease is already well advanced, the fingers can become completely numb. Due to the limited mobility of the affected hand, muscle wasting and a loss of strength in the thumb area also occur.

What are the causes of carpal tunnel syndrome?

There are many causes of carpal tunnel syndrome. For example, unusual, chronic movements of the hand, a fracture or various underlying diseases can trigger swelling in the area of the carpal tunnel. The canal through which the median nerve runs is narrowed and the median nerve is subjected to constant pressure, which causes typical wrist pain. People who constantly make the same movements with their wrist as part of their job are particularly prone to carpal tunnel syndrome. Because of their hormonal balance, women are more often affected than men. Diabetes, pregnancy, arthritis, tendinitis, hyperthyroidism and hormonal fluctuations also increase the risk of developing carpal tunnel syndrome.

How can carpal tunnel syndrome be treated?

In the initial stage, patients are prescribed pain-relieving tablets and a special splint that patients can use to keep their hand as steady as possible, especially at night. Treatment with cortisone injections can also help alleviate the pain in mild forms of carpal tunnel syndrome. If this conservative treatment shows no lasting success, surgery should be considered. As part of the procedure, the carpal ligament is severed, which leads to immediate postoperative pain relief.

What do I have to consider before treating carpal tunnel syndrome?

It is important to Dr. Matiasek to first have a detailed consultation with his patients in order to get an accurate picture of your symptoms and to be able to work out an optimal treatment plan. Here, Dr. Matiasek also informs you about all possible risks and complications of the treatment and is happy to answer all your questions. During the conversation, you will be advised, among other things, to stop taking blood-thinning medication and sleeping pills about two weeks before the procedure. You should also avoid nicotine and alcohol during this time. You should have the last meal at least six hours before the operation. In this way you are optimally prepared for the operation.

What is the treatment for carpal tunnel syndrome?

Carpal tunnel syndrome is treated under local anesthesia and usually on an outpatient basis; you may have to expect an inpatient stay. There are three types of surgery for permanent relief from the pain of carpal tunnel syndrome. First there is the open method, in which an incision is made on the inside of the wrist in order to gain direct access to the carpal ligament. With the half-open method, the procedure is similar, only here the cut is smaller. The endoscopic method is the third option. Two smaller cuts are made and a small camera, the endoscope, is used. This is inserted into the resulting opening, while the carpal ligament is severed through the other incision. 

After cutting the carpal ligament, Dr. Matiasek closes the wound and puts on a tight bandage. This protects the surgical wound and stabilizes your wrist at the same time. Your freedom of movement is somewhat restricted, but your wrist can heal optimally. Which method is ultimately carried out is decided individually for each patient. The decision is of course not up to Dr. Matiasek alone. After he has explained all the advantages and disadvantages of each technique and made his recommendation, he will work out the final treatment plan with you. Thus, you can decide for yourself what you feel most comfortable with

What complications can arise in the treatment of carpal tunnel syndrome?

An operation to correct the carpal tunnel syndrome is extremely promising and essential in order to be able to use the affected hand again without pain. However, like any procedure, it involves risks. Possible risks include bleeding, persistent numbness in the wrist due to nerve damage, infection of the wound, decalcification of the bones, swelling of the soft tissues, and impaired wound healing. However, Dr. Matiasek can assure you, based on his many years of experience, that the procedure is comparatively low-risk and that such complications are extremely rare. Immediately after the operation, you will notice slight swelling, redness and bruising in the surgical area. However, these symptoms will go away on their own within a few days and are nothing to worry about. For the relief of post-operative pain and swelling, Dr. Matiasek advises his patients to cool the affected wrist as often as possible.

What is the prognosis for carpal tunnel syndrome?

The chances of success for an operative treatment of the carpal tunnel syndrome are very good. By cutting the carpal ligament, it can be ensured that the pain in your wrist is significantly reduced and, in the best case, it will disappear completely immediately after the procedure. About three months after the treatment, you should be able to use your hand again without restriction and you will be pain-free. In most cases, a single operation for carpal tunnel syndrome is sufficient to provide lasting pain relief. However, it can happen that a follow-up operation is necessary due to renewed scarring in the wrist area or because of numbness or existing muscle wasting that cannot be revised due to long-term untreated damage to the hand median nerve.

If you have any questions or are interested in treating your carpal tunnel syndrome, please do not hesitate to contact Dr. Matiasek and his team. Dr. Matiasek looks forward to welcoming you to his practice and helping you regain a better quality of life.

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