The carpal tunnel is a kind of inextensible tunnel in the palm of the hand composed behind the carpal bones and in front of the anterior annular ligament of the carpal bone. It passes through the flexor tendons of the fingers, nerves and especially the median nerve. Carpal tunnel syndrome is a compression of the carpal tunnel responsible for irritation of the median nerve. This syndrome is more frequent from the age of 50, and affects women more. About 11% of women and 3.5% of men.
Carpal tunnel syndrome causes numbness and tingling in the fingers and a loss of muscle strength in the wrist and hand.
• Constraining postures for the hand
• Repeated wrist and forearm movements for extended periods of time.
• Movements that require a significant force in the hand.
Other possible causes are wrist injuries, wrist arthritis and neurological damage as a result of diabetes. For the moment, it is impossible to prove whether computer work can contribute to the problem.
Duration of hospital stay
The discharge can happen the same day.
Average length of stay
Follow-up is necessary to remove stitches.
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Wrist and hand radiography is not always mandatory. It is used to detect a narrowing of the bone root canal. X-rays of the cervical spine are sometimes requested to eliminate compression upstream or associated with wrist compression.
The electromyogram or EMG measures the electrical influx transmitted by the median nerve. The recording studies the sensitive and motor conduction rate of the nerve. This examination confirms the diagnosis to locate the level of compression and look for an abnormality on the other nerves of the arm.
The procedure is systematically started with medical treatment which consists of corticosteroid infiltration and/or the placement of a relief splint. Its effectiveness is limited in time: 2 to 3 months. Infiltration should not be repeated too often.
The only effective treatment is surgery. The earlier it is practiced, the better the results and the lower the risk of recovery.
Surgery consists of decompressing the contents of the carpal tunnel by opening the anterior annular ligament in the open air or by endoscopic means. The procedure is most often performed endoscopically because the consequences are faster and the risks much lower.
By endoscopy, the incision is transverse, 10mm long in a fold.
After the procedure, the night tingling usually disappears after the first night. On the other hand, when there was a decrease in sensitivity during the day, the symptoms often disappear only after several months, due to the slow recovery of the nerve.
You go out that same evening with a pain treatment prescribed by the anaesthetist, without any immobilization. You should move your fingers as normally as possible. You will see the surgeon again at 1 month for a check-up.
In the case of manual work, a work stoppage of 3 to 4 weeks is usual. Ligament healing is usually done in 6 weeks.
The sensitivity of the palmar region to pressure persists for 3 to 6 months.
A decrease in hand strength also persists for 3 to 6 months.
The patient keeps the large bandage for a week without getting it wet and avoiding heavy efforts. It is necessary to move the fingers as normally as possible.
It is normal to feel a little sore on the first day after the operation. These pains disappear by taking a common painkiller. The pain of the procedure disappears in 1 to 2 days.
MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.
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