Hand 2017-09-18T17:11:15+00:00

Carpal Tunnel Syndrom

Surgery is usually recommended for cases of CTS, when other treatments have failed to relieve symptoms. Surgery for CTS is known as carpal tunnel decompression or carpal tunnel release surgery and is performed on an outpatient basis, which means you will not have to stay in hospital overnight. During surgery the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist. A local anaesthetic is used to numb your hand and wrist, but you will remain awake throughout the operation. The surgery can be performed as open surgery, which involves making a single cut in the wrist, and is the traditional type of operation. This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.

Trapeziectomy

This surgery involves removal of a wrist bone (trapezium) for osteoarthritis (=wear and tear of joint) and sometimes involves reconstruction of one of the ligaments with a tendon graft. Surgery is done when other treatments have failed to relieve symptoms. Activity modification, splintage, pain-killers, steroid injections and physiotherapy are usually tried first. This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.

Dupuytren’s

A needle fasciotomy is also known as a needle aponeurotomy or a percutaneous needle fasciotomy (percutaneous means “performed through the skin”). It is usually performed as an outpatient procedure. This means you will not need to be admitted to hospital. You will be given a local anaesthetic that will numb your hand without making you lose consciousness. During the procedure, a sharp blade or a very fine needle will be inserted into the fibrous bands in the palm of your hand or your fingers. The blade or needle will be used to divide the cord under your skin. By dividing the thickened tissue, your surgeon will release the tightness in your hand that is forcing your finger to bend. The benefits of needle fasciotomy include: your fingers are less deformed, you recover more quickly compared to more extensive surgery, it is suitable for people who are unable to have more extensive surgery, such as the very frail or elderly, it has a low risk (around 1%) of complications. This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.

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