Carpal tunnel syndrome
Overview of the treatment
The most important facts
Duration of surgery: approx. 5–20 minutes
Anesthesia: local anesthesia
Dressing: a dressing change the following day, followed by a special plaster
Suitable if...
nocturnal pain, tingling in the fingers or numbness are permanently bothersome.
night splints are no longer sufficient and the symptoms persist permanently.
you want to be able to use the operated hand again quickly – without a plaster cast and without a long downtime.
Methods & Variants
Early Functional Concept (Standard)
Open release of the carpal tunnel via a very small incision, performed on an outpatient basis and under local anesthesia. No cast, no drainage – the hand is used again immediately after the operation.
Open Instead of Endoscopic – By Choice
In our experience, endoscopic procedures offer no advantages over the open procedure using a very small incision. The safety regarding complete release and protection of the median nerve is extremely high. That is why we deliberately rely on open carpal tunnel release via a very small incision. We have many years of experience with this procedure. The critical factors are complete decompression of the median nerve and the surgeon's experience.
Conservative Options
A night splint prevents bending of the wrist, but usually only works temporarily. An exception is carpal tunnel syndrome during pregnancy, which often disappears after childbirth.
When the Procedure Is Not Suitable
The early functional concept is not suitable for patients who are immediately dependent on the strenuous use of their hands: wheelchair and rollator users, people using walking aids, as well as patients with extreme obesity, immunodeficiency, or very severe co-morbidities. In these cases, we recommend inpatient treatment.
Patients on anticoagulant medication and diabetics can easily be treated on an outpatient basis. Marcumar usually does not need to be discontinued or adjusted – details will be discussed during the personal consultation.
Process – Step by Step
Diagnosis & Consultation
Carpal tunnel syndrome is primarily a clinical diagnosis: We will have you describe your symptoms and examine your hand. The pattern and extent of the sensory disturbances are indicative – symptoms on the back of the hand, for example, argue against carpal tunnel syndrome.
Preparation
Please do not stop taking ASA, Marcumar, or other anticoagulant medications on your own before the surgery. Whether and how your medication needs to be adjusted around the time of the procedure will be clarified with you individually.
The Procedure
The operation is performed on an outpatient basis under local anesthesia and takes about five minutes; the total time spent at our facility is usually half an hour. The procedures take place on Monday mornings by appointment and are billed through public or private insurance – without any co-payment.
Aftercare
On the following day, the first and only dressing change takes place: The cotton wool dressing is removed, and the wound is covered with a special postage stamp-sized plaster – allowing the hand to be washed. The stitches are removed after one week; physical therapy is not necessary in a normal recovery course.
Healing process
After one day, the operated hand is already conditionally ready for use again – after the dressing change, a special plaster protects the wound.
After one week, the threads are removed. Depending on the individual course of events, light office work can sometimes be done again after just a few days.
After six weeks, heavier physical or manual strain is usually possible again.
After a few months, sensory disturbances continue to recede, provided the nerve was not permanently damaged.
Risks & Safety
In the first few days, swelling, bruising, and a feeling of tension are possible; temporary sensory disturbances can occur. Wound healing disorders or inflammation rarely occur – especially in patients who must immediately put a heavy strain on the hand. Scar discomfort or temporary irritation of the median nerve are also possible.
We minimize risks through a minimally invasive, tissue-sparing procedure, an operation under local anesthesia, dispensing with casts and drains, standardized hygiene processes, and a follow-up check the day after the operation. Use your hand in whatever way feels good – whatever you like is allowed. If swelling increases, or in case of severe redness or fever, please contact us immediately.
Diagnostics & Alternatives
Neurological measurement, hand surgery examination to confirm the diagnosis
Night splint as a temporary conservative option
Waiting for only occasional, minor symptoms – prompt surgery for persistent symptoms
Inpatient treatment for patients who are not suitable for the early functional concept
