General Information

DEFINITION--Cutting the transverse carpal ligament, the fibrous tissue extending across the wrist.

BODY PARTS INVOLVED--Transverse carpal ligament; median nerve and surrounding fibrous tissue; wrist joint.

REASONS FOR SURGERY--Relief of pain or numbness caused by compression of the median nerve.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Poor nutrition.
• Recent illness.
• Alcoholism or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Hand surgeon, general surgeon, orthopedist or plastic and reconstructive surgeon.

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of wrist; nerve-conduction tests (See Glossary).
• After surgery: Blood studies.

ANESTHESIA

• Local anesthesia by injection, sometimes a regional block.
• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• A tourniquet is applied above the wrist to prevent bleeding in the surgical area.
• An incision is made in the underside of the wrist.
• The transverse carpal ligament is located and cut, releasing the compressed median nerve.
• The skin is closed with fine sutures, which usually can be removed about 10 days after surgery. Absorbable stitches are not removed.
• A bandage is applied, and a splint is used to hold the wrist in position. In some instances, the stitched wound may be left uncovered.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inadvertent injury to blood vessels or nerves.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 1 month for recovery from surgery.

Postoperative Care

> Apply non--prescription antibiotic ointment to the wound before applying new bandages.

> You may use non--prescription drugs, such as acetaminophen, for minor pain.

> To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving 1 week after returning home.

DIET---No special diet.

Call Your Doctor If

> Pain, swelling, redness, drainage or bleeding increases in the surgical area.