What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a prevalent medical condition caused by the compression of the median nerve, as it travels through the carpal tunnel located in the wrist. The tunnel is comprised of the transverse carpal ligament as its roof and a carpal arch as its base. Notably, the carpal tunnel accommodates not only the median nerve but also nine tendons connected to the fingers and thumb. Although it can affect individuals of any age, carpal tunnel syndrome is more commonly diagnosed in women over the age of 40, and it can be associated with conditions such as thyroid disease, pregnancy, wrist injuries, and rheumatoid arthritis.

The most common symptom of carpal tunnel syndrome is a pins-and-needles sensation that occurs in the thumb, index finger, and middle finger. This sensation can interrupt sleep and may require shaking the hand to alleviate it. Pins and needles may also occur during periods of extensive manual work. In severe cases, the small muscles in the thumb may weaken, leading to a loss of grip strength and difficulty holding onto objects.

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Treatment Options

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There are several treatment options available for carpal tunnel syndrome, including non-drug therapy such as physiotherapy and wearing wrist splints at night, medication such as steroid injections into the carpal tunnel, and surgery. Dr Kilian works with each patient to determine the most effective treatment plan for their specific situation.

For many patients with severe or persistent symptoms, surgical intervention may be necessary. Carpal tunnel surgery is typically performed as a day procedure under local or general anaesthetic and typically takes around 10 minutes to complete. During the procedure, a tourniquet is applied to the upper arm to create a bloodless surgical field. The surgeon will make one or two incisions in the palm over the carpal tunnel, taking care to avoid injury to the sensory nerves.

Next, the surgeon will release the transverse carpal ligament, a thick band of tissue that compresses the contents of the carpal tunnel, including the median nerve. The surgeon will then inspect the contents of the carpal tunnel to ensure that adequate release has been achieved, and perform a neurolysis, or freeing of the nerve, if necessary. Finally, the incision is closed with sutures, and dressings are applied.

Dr Kilian will guide you through every step of the process to ensure the best possible outcome.

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Hand & Wrist Trauma

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The hand and wrist are comprised of 27 bones that are susceptible to fracture. Because our hands are essential for daily activities, it is crucial to promptly seek treatment for any hand injury.

Fractures of the fingertips and the bones at the base of the little finger and thumb are the most common hand and wrist fractures. The type of treatment required will depend on whether the bones are displaced or non-displaced. Non-displaced fractures can often be successfully treated without surgery, using methods such as a cast or splint and physiotherapy, as well as medication like anti-inflammatories.

However, displaced fractures often require surgery to realign the bones and hold them together as they heal. Dr Kilian can determine the best course of treatment for your specific situation, taking into consideration your medical history, the location and severity of the fracture, and any other factors that may affect your recovery. At all times, we strive to provide our patients with the highest quality care to achieve the best possible outcomes.

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Wrist and hand fractures can be treated with surgery, where the bones are realigned and held together with internal pins or screws and plates or external devices such as a stable frame around the joint or bones.

After surgery, most patients can go home the same day. A therapist will provide instructions on keeping the hand clean and performing exercises to prevent stiffness while healing. Rehabilitation, including physiotherapy, can help speed up recovery and improve outcomes.

In most cases, finger movement is preserved, and exercises are recommended to maintain strength and mobility. Once the area is stable and pain is controlled, wrist exercises are also recommended.

If internal fixation causes problems, it may be removed, while external fixation is progressively removed as the healing takes place.