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The procedure is used as a treatment for carpal tunnel syndrome and according to the American Academy of Orthopaedic Surgeons (AAOS) treatment guidelines, early surgery is an option when there is clinical evidence of median nerve denervation or the patient elects to proceed directly to surgical treatment. [5]
Each year, doctors perform 400,000 to 600,000 carpal tunnel release surgeries — one type of surgery used to treat the condition — making this one of the most common upper-extremity procedures.
Nerve decompressions are still a relatively new surgery, however a picture emerges from looking at the outcomes of some of the most studied nerve decompressions: carpal tunnel release, sciatic nerve decompression, and migraine surgery. Even within these commonly performed surgeries, the measurement of outcomes is not always standardized.
Carpal tunnel syndrome (CTS) is a nerve compression syndrome associated with the collected signs and symptoms of compression of the median nerve at the carpal tunnel in the wrist. Carpal tunnel syndrome usually has no known cause, but there are environmental and medical risk factors associated with the condition. [1] [6] CTS can affect both wrists.
In this way a nerve decompression can directly address the underlying cause of entrapment. A nerve decompression can either be done by open surgery or laparoscopic surgery. In some cases, like carpal tunnel syndrome, either approach is viable. [64] For deeper nerves, a laparoscopic approach is the only choice.
Thread carpal tunnel release (TCTR) is a minimally-invasive procedure of performing carpal tunnel release using a piece of surgical dissecting thread as a dividing element. [1] This is instead of using a scalpel as in the situation of open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR). [2]
At the 2007 meeting of the American Society for Surgery of the Hand, a former advocate of endoscopic carpal tunnel release, Thomas J. Fischer, MD, retracted his advocacy of the technique, based on his own personal assessment that the benefit of the procedure (slightly faster recovery) did not outweigh the risk of injury to the median nerve.
The long-term use of a wrist splint during recovery from carpal tunnel surgery may cause adhesion formation. [18] For that reason, it is advised that wrist splints be used only for short-term protection in work environments, but otherwise, splints do not improve grip strength, lateral pinch strength, or bowstringing. [18]