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Carpal Tunnel Release Protocol

Surgical Procedure

With an open carpal tunnel release procedure, a small incision is made in the palm. The transverse carpal ligament is divided, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome. Dissolvable sutures are used to close the skin, sutures will not need to be removed post-operatively.

When you go home from surgery, you will have light dressings placed to cover the incision made in the palm. You will have immediate mobility of all fingers and moderate mobility of wrist. Dressings may be removed and changed approximately 3 days after surgery. Incision should remain covered and kept dry until your first post-op appointment or 7-10 days after surgery.

NOTES: Post-op therapy will likely be brief and will emphasize home exercise program / scar management techniques.

6-10 Days Post-Op (Initial Post-op Visit):

  • Dressing:
    • Bulky dressing is removed, and a light compressive dressing is applied.
  • Exercise:
    • Full Active/Passive Range of Motion, tendon gliding exercises for digits and thumb.
    • Full Active/Passive Range of Motion of the wrist, forearm, elbow.
    • Initiation of median nerve gliding exercises.
  • Education:
    • Full use of the involved extremity for activities of daily living (ADL’s).
    • Avoid heavy gripping or lifting.
    • Ergonomics/work-station setup.

10-14 Days Post-Op:

  • Therapist authorized to remove sutures if still in place/ if applicable.
  • Once the incision is completely healed, scar management techniques may be initiated.
    • Scar massage
    • Use of silicone gel sheeting
    • Scar desensitization

2-4 Weeks Post-Op:

  • Progressive strengthening may be initiated at this time.
    • Theraputty – emphasis on intrinsic strengthening (vs. gripping)
  • Encourage normal functional use of the hand.

FAQ’s

All surgical patients having a carpal tunnel release will have full use of fingers immediately following surgery and may feel up to typing and performing basic activities of daily living within a few days. Special attention should be taken to avoid any activities that may increase the possibility of reopening surgical incision.

No, incision should be kept clean and dry for about 7-10 days following surgery. When you go home from surgery, we place you in light dressing to cover the incision to help remind you to protect that incision as it heals.

No, a splint will not be needed after surgery. You will be placed in a soft dressing with full use of your fingers immediately following surgery and will not need a spint at any point during your recovery.

As soon as your incision is fully healed, you may return to all the activities that you enjoy (Approximately 7-10 days after surgery)

Pain from carpal tunnel surgery is typically minimal, however, everyone experiences pain differently and we address your pain on an individual basis. Pain is always worse at night and elevating the surgical extremity is the most important factor when working to improve pain. If tolerated, we use extra strength Tylenol and Ibuprofen/Naproxen as a first line medication. Most patients do well with this regimen alone, however, a prescription of Tramadol (if tolerated) is provided to help with breakthrough pain and to help you sleep through the first few nights. Most patients only utilize narcotic pain medication for the first 2-3 days.

Our team prefers to perform our open carpal tunnel release under local anesthetic. We would numb the region with 1% lidocaine with epinephrine prior to the procedure. If you do not tolerate being awake for a surgical procedure, a light sedation would be offered.

At a Glance

Dr. Kavi Sachar

  • Specializing in Hand, Wrist, & Elbow Surgery
  • Board Certified Orthopedic & Hand Surgeon
  • Consultant to the US Ski & Snowboard Team & Colorado Avalanche
  • Learn more

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