Endoscopic treatment of carpal tunnel syndrome - Causes, symptoms and treatment. MF.

Carpal tunnel syndrome - carpal tunnel syndrome, carpal tunnel syndrome - is the compression of the median nerve in a narrow canal under the transverse ligament of the wrist, where along the nerve pass 9 tendons.

Endoscopic decompression of the median nerve is a modern, effective method of treatment, performed in the event of failure of conservative therapy( nonsteroidal anti-inflammatory drugs, the introduction of hormonal drugs in the form of blockades, muscle relaxants, vitamins), with repeated disease.

Preparing for operation

For the referral, an established diagnosis, general clinical examinations, blood group, DAC, electroneuromyography, radiography and ultrasound of the wrist joint are required.

Performing the operation

The operations on the brush require a high qualification of the surgeon. In the wrist area, "meet" the radial and ulnar bones, 8 small bones of the hand, three nerves, tendons of the muscles, providing the movement of the five fingers of the hand, artery and vein.

The method of anesthesia is discussed individually, taking into account the wishes of the patient, his physical condition and medical necessity - local, conductive, combination with sedation. ..

The patient lies on the operating table, on the back. On the shoulder, a cuff is applied to bleed the hand. The incision is minimal( 1 centimeter) along the skin fold in the transverse direction in the projection of the carpal canal on the wrist. The expander and the camera are introduced. Among the tendons, the median nerve is prominent. Under the control of optics, the median nerve is released from compression - a ligament is dissected. Complete or partial resection of the transverse ligament is possible. Individually it is possible to carry out neurology - excising scar tissue around the nerve. The skin is sewn with a cosmetic suture. A soft bandage is applied. Gypsum is not required. The wrist should be at rest for several days, and the exercises for the fingers of the hand begin immediately.

Stay in the hospital - 1 2 days. In some cases and clinics, an outpatient treatment option is possible. The scar is minimal.

Scar after endoscopic decompression of the median nerve

After operation

Improvement occurs immediately, full recovery will take some time( individually).With prolonged disease, it is possible to develop tendovaginitis and arthritis, irreversible changes in the nerve. In such cases, after the operation, the improvement may not occur, and even on the contrary, the condition may worsen.

The rehabilitation period can last up to 1 - 3 months individually.

In the process of rehabilitation, B vitamins, anticholinesterase drugs, drugs that improve blood circulation and nerve and tissue trophism, physiotherapy, physiotherapy exercises, water - mud therapy are used.

Doctor neurologist Kobzeva S.V.