If you have been suffering from pain, numbness, tingling and even loss of use of strength in your hand, you may be suffering from Carpal Tunnel Syndrome. There are multiple methods to care for this problem including splints, braces, steroid injections, weight loss and surgery.
Even with surgery, there are multiple techniques. The two main types are open and closed. Minimally invasive techniques use a scope (endoscopic) and indirect imaging on a screen to visualize the treatment through a very tiny incision that generally requires no stitches. Even with the closed technique, some techniques require multiple incisions and some only require one. We have surgeons on staff that have extensive experience in the minimally invasive technique that generally takes less than 10 minutes!
So if you are in Las Vegas and are experiencing carpal tunnel symptoms and have decided that surgery is your best option, just give us a call and we would be happy to refer you to a member of our well trained and experienced staff or you can call 702-227-5848 or fill in the form below.
If you want to read the text from the video Dr. Knight has shared above please continue reading below.
: over two and a half million people a
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year inflicted with the diagnosis of
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carpal tunnel syndrome to understand
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this diagnosis in better detail it’s
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important to understand a little of the
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anatomy in the wrist the carpal tunnel
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is a tunnel deep in the wrist here
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that’s made up of a the floor of the
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tunnel is made up of the back of the
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bones of the wrist across that tunnel is
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a ligament called the transverse carpal
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ligament which we’ll talk about when we
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talk about the surgery for this
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condition but with technology today
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there’s increased use of the fingers
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flexing through that tunnel that leads
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to a development of inflammation on the
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tendons within that tight unyielding
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space the inflammation puts pressure on
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the median nerve which is a nerve that
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goes through the tunnel out to the
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fingers of the hand within from
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repetitive use with daily activities
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with increased computer use with
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blackberries etc our technology has made
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this a more common occurrence to discuss
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a little of the diagnosis of carpal
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tunnel syndrome
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the subjective compliance or when a
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patient comes into my office one of the
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first things they talk about is that
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they have numbness and tingling more
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commonly awaking them at night
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commonly it occurs because the nerve
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goes to these four digits it’s mainly
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the four did these four digits excluding
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the little finger
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they also with more pronounced symptoms
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may get actually loss of feeling in
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their hand and actual motor loss of the
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muscles that allow the thumb to oppose
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to the digits resulting in clumsiness
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with buttoning clothes using a pen for
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writing etc
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under examination the patient we tap
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over the nerve at the tunnel the median
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nerve if that causes tingling within the
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fingers that suggestive the diagnosis we
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also ask the patients to flex their
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wrists leading to increased pressure
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within the carpal tunnel which is a call
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to fail ins test so that reproduces what
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happens at night when you’re sleeping
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you tend to sleep in a fetal position
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the wrists drawn up leading which causes
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increased pressure within the carpal
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tunnel also we look at that we do a full
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sensory and a full sensory and motor
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exam to see if there’s loss of feeling
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in any loss of strength within the thumb
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muscles so once we have a proper
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diagnosis of carpal tunnel syndrome now
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it’s important to talk about treatment
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treatment in most cases with
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conservative treatment the symptoms will
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go away in severe cases though surgery
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may be necessary for the conservative
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treatment wearing a wrist brace at night
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when you’re sleeping to prevent flexing
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flexion of the wrist is important that’s
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the number one treatment also resting
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the wrist and the fingers ergonomically
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looking at the workstation at work if
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they’re a typist or if adjusting the
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string tension if they’re a guitar
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player etc anti-inflammatory medication
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in some cases a cortisone shot into the
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carpal tunnel may also reduce swelling
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in more severe cases though surgery may
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be necessary now with the advent of
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endoscopic carpal tunnel release surgery
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is highly effective but with minimal
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scarring and a very quick return to work
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we do a ten-minute outpatient surgical
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procedure that involves a one-and-a-half
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centimeter incision across the crease of
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the wrist and the pain and the recovery
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the pain is lessened significantly
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compared to the old-fashioned open
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procedure which involved a very lengthy
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scar across the palm now I have patients
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returning to full work within a month
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after surgery so it’s highly effective
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and much less pain than the other than
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the standard open procedure
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now we’ll start with a skin incision
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I’m going to complete the cut
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proximal
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and now I have a u-shaped distil based
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flap that we’re going to now place a
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small skin hook line that will
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essentially be my guide into the carpal
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tunnel
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I’m going to open approximately two
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centimeters of the antebrachial fascia
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at the lower midline of the distal
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forearm proximal that’ll help facilitate
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the scope placement into the carpal
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tunnel now we’ll take the spatula and
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I’m going to run this into the carpal
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tunnel I’m going to scrape the
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undersurface of the transverse carpal
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ligament just to make sure there’s no T
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no synovium or lining of the tendons
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that’s adherent to the under surface of
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where I’m going to be dividing the
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transverse carpal ligament
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now we’re going in into the carpal
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tunnel
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you see the transverse carpal ligament
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fibers
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you see I’m pushing beyond the
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transverse carpal ligament beyond the
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carpal tunnel
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I’m going to engage the
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blade you see right there
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and the cut-the-knot go all the way the
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very end I’m to cut the distal fibers
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here partially
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you’re partial cut there now there’s two
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edges you can see or still intact there
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so you got it if you see those within
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the viewing surface of the or within the
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video monitor in the you haven’t and
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it’s a v-shaped configuration there you
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haven’t completely transected it bad on
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the
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complete the transection proximal we’re
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going to go all the way but not to the
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very edge
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proxxon will come back and do that with
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our scissors pistol
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now we we’re gonna run the radial column
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of the transverse carpal ligament all
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the way proximal showing complete
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division except what we’re going to
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complete proximal with our scissors on
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the way out and then there’s the owner
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column again you don’t see the two edges
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within the view of the scope at any
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point so that’s open all the way down
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and we’re gonna inspect the median nerve
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now you can through this field look at
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the nerve and make sure there’s no
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masses within the carpal tunnel there
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and it’s intact after the procedure
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which is important obviously
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what up now we’re gonna let just apply
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some pressure to the incision and we’re
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gonna let the tourniquet down now
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tourniquet down please it’s usually with
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direct pressure for about five minutes
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it’s all that’s needed to stop any
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boozing before closing the wound
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you can see the fingers pinking up now
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all of them and the palm just liberally
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apply some derma bonds in brutal
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dressing
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put a little little sponge with a
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Tegaderm dressing over it so they can
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start showering right away
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and now they can apply ice
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postoperatively
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along with elevation to minimize
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swelling and can start a range of motion
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of the hand and wrist within the first
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hours this procedure as you can see
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involved a very small incision through a
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minimally invasive approach as you can
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see from her left wrist on three months
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again with this latest technology we are
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now able to bring life back to her hands