RS08P 'RELEASE OF CARPAL TUNNEL SYNDROME’ AND HOW WE DO IT – THREE years’ EXPERIENCE IN RURAL HOSPITAL

Abstract

Purpose: 1. To point out that our complication rate is lower than the available literature report. Methodology: In this study three surgeons’ personal audit on Carpal Tunnel Release surgery have been counted over a period of three years. Reason of this selection criterion is all the three surgeons do the procedure in a similar technique: open and release the retinaculum under direct vision. All cases have been done as day case surgery. Follow up at two weeks and three months done in surgical clinic and a six month check at GP clinic. Result: 221 wrists on 179 patients have been operated with complication as follows: recurrence nil, ulnar nerve injury 2, wound infection 3, delayed start of work 4, painful scar 4. The complication rate never had been above 6%. Available literature shows in most series the complication rate between 15–20%. Long term follow up is necessary. A bloodless field makes easy to identify the structures and reduces operation time. Expose, see cut and feel with finger tip to complete the split are the mainstay of our procedure. Wool with crepe, elevation with encouraged finger exercise is very important for quick functional recovery. Conclusion: 1 Direct linear incision is our favourite. 2 Most cases need small incision, but can be extended both directions when needed. 3 We like a single layer interrupted sutures.