Orthopaedic surgery for carpal tunnel syndrome

Abstract

Carpal tunnel syndrome is the most commonly occurring mono neuropathy, affecting between 2% and 5% of the population and is more commonly present in women. Patients may experience a wide range of symptoms, the most frequent of which is a change in sensation or pain in the area of the arm, wrist, or forearm. The pathology is associated with the compression, clamping, or irritation of median nerve in the carpal tunnel. Diagnosis can be based on a medical examination, supported by electrophysiological and ultrasound results. Although spontaneous improvement is possible, in general symptoms worsen. Therefore, early recognition of carpal tunnel syndrome, through clinical and instrumental investigations, is essential for preventing disturbance of hand functions and permanent nerve damage. In the early stages of the disease, treatment is mostly conservative. In case conservative treatment fails, and in medium to severe forms of the disease, surgical intervention is performed. In the present paper we review the literature on the various techniques of operative treatment-open surgery, endoscopic and mini-invasive percutaneous technique under echo graphic control.