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Carpal
Tunnel |
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Transverse
carpal ligament: A tough ligament (tissue that connects bone to bone) that
lies across the arch of carpal bones and forms the roof of the carpal tunnel. |
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CTS |
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Carpal
tunnel syndrome (CTS) is a problem that affects the wrist and hand. If you
have CTS, tingling and numbness can make you even simple tasks hard to do.
But CTS can be treated, and your symptoms can be controlled. Reading this
will help you better understand what CTS is. You'll also learn how treatment
can help.
Tingling and numbness are the most common symptoms of CTS.
Some people also have hand pain or even a weakened grip. At first, symptoms
may wake you up at night. Later, they may also occur during your daily routines.
For instance, you may notice symptoms while you are driving, or holding a newspaper.
Your symptoms may become more severe over time.
Another common problem is the inability to fully open
the hand. This is known as Dupuytren's Contracture, a problem which afflicted
President Reagan. This can also be treated in an outpatient basis so that
you can fully open your hand.
The carpal tunnel is a narrow space inside the wrist. This
space lets certain tendons and a major nerve pass from the forearm into the
hand. Learning about the carpal tunnel can help you understand your symptoms
and treatment.
Two types of surgery—open and
endoscopic—are used to treat CTS. No matter which one you have,
the goal remains the same: Your surgeon will relieve pressure on the median
nerve. To do this, the transverse carpal ligament is cut (released). CTS usually
takes 10 minutes or less. Dr. Worland does not advocate endoscopic releases,
due to possible serious complications. |
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Median
nerve: A major nerve that carries messages between the hand and the brain. |
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Tendon
sheath: A protective outer covering that lets the tendon move easily. |
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Flexor
tendons: These tendons (fibrous tissues that connect muscle to bone) slide
back and forth as the fingers move. |
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Carpal
bones: A U-Shaped group of bones at the base of the palm. These bones from
the hard floor and sides of the carpal tunnel. |
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A
Healthy Wrist |
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Median
nerve |
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Transverse
carpal ligament |
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Tendon
sheath |
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Carpal
bones |
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A
Wrist with CTS |
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Compressed
median nerve |
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Thickened
tendon sheath |
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Endoscopic
Surgery
With endoscopic surgery, one or two small incisions
may be made in your hand. A scope (with a very small camera attached) and tools
are inserted under the transverse carpal ligament. The surgeon then operates
while watching images on a video screen. |
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incision sites |
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Open
Surgery
With open surgery, your surgeon makes one incision
in your palm. Then he or she releases the transverse carpal ligament. Standard
surgical tools are used. |
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Possible
incision site |
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Releasing
the transverse carpal ligament creates space in the carpal tunnel. This
relieves pressure on the median nerve. |
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Median
nerve |
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Median
Nerve |
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Site
of a transverse carpal ligament release |
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Carpal
Tunnel |
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Dr.
Worland was the first certified hand surgeon in southern Oregon and has performed
over 2000 successful hand surgeries. The vast majority are outpatient procedures. |
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