Open Carpal Tunnel Release

What is an open carpal tunnel release?

An open carpal tunnel release is the traditional procedure and surgical method of repair for CTS. The open approach allows better visualization of the entire transverse carpal ligament. This outpatient minor procedure has an operative time that ranges from 15 to 45 minutes. The procedure is performed with local anesthetic to numb the hand and wrist. An incision is made over the transverse carpal tunnel on the wrist and palm of the hand. Careful dissection allows identification of the transverse carpal ligament, which is then cut under direct vision. Successful carpal tunnel release is ensured under direct vision. The palmar/wrist incision is then sutured closed and a bandage applied.  A splint may or may not be placed to provide comfort and support postoperatively.

Some surgeons perform a smaller version of the open release by making a smaller incision on the palm.(see below) Direct visualization is still achieved. When compared to the traditional open carpal tunnel release, patients likely experience less postoperative pain and recover faster. Unfortunately, fewer studies exist comparing this surgical option.

Fig 5. Approach for an open carpal tunnel release is shown and demonstrates exposure of the carpal tunnel ligament to be cut. The approach shown utilizes a slightly shorter incision("limited-incision") compared to the incision of a traditional open carpal tunnel release.

Depending on the patient and their level of assistance at home, it is possible to perform bilateral open carpal tunnel surgery. Postoperatively, patients are instructed move as much as they can tolerate from a pain standpoint. There is a slightly longer recovery time with the open release.  A longer scar remains from longer incision. The combination of the larger incision and soft tissue disruption from open dissection results in the open carpal tunnel release being associated with more pain postoperatively. There may be a slightly less, but not significant, chance of complications, secondary to the ability for direct surgical visualization with the open procedure.

 

Continue to "Endoscopic Carpal Tunnel Release"

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Additional Information

Please see the provided Additional Links and Resources about Carpal Tunnel Syndrome for additional information and references.