Ultrasound Guided Carpal Tunnel Release
What is Ultrasound Guided Carpal Tunnel Release?
Carpal Tunnel Syndrome (CTS) is a common entrapment neuropathy caused by median nerve compression within the carpal tunnel. Traditional surgical management includes open or endoscopic carpal tunnel release (CTR). However, ultrasound-guided carpal tunnel release (USG-CTR) has emerged as a minimally invasive alternative, offering reduced recovery time and lower complication rates.
Indications of Ultrasound Guided Carpal Tunnel Release
USG-CTR is indicated for individuals with moderate to severe CTS who have not responded to conservative treatments such as splinting, steroid injections, or physical therapy. It is particularly beneficial for individuals seeking a quicker return to daily activities with minimal surgical morbidity.
Procedure of Ultrasound Guided Carpal Tunnel Release
USG-CTR involves real-time ultrasound imaging to visualize the transverse carpal ligament (TCL), median nerve, and surrounding structures. The procedure is typically performed under local anesthesia and involves the following steps:
- You will be placed in a supine position with the wrist extended and supported.
- A high-frequency linear probe is used to identify the median nerve, flexor tendons, and TCL. Local anesthesia is injected around your TCL to ensure comfort.
- A small incision is made at the proximal carpal tunnel, and a specialized ultrasonic scalpel or micro knife is inserted.
- Under ultrasound guidance, the TCL is carefully transected while ensuring that there is no injury to the median nerve or surrounding structures.
- The incision is then closed with adhesive strips or sutures, and a soft dressing is applied.
Advantages of USG-CTR
Ultrasound guided carpal tunnel release has various benefits including:
- Minimally Invasive: Requires only a small incision, reducing scarring and post-operative pain.
- Enhanced Precision: Real-time ultrasound guidance allows for accurate visualization and protection of the median nerve.
- Faster Recovery: You may typically experience quicker symptom relief and return to daily activities.
- Reduced Complications: There is lower risk of infection, pillar pain (a temporary soreness in the palm), and nerve injury compared to open surgery.
Potential Complications of Ultrasound Guided Carpal Tunnel Release
While USG-CTR is generally safe, potential complications include:
- Incomplete ligament release, leading to persistent symptoms
- Temporary nerve irritation or paresthesia
- Infection at the incision site
Post-Operative Care and Rehabilitation of USG-CTR
You may be advised to keep the hand elevated for the first 24–48 hours to minimize swelling. Gentle range-of-motion exercises can be initiated early, with a gradual return to normal activities over 2–3 weeks. Most individuals experience significant symptom relief within a few weeks.
