Carpal Tunnel Syndrome is a disorder which causes tingling, numbness and dull aches in the hand and thumb through ring fingers and is the most common site for upper extremity nerve compression (termed compression neuropathy). The carpal tunnel is a passageway through the wrist carrying multiple tendons and one of the hand’s major nerves, called the median nerve. Pressure may build up within the tunnel because of disease such as rheumatoid arthritis, injury, fluid retention during pregnancy, overuse, or repetitive motion. The resulting pressure on the nerve within the tunnel causes these symptoms. The procedure performed to correct this, termed carpal tunnel release, involves division of a thickened ligament compressing the median nerve at the base of the palm causing dramatic relief of symptoms.
Additional, less common, upper extremity compression neuropathies may occur in other anatomic locations and involving other nerves. Among these are ulnar nerve compression at the elbow (known as ‘Cubital Tunnel Syndrome’) and wrist (known as ‘Guyon Canal Syndrome’). Excessive pressure within these passageways may similarly lead to symptoms of numbness, tingling and discomfort along the inner aspect of the forearm and ring and little fingers. Testing performed to measure speed of conduction along these nerves is commonly performed to confirm these diagnoses. Once confirmed, surgical release of these compressive zones results in symptomatic relief.
Since hand surgery is performed primarily to correct physical abnormalities and maintain or restore function, it is considered ‘reconstructive’ in nature and therefore as a ‘covered’ procedure by most health insurance plans. This can be verified by checking your policy or contacting your health insurance carrier. These Procedures are most appropriately performed in a State Licensed, Nationally Accredited Ambulatory Surgery Center (see ‘about Keystone Surgery Center’) as a brief outpatient surgery utilizing a combination or intravenous sedation and local anesthesia.
When considering hand surgery, be sure to select a qualified, experienced physician skilled in the diagnosis and management of disorders of the hand. As a board certified plastic surgeon with over 20 years of hand surgery clinical practice experience and member of the American Society of Plastic Surgeons (ASPS), Dr. Robert Kimmel welcomes the opportunity to provide optimal care to patients with disorders of the hand.