Carpal Tunnel Decompression
The Carpal tunnel in the wrist may be the site of compression of the median nerve causing numbness and even muscular weakness in the hand.
What and where is the carpal tunnel?
Beneath the base of the palm is a tunnel through which all the tendons that bend the fingers pass from the forearm into the hand, together with one major nerve, called the median nerve.
What does the median nerve do?
The median nerve is a mixed nerve, meaning that it carries fibres conveying sensation and motor fibres which supply muscle, causing movement. The areas served for sensation are the thumb, index, middle and ring fingers on the palmar side; the main muscles supplied are those at the base of the thumb that rotate or “oppose” the thumb in front of the rest of the hand.
What is Dupuytrens disease?
A gradual thickening of fibrous (scar like) tissue beneath the skin of the palm and fingers (or occasionally the sole of the foot) which then contracts and prevents full straightening of the fingers. There may also be pits and nodules in the skin itself. We do not know for certain why some people develop this condition and not others. The condition is common and may affect up to one third of men to some degree. It is not a form of cancer. It is named after Baron Dupuytren, a Paris surgeon of the early 1800’s who did much research on this condition.
What will happen if it is not treated?
If left untreated Dupuytrens disease in many cases causes no problems. In others it tends to cause more and more bending of the fingers and may start to involve more fingers on the hand. In these cases the fingers get more awkward and useless as time goes on. If treatment is postponed beyond a certain point the chance of good recovery of function is less.
What kind of treatment is available?
Treatment is by operation, but is not always immediately necessary, depending on how bad the disease is. Different operations are done according to how severe the deformity is. If the skin is badly involved it will be removed and replaced with normal skin from another part of your body (this is called a skin graft) usually the arm.