carpal tunnel release adverse outcomes

This operation involves enlarging the “carpal" (wrist) tunnel.  It is done to decrease pressure on the median nerve for carpal tunnel syndrome.

The following list covers most of the common and/or serious risks or complications of carpal tunnel surgey. However, you need to remember that the vast majority of patients have a good or excellent outcome from this operation and you need to keep in perspective the small chance of any of these events below occurring against the likely benefits of this operation. 

INFECTION: Infections can either be close to the skin surface (superficial) or deep in the wound (deep).  The risk of a superficial wound infection is approximately 1 to 2 in 100 (1 to 2%).  The risk of a deep infection is less than1 in 100 (1%).  Usually antibiotics alone are sufficient to treat any infection.

 NERVE DAMAGE:  The risk of direct surgical damage of the median nerve is less than 1 in 1000 (0.01%).  Nerve damage can cause only slight numbness or weakness to total loss of function of the damaged nerve; however, permanent total loss of nerve function is very unlikely.

HAEMATOMA/EPIDURAL HAEMATOMA: Following any surgery excessive bleeding may occur.  The blood may then accumulate and form a clot (haematoma).  The risk of a serious haematoma is very small but is inceased if you are on any medication that “thins the blood”.  If you are on any of these medications please inform me prior to the procedure.

 CRPS: This stands for Complex Regional Pain Syndrome.  It is a rare but potentially significantly disabling condition.  It can occur after surgery or trauma to the wrist (or indeed other body sites).  The risk after Carpal Tunnel Release is somewhere in the order of 1 in 40,000.  You cannot predict who may get this a condition and unfortunately treatments are limited.  It may cause prolonged pain and or stiffness of the wrist and hand.

 PERSISTING SYMPTOMS:  Despite surgical release of the tissues surrounding the median nerve symptoms don’t always completely resolve.  Often there is a degree of internal derangement of the nerve itself and we are not able to address this surgically.  Sometimes associated conditions also affect the nerve – surgery will only help the symptoms due to the pressure on the nerve and not any other condition that may contribute to the symptoms being experienced.

Please also note that it has been shown that smoking significantly increases the risks and complications of surgery and reduces the chance of a successful outcome.