Carpal Tunnel Release

Carpal tunnel release is the surgical procedure used to treat patients who suffer from carpal tunnel syndrome. There are two variations of this procedure, with both aiming to relieve pressure on the median nerve, which is achieved by cutting the ligament that forms the roof of the carpal tunnel. Carpal tunnel surgery is usually performed on an outpatient basis under local or general anesthetic.

Open Carpal Tunnel Release Surgery

In open surgery, a small cut is made into the palm to allow the surgeon to view inside of the hand and wrist. The transverse carpal ligament (the roof of the carpal tunnel) is cut to create more space in the carpal tunnel and to decrease pressure on the median nerve.

The cut ligaments will gradually grow back together, but with more room in the carpal tunnel than before the surgery- and therefore, less pressure on the nerve.

Endoscopic Carpal Tunnel Release

Endoscopic carpal release surgery makes use of an endoscope to see inside the hand and wrist. The camera is inserted through two small skin incisions. Guided by the camera, Dr. Innes divides the transverse carpal ligament in a way similar way to open carpal tunnel surgery.

Dr. Innes has extensive experience with carpal tunnel release surgery and will discuss which surgical technique is best for your specific condition.

Thumb CMC Arthroplasty

Thumb CMC arthroplasty is used to treat osteoarthritis in the thumb. This form of arthritis affects the carpometacarpal (CMC) joint, located at the base of the thumb. The CMC joint is what helps the thumb move and is what enables you to pinch. The two bones found in the joint are covered with cartilage that helps absorb shock and allows smooth movements. Osteoarthritis causes this cartilage to wear down and leads to chronic pain and inflammation, making treatment necessary.

The purpose of Thumb CMC arthroplasty is to remove the small wrist bone (trapezium) that is part of the CMC joint and to replace it with a wrist flexor tendon.

De Quervain’s Tendinosis Surgery

De Quervain’s tendinosis is a condition that occurs at the base of the thumb, caused by irritated and constricted tendons. If the tendonitis is too severe, surgery may be recommended. Surgery aims to open up the thumb compartment, making more space for the irritated tendons.

The procedure is relatively painless and is performed on an outpatient basis. During the surgery, a small incision is made and the tendons are released in order for them to heal. Following surgery, a splint is worn for a few days to provide extra support and prevent movement during the healing process.

Dupuytren’s Contracture Surgery

Dupuytren’s contracture is a thickening of the fibrous tissue layer underneath the skin of the palm and fingers. Although painless, the thickening and tightening (contracture) of this fibrous tissue can cause the fingers to curl.

There are various non-surgical treatments for this condition, although if these treatments do not prove successful, your doctor may recommend surgery. Surgery for Dupuytren’s contracture divides or removes the thickened bands to help restore finger motion. Sometimes the wound is left open and allowed to heal gradually.

Trigger Finger Release

Trigger finger is a condition involving a tendon in the finger or thumb that forces the finger/thumb to lock up before it can pop out straight again. If your finger is stuck in a bent position, your doctor may recommend surgery to prevent permanent stiffness. Surgical procedures for trigger finger are usually performed on an outpatient basis using local anesthetic.

During the procedure, a small incision is made in the palm of the hand. The sheath of the affected tendon is then cut. Over time as the sheath heals it will become looser, making it easier for the tendon to move.

Distal Radius Fracture Surgery

A distal radius fractures are more commonly known as a broken wrist. When the break cannot be corrected with a cast alone, long-term problems with the function of the arm may be a result. In this case, surgery is often necessary.

In these procedures, a metal plate and screws/pins may be used to hold the broken fragments in position while they heal. This is done under general anesthetic. In the case of open fractures, urgent surgery following the injury is required, as exposed soft tissue and bone are at great risk of infection. Dr. Innes may use external or internal fixation methods to hold the bones in place.

Complete/Limited Wrist Fusion

The wrist has many small joints which over time can become arthritic. When this happens, the wrist joint can become extremely painful and even moving it can become difficult. In advanced problems with arthritis, the alignment of the wrist can change, leading to deformity. Fusing the bones together is a way to improve the alignment and prevent further deformation. Fusion may also be needed to align the wrist after a severe wrist injury.

A fusion of any joint eliminates pain by making all the bones grow together into one solid bone. When the bone ends can no longer rub together, pain is reduced.

Ulnar Nerve Transposition

Ulnar nerve compression is brought on by increased pressure on the ulnar nerve at the elbow. The ulnar nerve controls muscles used for gripping and the coordination of fine movements. When the ulnar nerve is compressed, it can cause a sharp, tingling sensation - similar to the sensation you feel when you hit your funny bone.

Treatment for this condition involves moving the nerve, an ulnar nerve transposition, to allow more room for the nerve to move behind the elbow.