Carpal Tunnel Syndrome

Ultrasound-guided microrelease in WALANT, 3-4 mm skin opening, no stitches, usually back to function in about 2 weeks.

This is the technique I use. Under local WALANT anesthesia, through a 3-4 mm skin opening, I perform the whole release under the skin with dedicated instruments and continuous ultrasound guidance. No stitches, only a small dressing. Functional recovery is usually around 2 weeks, with almost no visible scar and minimal risk of adhesions. Hydrodissection may bring temporary relief, but often does not provide durable benefit, and I regularly see patients who return after some time. Open surgery is mainly reserved for revision cases after 1-2 previous operations.

Symptoms

Numbness in thumb/index
Night pain
Weakness
Dropping objects

Conservative treatment

Night splinting
Ergonomic modification
Median nerve gliding
Steroid injection

When is surgery needed?

My standard option is micro-invasive ultrasound-guided release in WALANT; open surgery is mainly for revision after prior procedures.