My daughter underwent a finger joining treatment using leeches. Will this cause a problem for her later in life?
In 2007, I authored a paper that was published in Plastic and Reconstructive Surgery that reviewed a total of 14,722 patients with carpal tunnel syndrome who were treated with the endoscopic technique, the largest retrospective series published to date. What I noted from the data collected from this series of patients, was the direct correlation of the duration of symptoms and the incidence of permanent nerve injury. Moreover, review of the data also showed that the incidence of complications was much lower for the endoscopic over the open technique.
I recommend the endoscopic technique of release over the open technique for the following reasons: 1) The recovery time is much quicker. Most people can return to a desk job within a week of the surgery. I have seen patients return to work even faster if they were self-employed or they thought that their job was in jeopardy even though that was not recommended. With the open technique, the recovery can be as long as six weeks; 2) The safety record of the endoscopic technique as detailed above; 3) The lower scar burden associated with the endoscopic technique. Only the transverse carpal ligament is divided in the endoscopic technique, whereas in the open technique every layer of tissue from the surface of the nerve to the skin is divided, resulting in obliteration of gliding mechanism between the various tissue layers as they are now tethered with scar; and 4) The procedure only takes a few minutes to perform in experienced hands.
To summarize, in the case that conservative measures fail to completely relieve your symptoms within a two week period, surgical decompression should not be delayed. Endoscopic carpal tunnel release is safe and has a shorter recovery period than the open approach.