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DECOMPRESSION OF THE MEDIAN NERVE

Method
Open or endoscopic decompression of the median nerve
Duration
20 to 40 minutes
Recovery time
2 to 6 weeks

Decompression of the median nerve is a surgical procedure for treating carpal tunnel syndrome. The flexor retinaculum (the transverse carpal ligament) is divided in order to reduce the pressure on the median nerve and relieve symptoms such as numbness, tingling and pain in the hand.

Carpal tunnel syndrome arises when the median nerve is compressed in the carpal tunnel of the wrist. The operation can be carried out open or endoscopically and in most cases leads to a marked improvement in the symptoms.

How does decompression of the median nerve work?

In the open technique a small incision is made at the wrist in order to gain access to the carpal tunnel. The flexor retinaculum is divided under direct vision, which reduces the pressure on the median nerve. This method allows the surgeon to see the structures directly and is particularly suited to complex cases.

The endoscopic technique is carried out through a minimal incision and allows a faster recovery. An endoscope is introduced into the carpal tunnel so that the retinaculum can be divided under direct vision. This method is less invasive and causes fewer symptoms after the operation.

Rehabilitation after decompression of the median nerve

Aftercare following decompression of the median nerve is comparatively straightforward. Most patients can move the hand again and take up everyday activities on the day of the operation.

Phase I (weeks 1 to 2): early mobilisation

The first phase of rehabilitation concentrates on restoring movement and reducing swelling. Gentle mobilisation exercises for the fingers and the wrist are possible on the very first day.

Phase II (weeks 3 to 4): functional activation

The second phase comprises exercises to strengthen the muscles of the hand and a step-by-step return to everyday activities. Wound healing is usually complete.

Phase III (weeks 5 to 6): building up load

Phase III focuses on taking up normal loading again and on integrating the hand fully into everyday life. Sporting activities can be resumed step by step.

Phase IV (from week 7): full integration

The final phase aims to restore full load-bearing capacity and to allow all activities without restriction. The symptoms of carpal tunnel syndrome should be markedly improved.