Sequelae of carpal tunnel syndrome
Compression of the median nerve around the wrist (please see the blog on carpal tunnel
compression for further information), if left untreated can result in loss of use of the thumb for simple day to day activities. In such cases carpal tunnel surgery alone will not address the patient’s symptoms. In addition to releasing the carpal tunnel, patient would benefit from tendon transfer surgery to the thumb. This involves borrowing a strip of tendon from the front of the forearm (lower part of the arm) and re-routing it to the base of the thumb.
I would like to share the case of a 70- year old patient who came to see me with pins and needles in his fingers and thumb and loss of thumb function as shown in the video. Once relevant clinical examination and the relevant investigations were performed, carpal tunnel release and tendon transfer surgery was planned. The surgery was performed under local anaesthesia with the patient fully awake, and patient was discharged the same day following his surgery. Subsequently, he underwent rehabilitation under the closed supervision of the hand therapist and regained full use of the thumb as demonstrated below.