Complications following endoscopic release surgery.

johnno1970
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I am almost 9 weeks post endoscopic release surgery on my right hand. From the very first few days following surgery I knew something wasnt right. I had my left hand done 4 weeks prior to my right hand and everything went well with that recovery. My right hand is a completely different story. The nerve block wore off after 2 or 3 days but left me with constant numbness on half of my middle finger and half of my ring finger. This has not passed and remains numb. My hand remains quite swollen and has a very red blotchy look to it. I have constant throbbing pain in the tips of both the numb fingers. I cannot make a fist as I have limited movement and my wrist feels tight. I'm not able to lift anything either. I saw the surgeon last Friday and he doesnt know whats happening with it, so is sending me for a nerve conduction study. I fear that a nerve may have been damaged during surgery and that he may need to go back in to repair. I am trying to steer my mind away from possible CRPS as that would be a bad place to be. Anyway, fingers crossed that this can be fixed.

jeremydpbland
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Sounds like a problem with one of the palmar branches of the median nerve. If you have pre-operative NCS to compare with then repeating them carefully may yield some information but the new studies will need to be adapted in view of the new symptoms in the ring and middle fingers so you don't need just a 'standard' CTS test done by a technologist. High resolution ultrasound imaging by someone who knows about nerve imaging might also be useful but these are very smalll nerve branches we are talking about. JB 

johnno1970
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The only NCS on file for me was carried out in 2003. No new NCS was ordered prior to the surgery so I'm not sure if these would be worth looking at.
Back in 2003 I was advised to get the surgery done but with work commitments and endoscopic surgery not being an option at the time, I put the surgery off. I was a bit surprised that the surgeon did not order a new NCS this time.
One other symptom I forgot to mention was that the palm and inside of my hand get more sensitive as the day goes on.
If one of the palmar branches has been injured, can it be corrected without surgery? or does it depend on the nature of the injury?
Thanks for taking the time to give your opinion on this.

jeremydpbland
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It does depend to some extent on the nature of the injury but relatively few of these will be surgically repairable. You are right that 2003 NCS are severely out of date but still a little better than nothing. Not sure what to make of the palm symptoms - there is a separate nerve branch supplying the palm which passes outside the carpal tunnel. This is sometimes injured during surgery but not usually with the endoscopic version. JB

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