hi Dr Bland
when i saw you in jan you suggested that i be put on list for operation for my cts would this be on both wrists or just the worst wrist as the symptoms are worse in my right hand but my left hand has the worse result from the tests or do you think more injections would be of benefit as they seemed to have a good effect
I would like to know if there is going to be any issues with my medication having the surgery as i take antiplatelet medication and am diabetic

chris morris


We would generally operate on one wrist at a time, mostly doing the one which was causing the patient most trouble first regardless of the neurophysiological results, though it would be a bit odd for example to have a grade 5 which was causing less trouble than a grade 1 and if you saw a patient with that sort of asymmetry you would wonder if there was not another problem with the grade 1 hand.

Second injections are interesting. We are just about to publish a study on the subject and I can't put the details on here until the journal paper has appeared but the bottom line is that they are, on average about as successful as first injections, with some patients doing better and some worse with a second attempt at steroid treatment.

Antiplatelet medications and diabetes are issues for the operating surgeon - and one reason that we have a pre-op assessment before surgery. They do not normally cause major difficulties though as this surgery is done under local anaesthetic. JB

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