Bilateral (Both Wrists) Carpal Tunnel Syndrome Surgery

Endoscopic carpal tunnel release can be done, and is frequently done, on both wrists during one session of general anesthesia. This allows for one episode of surgical care and one postoperative rehabilitation period. Patients are advised to and should be able to return to activities of daily living, light work and hobbies as tolerated shortly after surgery on both wrists. Padded dressings are to be kept dry for 24 to 48 hours and can then be removed and the waterproof dressing placed at the time of surgery is to be left in place until 10 to 14 days after surgery. The palms and wrists will be sore for approximately two months postoperatively. Heavy gripping, grasping, lifting, pushing and pulling activities can commence shortly thereafter.

Endoscopic carpal tunnel release can be done on one side at a time approximately 6 to 12 weeks apart. However, many patients will minimally use the operative hand and will develop increasing stiffness and weakness as a result of disuse. Additionally, the hand and wrist that has not been surgically treated for ongoing carpal tunnel syndrome will tend to be used in isolated fashion and will likely lead to an increase in carpal tunnel syndrome symptoms secondary to the increased demand.

Therefore, for the majority of patients with bilateral, or both sides, carpal tunnel syndrome, the recommendation for bilateral endoscopic carpal tunnel release is provided.

Research from the flagship orthopedic journal, Journal of Bone and Joint Surgery (JBJS), provides support for maintenance of independence with respect to activities of daily living after bilateral carpal tunnel release surgery: 

 

https://www.ncbi.nlm.nih.gov/pubmed/24897736

 

J Bone Joint Surg Am. 2014 Jun 4;96(11):889-896. Epub 2014 Jun 4.

Simultaneous Bilateral or Unilateral Carpal Tunnel Release? A Prospective Cohort Study of Early Outcomes and Limitations.

Osei DA1Calfee RP1Stepan JG1Boyer MI1Goldfarb CA1Gelberman RH1.

Author
Kristopher L Downing MD

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