Endoscopic Carpal Tunnel Release (ECTR) is a minimally invasive surgical procedure used to treat carpal tunnel syndrome, a condition that causes pain, numbness, and tingling in the hand and fingers due to pressure on the median nerve. The procedure relieves this pressure by releasing the ligament that forms the roof of the carpal tunnel.

The carpal tunnel is a narrow, rigid passageway that can be found on the palm side of your wrist. Comprising ligaments and bones, the carpal tunnel protects the median nerve and the tendons responsible for bending your fingers. Any condition that causes a narrowing of the carpal tunnel or otherwise exerts pressure on the median nerve can result in carpal tunnel syndrome.

When Is Carpal Tunnel Surgery Recommended?

Carpal tunnel may be considered when:

• Symptoms persist despite non-surgical treatment such as splinting or injections.

• Numbness or weakness in the hand is worsening

• Daily activities such as gripping, writing, or sleeping are affected

• There is evidence of nerve compression or damage

Goals of Surgery

The aim of carpal tunnel surgery is to:

• Relieve pressure on the median nerve

• Reduce pain, numbness, and tingling

• Restore hand strength and function

• Allow a quicker recovery with minimal scarring

Endoscopic carpal tunnel release is an effective treatment for relieving symptoms of carpal tunnel syndrome and helping patients return to normal hand function and daily activities.

De Quervain’s Release is a minor surgical procedure used to treat persistent pain and inflammation caused by De Quervain’s tenosynovitis. It can affect the tendons on the thumb side of the wrist, leading to pain with thumb movement and gripping activities. The procedure relieves pressure on the tendons to restore comfortable movement.

The affected area involves the sheath (tunnel) that surrounds the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons near the base of the thumb. In De Quervain’s tenosynovitis, this sheath becomes thickened and constricted. During surgery, the sheath is carefully released to allow the tendons to glide freely again.

Treatment for De Quervain’s Tenosynovitis:

It is often possible to treat De Quervain’s tenosynovitis non-surgically, simply by resting the affected wrist and thumb for four to six weeks while wearing a splint to hold the area still. 

If more conservative treatments prove ineffective, then Dr. Sungaran may recommend surgery to release the tendon sheath.  This will allow the tendons greater room to move, thereby removing friction and restoring ease of movement.  After a suitable healing period, patients undergo a physical therapy program with a trusted hand therapist in order to rebuild strength in their thumbs and wrists.

Dupuytren’s contracture, also known as palmar fibromatosis, is a hand deformity marked by the gradual thickening of the tissue beneath the surface of the palm.  As this tissue thickens, lumps, or nodules, eventually begin to form.  Over time, these nodules harden into tough, thick cords that contract, pulling the fingers most often the ring and pinkie fingers back into a permanently curled position.  While not dangerous to one’s health, the deformity can certainly complicate one’s life and ability to perform even simple tasks.

When Is Surgery Recommended?

Surgical treatment may be considered when:

• Finger contracture interferes with daily activities such as grasping or placing the hand flat

• The fingers are progressively bending and cannot be straightened

• Hand function and dexterity are significantly reduced

• Non-surgical options are no longer effective or appropriate

Goals of Surgery

The aim of Dupuytren’s contracture release is to:

• Improve finger extension (straightening)

• Restore hand function and grip

• Slow progression of the condition

• Improve overall quality of life

It is important to note that even after surgery for Dupuytren’s contracture, symptoms may recur.  Months of post-surgical physical therapy are necessary to achieving the best possible results.

When a joint is affected by arthritis, this can cause a variety of symptoms, including pain and limited mobility. In some cases, medical treatments like medications or injections may help. Unfortunately, medical treatments aren’t always able to resolve the symptoms. Patients may experience limitations on their daily activity, and their quality of life may be affected.

When Is A Wrist Replacement Recommended?

Wrist replacement may be considered when:

• Wrist pain persists despite non-surgical treatment

• Arthritis has significantly damaged the joint

• Daily activities such as gripping, lifting, or writing are affected

• Mobility and hand function are reduced

Goals of Surgery

The aim of total wrist replacement is to:

• Reduce or eliminate wrist pain

• Improve joint movement and flexibility

• Restore hand and wrist function for everyday activities

• Improve overall quality of life

Trigger finger, clinically known as stenosing tenosynovitis, is a condition in which the flexor tendons no longer function properly, thereby restricting a person’s ability to straighten his or her finger after bending it. This condition may affect one or more of the fingers as well as the thumb at any given time. Commonly, the affected finger straightens with a sudden snap, similar to that which occurs when a trigger is released. However, in severe cases, the finger may become locked in the bent position.

When Is A Trigger Finger Release Recommended?

Trigger finger release may be considered when:

• Finger locking or catching persists despite non-surgical treatment

• Pain or stiffness interferes with daily activities

• Symptoms do not improve with splinting, rest, or corticosteroid injections

• Finger movement becomes increasingly limited

Goals of Treatment

The aim of trigger finger release is to:

• Eliminate locking or catching of the finger

• Reduce pain and stiffness

• Restore smooth finger movement

• Improve hand function for everyday activities

Trigger finger release is typically a quick and highly effective procedure, with most patients experiencing rapid relief of symptoms and a return to normal hand use.

Ganglion Cyst Excision is a surgical procedure used to remove a ganglion cyst, a benign fluid-filled lump that commonly develops around the wrist or hand. While many ganglion cysts are harmless, surgery may be recommended if the cyst causes persistent pain, restricts movement, compresses nearby nerves, or continues to recur after aspiration or other non-surgical treatments.

A ganglion cyst arises from the lining of a joint or tendon sheath and is filled with a thick, jelly-like fluid. Although the exact cause is not always known, these cysts can vary in size and may become more noticeable with activity. They most commonly occur on the back or front of the wrist but can also develop on the fingers or other joints of the hand.

Ganglion cyst surgery may be considered when:

• The cyst causes ongoing pain or discomfort

• The cyst interferes with hand or wrist movement and function

• There is pressure on a nearby nerve causing numbness or tingling

• The cyst has recurred after aspiration or other conservative treatment

• The appearance of the cyst is a significant concern for the patient

The aim of ganglion cyst surgery is to:

• Remove the cyst along with its stalk to reduce the risk of recurrence

• Relieve pain and pressure on surrounding structures

• Restore normal hand and wrist movement

• Improve hand function and comfort during daily activities

Ganglion cyst excision is a safe and effective procedure that can provide lasting relief from symptoms while restoring normal hand and wrist function, allowing most patients to return to their usual activities following recovery.

Cubital Tunnel Release is a surgical procedure used to treat cubital tunnel syndrome, a condition that causes pain, numbness, and tingling in the ring and little fingers due to pressure on the ulnar nerve at the elbow. The procedure relieves this pressure by releasing the tissues that compress the nerve and, in some cases, repositioning the nerve to reduce ongoing irritation.

Cubital tunnel surgery may be considered when:

• Symptoms persist despite non-surgical treatment such as activity modification, splinting, or physiotherapy

• Numbness or weakness in the hand is worsening

• Hand grip strength or finger coordination is affected

• Daily activities or sleep are disrupted by symptoms

• There is evidence of ongoing nerve compression or muscle wasting

The aim of cubital tunnel surgery is to:

• Relieve pressure on the ulnar nerve

• Reduce pain, numbness, and tingling

• Prevent further nerve damage

• Restore hand strength and function

• Improve comfort and allow a return to normal daily activities

Cubital tunnel release is an effective treatment for relieving symptoms of ulnar nerve compression at the elbow and helping patients regain hand function while preventing permanent nerve damage.