Carpal Tunnel Decompression Orthopaedic Department Patient Information Leaflet

Transcription

1 Carpal Tunnel Decompression Orthopaedic Department Patient Information Leaflet Originator: G Parsons Date: March 2012 Version: 3 Date for Review: March 2015 DGOH Ref No: DGOH/PIL/00648

2 Contact numbers If you have any questions or are unsure about any of the information provided in thisorbooklet, you about can contact If you have any questions are unsure any ofthe the pre-assessment on the following number: information provided in this booklet, you can contact the pre-assessment on the following number: Pre-Assessment Tel: Pre-Assessment Tel:

3 Do you have any questions? Introduction Please use the space below to remind you of what you want to ask Nerves are more sensitive to pressure changes than most body parts. Continuous or periodic compression on a nerve can cause damage over time. Certain nerves are located in regions of the body that are especially vulnerable to compression injuries. The most common is the Carpal Tunnel. Illustrations used by kind permission of the Arthritis Research Campaign ( Carpal tunnel syndrome The Carpal Tunnel is a narrow, channel formed by the carpal bones of the wrist. The median nerve enters the hand through the carpal tunnel. Inflammation of the muscles, tendons or a fracture of the wrist can reduce space in the carpal tunnel and so cause pressure on the nerves Oedema - increased fluid in the carpal tunnel due to tissue injury, congestive cardiac failure or pregnancy Fractures - Fractures and dislocations of the wrist, displaced bones or spurs disrupt the carpal tunnel 3

4 Carpal tunnel size - inherited small bone structure may lead to increased evidence of carpal tunnel syndrome Hypothyroidism Symptoms of carpal tunnel syndrome are:a dull ache in the wrist and forearm with pain radiating in to the fingers A burning pain in the wrist with numbness or loss of feeling in the thumb, index finger and middle finger which the median nerve supplies Pain which is worse at night Conservative treatment Resting the hand Wearing a wrist splint at night Modify hand activity and work environment Steroid injections or thyriod replacement Surgery In moderate and severe cases, surgery may be necessary. The aim of surgery is to prevent further damage to the nerve. The nurse discharging you will provide you with a discharge sheet for your own reference, a letter for your G.P, a sick note, should you require one, and any medications required Arrangements will be made to have your sutures removed, usually after days Your follow up appointment will be made for 6 weeks following surgery When may I return to work? It is advisable to wait until after your sutures are removed before returning to work or driving a car. Manual worker may require a little more time to recover and return to work. Please ensure that your wound dressing remains clean and dry. If you should have any problems with your dressing, or have any other queries, please contact the orthopaedic assessment unit or the ward where you had your surgery. Further Information If you require any further information please call: Pre-Assessment Risks of surgery There is always a small element of risk involved in any type of surgery. 4 9

5 Theatre A Nurse will walk to theatre with you, on entering; a theatre representative will again check your personal details with you and will accompany you into the anaesthetic room. Post operative care Your blood pressure and pulse will be taken Your hand will be observed for colour, warmth and sensation; you may have your hand elevated on one pillow You will be asked if you have any pain, and pain relief will be administered orally if this is the case Once you have had something to eat and drink you will be allowed out of bed If you are comfortable and recovered from the anaesthetic, you will be allowed to go home You will be fitted with an arm sling to wear during the day Your dressing will need to be reduced (padding removed) after 48 hours. You will be advised how to care for your dressing prior to your discharge home You must ensure you arrange for an adult to take you home as you will not be able to drive You will need an adult to stay with you for 24 hours, if you are allowed to go home on the day of surgery The main complications are as follows:infection Symptoms - tingling and numbness may take several weeks to settle, and some of the symptoms may not completely go away, because the nerve has been compressed for a long time Reduced grip strength for a few months Muscle weakness prior to the surgery, may never recover Rarely, injury to the median nerve Pre-operative assessment You will be seen in orthopaedic assessment unit prior to you admission. You may require the following test (s): Blood Test: Necessary if you are a diabetic or take certain medications E.C.G: or heart trace test. This is nothing to be alarmed about, just a routine test necessary if you have high blood pressure or are a smoker and so on Your blood pressure, pulse and weight will also be recorded You will have groin & nasal swabs taken for MRSA this is a routine procedure for all elective surgery Your visit to the Orthopaedic assessment unit will give you an opportunity to discuss any problems you may have to ask any questions regarding your surgery and hopefully, give you a better understanding of your treatment. 8 5

6 What to do if you become ill before your admission Following your assessment please contact the unit if you develop any of the following: A cold, chesty cough or throat infection Skin problems, for example, abrasions/lacerations, rashes infections, especially on the area that is to be operated on Orthopaedic assessment unit: Day Case Unit: What you will need to bring into hospital Please bring a dressing gown and slippers with you if you are attending the day case unit. If you require an overnight stay, please bring night attire, toiletries etc (you will be informed in your assessment, if you require an overnight stay). What you will not need Ladies- please do not wear any makeup or nail varnish, including toenails. All jewellery must be removed prior to surgery, and we advise you to leave your jewellery at home. Wedding rings can be worn as long as surgery is not on the left side. 6 Ward admission On admission to the ward you will be shown to your bed and locker, where personal belongings can be stored. It is important that valuables, for example, jewellery and large cash sums are not brought into the hospital, as the trust will not accept responsibility for loss or damage, (you will have signed a trust disclaimer form during your assessment). The ward takes a team based approach to nursing care; a member of the team will complete all relevant documentation with you. Theatre preparation On admission a member of the team will check blood pressure, temperature and pulse. They nurse will also ask you a number of questions from the theatre checklist, which will be rechecked several times prior to surgery. These questions are to ensure you full understand the theatre procedure. During this time you will be informed of the approximate time of surgery and will be asked to undress and to put on a theatre gown, paper pants and cap The anaesthetist may visit you to assess you and will discuss whether you may require a General Anaesthetic (GA) or a Local Anaesthetic (LA). The Orthopaedic doctor will also be on hand to answer any questions you may have and to explain the procedure, and witness you signing the consent form if you have not already done so. The doctor will also "mark" the limb which is to be operated on. 7