Surgery

Surgery is usually recommended if you’ve had a musculoskeletal disorder for a long time, your symptoms are severe and non-surgical treatments have failed. It can also be recommended if the doctor detects a wasting of the muscles or loss of sensation due to computer activity. In very rare cases, surgery is performed in initial stages of RSI development. There aren’t many ways in which hand surgery can be performed, and the few RSI-related disorders which have surgical solutions are:

• Carpal Tunnel Syndrome
• Trigger Fingers
• Arthritis

Surgical solutions for these disorders use three techniques:

• Carpal Ligament Release Surgery
• Triggers Fingers Release Surgery
• Arthritis Surgery

Below is a brief description of the three surgeries.

Carpal Ligament Release Surgery

This is a surgical procedure in which the surgeon opens the wrists to cut the flexor rentinaulum ligament at the bottom of wrist to relieve the pressure. First a local anesthetic is injected in the wrist and the carpal ligament is severed. This results in a release in pressure on the median nerve. Surgeons will then close the skin and subcutaneous tissues only over carpal ligament leaving the carpal tunnel uncovered. Few surgeons reattach the carpal ligament after stretching it. After surgery a physiotherapy program begins. Carpal Ligament Release Surgery can be performed endoscopically. Only a skilled surgeon can operate in this way.

Trigger Finger Release Surgery

This surgery enlarges narrow part of the tunnel. This allows the lump in tendon to pass freely back and forth through the narrow area resulting normal motion.

Arthritis Surgery

In this type of surgery, the arithiel surfaces are removed and material is inserted between the two ends of the bones. Material can be a natural tendon from patient or a synthetic plastic rubber shaped to fit the space.   Some surgeons fuse the two bones making up the joint thereby eliminating the joint and pain.

Surgery Success Rate

 A study found, in an average of 5.5 years, 30% of all patients rate the results as poor to fair. 57% report rate the return of some preoperative symptoms, most commonly pains beginning an average of 2 years after surgery, although only one patient required further surgery. Intermittent pain was reported by 42%, digital numbness by 32% and tingling highly 35%. This study was presented in American Medical Association meeting.

Cost of surgery

According to US Government datasets, average total charges per patient for diagnosis related group of carpal tunnel release were $8185.24. The reported median cost for endoscopic release of the transverse carpal ligament was $849.84.

The average lifetime cost of carpal tunnel syndrome, endured by employees, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker.

Although surgery may seem to be an attractive option, it is certainly not the most effective one. The numbers certainly go against these surgical techniques and the cost of the diagnosis and surgery is very high. Non-surgical techniques should be considered and explored more rigorously before resorting to surgery.

Surgery related links:

http://eeshop.unl.edu/rsi.html

http://en.wikipedia.org/wiki/Carpal_tunnel_syndrome