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.
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.
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.
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.
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.
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 Stop
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