NCCT Case 1

Grace, a secretary at the local high school, presents to Dr. Smith with complaints of numbness, tingling and pain in her left hand. After examination of the volar surface of the hand, Dr. Smith notes that the symptoms are localized to the thumb and index finger. He also notes the pain sometimes radiates up her arm, into her shoulder, and occasionally wakes her up at night. Grace has been diagnosed with Carpal Tunnel Syndrome.

What anatomical structures will be the focus of the surgery to relieve the carpal tunnel syndrome?

Median nerve, carpal ligament, specifically the left wrist for this scenario. 

In what position should the patient be placed?

Supine, with affected arm extended on a hand table 

What are the surgical repair options? 

Open carpal tunnel release 

Endoscopic carpal tunnel release

List equipment that the surgical tech assigned to this case should ensure is in the operating room before the surgery starts.

• Hand tray 

• Hand table 

• Video equipment for endoscopic release 

• Tournique