The purpose of the splint is to position the wrist in extension and resist the fetal flexion position that we assume at nighttime that leads to compression of the median nerve for 6 to 8 hours at a time. The second line of conservative care is to minimize or remove the offending activity from the patient's everyday routine. Changing work habits from using larger grip tools, or using shock-absorbing gloves for vibration jobs can be very helpful. Ergonomic evaluation of computer workstations can identify poor typing techniques or keyboard layouts that exacerbate the patient's symptoms. Delivery at the end of pregnancy and controlling diabetes or hypothyroidism also usually helps lessen the symptomatology.
Surgical treatment is offered for patients with profound changes on their nerve studies.
Another technique with an endoscope can also be performed with a horizontal incision at the wrist, which has quicker recovery time. The newest technique, one that I introduced to the community and featured on Channel 8 and 13 news, utilizes less than a 1 inch incision in the mid palm which has a recovery time of three to six weeks, after an aggressive occupational hand therapy program. I have performed almost 600 surgeries with this newer technique in the last four years, and have had significantly improved results that heal even quicker than the endoscopic technique. All techniques are performed as out-patient requiring no hospital stay and pain relief is near immediate with the numbness slowly resolving thereafter. Bronstein and Vahey are orthopaedic, hand and microvascular surgeons.