Carpal tunnel syndrome, Dupuytren’s contracture, trigger finger, and ganglia: skills

With all but the most severe cases of carpal tunnel syndrome (CTS), injection should be considered before surgery. Severity includes muscle wasting and permanent numbness in the median nerve distribution. Wasting of the thenar muscles tends to be permanent, even after decompression (Figure 22.1). In cases such as these, the priority is urgent referral for surgical carpal tunnel decompression (CTD).