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Physician Treats Loss of Feeling in Thumbs, Giners
Wednesday, October 20, 2010 • Posted October 20, 2010

When Juanita Waliky of Llano couldn’t feel her fingers anymore, she knew she needed to seek help.

"My hands started getting numb, and I would have to shake my hands before I could grab something," she said.

She had always worked with her hands, making jewelry, doing crafts and using the computer. Over the years, she did what she loved, but like many others who use their hands a lot, she developed carpal tunnel syndrome.

Carpal tunnel syndrome is caused by pressure on the median nerve—the nerve that runs down the forearm and into the palm. It supplies feeling and movement to parts of the hand, and when it is compressed, the restriction leads to numbness, tingling, weakness, or muscle damage in the hand and fingers. Some people experience numbness all the way up to their shoulder.

Ms. Waliky was referred by her primary care physician to J. Steven Hoerster, MD, an orthopedic surgeon with Texas Hill Country Orthopedics & Sports Medicine, P.A., in Fredericksburg.

Hand Surgery

Dr. Hoerster performed a procedure on Ms. Waliky’s hands called the Centerline Endoscopic Carpal Tunnel Release System. The procedure takes 5 to 10 minutes to perform, requires no external stitches, and a patient can use his or her hand to a limited extent the day of the surgery. Most importantly, the procedure restores median nerve functionality, renewing feeling throughout the hand. Dr. Hoerster said a hand which has undergone the procedure is normally able to pick up 5 lbs. in two weeks. The procedure can be performed on separate hands, two weeks apart, at Hill Country Memorial in Fredericksburg.

A company called Arthrex, located in Naples, Florida, developed the Centerline Endoscopic Carpal Tunnel Release System. Narrower than a pencil, the Arthrex instrument is inserted through a two to three centimeter incision at the apex of the wrist, and under the carpal ligament. Using a microscopic camera, Dr. Hoerster is able to make a shallow incision across the ligament, in line with the median nerve. The cut relieves pressure from the nerve and frees it to transmit signals all the way to the fingertips.

Dr. Hoerster, who was certified in hand surgery by the American Board of Orthopedic Surgery in 1990, was recently trained by Arthrex to perform the endoscopic procedure.

The loss of touch

Some people develop carpal tunnel because of manual labor or operating vibrating equipment. Repetitive motions, like doing a lot of typing, also contribute to the ailment. When the condition occurs, some lose the feeling in their fingers to such an extent that they have a difficult time feeling loose change in their pocket. They have to look at their hands to see if they’re holding the coins and determine if it’s quarters, nickels or dimes. For some, the condition is so severe they can’t feel if their fingers are on fire.

A physician can test the severity of carpal tunnel syndrome by testing the speed of signals traveling through the median nerve, and this is often the first step in diagnosing the problem.

Renewed feeling

For those who have undergone the Centerline Endoscopic Carpal Tunnel Release System performed by Dr. Hoerster, those signals can regain their velocity and the feeling completely returns, and all the conveniences that come with the sense of touch are restored. For Ms. Waliky, she was able to renew her crafts, including making jewelry.

"It brought feeling back into my hands," she said. "They’re no longer numb, and I don’t have to stop and shake them so I can feel and pick things up. I had both hands done, and you can hardly see where the incisions were made on my wrists."

Ms. Waliky said that before the procedures were performed, the signals traveling down her median nerve were clocked at 20 miles per hour. After the procedure, they were clocked at 55 miles per hour.

"I’m so thankful for this procedure, and that it is available in Fredericksburg," she said. "I would prefer to go to Hill Country Memorial, and Dr. Hoerster did a great job."

For more information about the Centerline Endoscopic Carpal Tunnel Release System, contact Dr. Hoerster at (830) 997-4043.


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