Surgery to the wrist or hand

This factor is limited to surgery which:

·    alters the normal contour of the carpal tunnel; or

·    damages the median nerve or flexor tendons within the carpal tunnel.

The wrist is the part of the arm between the forearm and the hand, in the region of the wrist joint.  It is also called the carpus.

The carpal tunnel lies between the carpal bones and the flexor retinaculum (an overlying tough band of connective tissue).

Any surgical procedure to the wrist or hand would normally be recorded in doctors' notes and/or hospital records.  Because it is necessary to identify whether or not the surgery altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel, you must seek medical advice if this is not established by the information available.

LAST REVIEWED FOR CCPS 21 FEBRUARY 2014.

INVESTIGATIVE DOCUMENTS

PRELIMINARY QUESTIONS [17097]

17511 there is some evidence that surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel may be a factor in the development or worsening of the condition under consideration.

25473 the veteran has undergone surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body at some time.

17291 the surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body was for treatment of an illness or injury which is identifiable.

17276  the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and VEA service for carpal tunnel syndrome.

25474 the veteran underwent the surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, for the identified illness or injury, within the year before the clinical onset of the condition under consideration.

17278   the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and VEA service for the clinical onset of carpal tunnel syndrome.

17281  the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and operational service for the clinical onset of carpal tunnel syndrome.

or

17282  the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and eligible service for the clinical onset of carpal tunnel syndrome.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

17290 the veteran underwent the surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, for the identified illness or injury, within the year before the clinical worsening of the condition under consideration.

17280   the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and VEA service for the clinical worsening of carpal tunnel syndrome.

17283  the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and operational service for the clinical worsening of carpal tunnel syndrome.

or

17284  the veteran has established the causal connection between the surgery which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel and eligible service for the clinical worsening of carpal tunnel syndrome.

CLINICAL ONSET AND OPERATIONAL SERVICE [17281]

17292  the identified illness or injury, for which the veteran underwent surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, is causally related to operational service.

CLINICAL ONSET AND ELIGIBLE SERVICE [17282]

17293  the identified illness or injury, for which the veteran underwent surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, is causally related to eligible service.

CLINICAL WORSENING AND OPERATIONAL SERVICE [17283]

17292  the identified illness or injury, for which the veteran underwent surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, is causally related to operational service.

17294 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for which the veteran underwent surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, is causally related.

CLINICAL WORSENING AND ELIGIBLE SERVICE [17284]

17293  the identified illness or injury, for which the veteran underwent surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, is causally related to eligible service.

17295 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for which the veteran underwent surgery to other relevant side and site of the body or wrist which altered the normal contour of the carpal tunnel or damaged the median nerve or flexor tendons within the carpal tunnel of side and site of the body, is causally related.