After carpel tunnel surgery i fell on it open handed. x-rays show no broken bones, but it is so painful, even 3 weeks after the fall. what could it be?

Soft tissue trauma: Every fall does not mean fracture, you have soft tissue trauma to surgical area , may be to nerve, see a neurologist.

Reinjured surg. site: Falling on your rsurgical incision area can be painful, even weeks after surgery depending on the nature of your fall, and how hard you landed on your hand(s). Speak to your doctor for pain management. Get a 2nd opinion from a do, who can also treat you osteopathically, post trauma to remove some of the vector forces that's still at play from the fall, and have that corrected. May decrease pain.

After: Carpal tunnel release patients need to avoid pressure on the palm of the hand to avoid what is known as pilar pain. That is probably your problem, but further evaluation is needed. Need to talk to your doctor. Therapy, steroid, splinting and other forms of treatment are available

Have it evaluated.: If it is not fractured you may have sustained a soft tissue injury to the ligaments, tendons or the nerve. Have it evaluated and get the appropriate treatment.