Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome

Demirci, Serpil; Kutluhan, Süleyman; Koyuncuoglu, Rifat H.; Kerman, Memduh; Heybeli, Nurettin; Akkuş, Selami; Akhan, Galip

doi:10.1007/s00296-002-0184-0

Cited by 55 publications

(60 citation statements)

References 17 publications

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“…Demirci et al compared open carpal tunnel release to steroid injection in 90 patients with electrodiagnostically proven carpal tunnel syndrome [12]. They followed patients symptomatically and with electrodiagnostics and the Boston Questionnaire at 3 and 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have combined outcome measures and the results of NCS with treatment with steroids [1,12,22,24].…”

Section: Introductionmentioning

confidence: 99%

“…While the shortterm efficacy of steroid injections is well established, the duration of benefit is variable [5,13,15,23,28,36,38]. Steroid injections into the carpal tunnel produce improvement in nerve conduction studies (NCS) [1,6,8,12,22,36].…”

Section: Introductionmentioning

confidence: 99%

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Prospective Comparison of the Six-Item Carpal Tunnel Symptoms Scale and Portable Nerve Conduction Testing in Measuring the Outcomes of Treatment of Carpal Tunnel Syndrome with Steroid Injection

Craw

Church

Hutchison

2014

Hand (New York, N,Y.)

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Background We prospectively studied patients clinically diagnosed with carpal tunnel syndrome (CTS) and treated with the injection of corticosteroid into their carpal tunnel in order to compare changes in the six-item CTS symptoms scale and portable nerve conduction study (NCS) parameters as outcome tools. Our pilot study was the first to assess the utility of the six-item CTS symptom scale (CTS-6) with steroid injections as a patient-directed outcome measure for the treatment of CTS. Methods We enrolled patients who presented to our county hospital orthopedic surgery clinic from August 2012 through August 2013. The patients were clinically diagnosed with CTS. After completing the six-item CTS symptoms scale questionnaire, portable NCS was obtained. Each patient then received an injection of 1 ml of triamcinolone acetonide 40 mg/ml mixed with 1 ml of 1 % lidocaine into the carpal tunnel. Six weeks postinjection, each patient repeated a CTS-6 questionnaire and underwent a repeat portable NCS. The CTS-6 and NCS results were analyzed using the paired samples t test. A Pearson correlation was used to assess the correlation between the changes in the CTS-6 and the NCS measurements. Statistical significance was set at P<0.05. Results Thirty-two wrists in 20 patients were evaluated. There was a statistically significant difference between the CTS-6 scores before and after injection. There were also statistically significant changes in the five of the NCS parameters. None of the correlations between the CTS-6 and the NCS parameters were statistically significant. Conclusions The six-item CTS symptoms scale and portable NCS are both useful measures for evaluating the results of steroid injections. The CTS-6 is an effective tool because of its ease of use, low cost, correspondence with changes in NCS, and ability to monitor the outcome of steroid treatment for carpal tunnel syndrome.

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Section: Discussionmentioning

confidence: 99%

“…Few studies have combined outcome measures and the results of NCS with treatment with steroids [1,12,22,24].…”

Section: Introductionmentioning

confidence: 99%

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Prospective Comparison of the Six-Item Carpal Tunnel Symptoms Scale and Portable Nerve Conduction Testing in Measuring the Outcomes of Treatment of Carpal Tunnel Syndrome with Steroid Injection

Craw

Church

Hutchison

2014

Hand (New York, N,Y.)

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“…Nonoperative treatments often fail, including local steroid injections, splinting, oral steroids, and ultrasound therapy and a complete division of the transverse carpal ligament should be considered to treat this compressive neuropathy [9,14,28].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Carpal Tunnel Release Is Preferred Over Mini-open Despite Similar Outcome: A Randomized Trial

Kang

Koh

Lee

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The decision to perform endoscopic versus the mini-open carpal tunnel release technique is most likely left to surgeons rather than patients with idiopathic carpal tunnel syndrome. Questions/purposes We hypothesized that (1) at 3 months after surgery, the subjective outcomes of endoscopic release, performed on one hand, and mini-incision release, performed on the other, would not differ in patients with bilateral carpal tunnel syndrome; however, (2) each patient would likely prefer one technique over the other for specific reasons. Methods Fifty-two patients with bilateral carpal tunnel syndrome had one hand randomized to undergo endoscopic release and the other to undergo mini-incision release. Each patient was assessed with the Boston Carpal Tunnel Questionnaire (BCTQ) and DASH preoperatively and at each followup. Three months after surgery, the patients commented on which technique they preferred and completed a questionnaire regarding the reasons for not preferring the other technique. Results The mean BCTQ symptom/function score and DASH improved similarly in the endoscopic release group and the mini-incision release group. Thirty-four patients preferred endoscopic release and 13 preferred the miniincision technique. Scar or pillar pain was the most commonly cited factor in not preferring either technique followed by postoperative pain for the open technique and transient worsening of symptoms for the endoscopic technique. Conclusions Despite similar improvements in BCTQ and DASH scores after endoscopic and open techniques at 3 months postoperatively, the majority of our patients preferred the endoscopic technique. The most concerning reason for not preferring the other technique was scar or pillar pain. Level of Evidence Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…Motor nerve action potentials were assessed as orthodromic. Motor sweep speed was 5 msec/div (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Sensory sweep speed was 1 msec/div (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Methodsmentioning

confidence: 99%

The effect of steroid injection by Novel method in carpal tunnel syndrome on pain severity and electrophysiological findings

Özdemir¹,

Demir²,

Özel³

et al. 2014

Diclemedj

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ÖZETAmaç: Bu çalışmadaki amacımız Novel metodu ile yapı-lan lokal steroid enjeksiyon tedavisini hastanın sübjektif şikayetleri ile elektrofizyolojik çalışmalar üzerine olan etkilerinin 3 ay sonra incelenmesidir.Yöntemler: Hafif düzeyde karpal tünel sendromu olan, 5 erkek ve 54 kadın olmak üzere toplam 59 kişide ve 101 elden Novel tekniği ile steroid enjeksiyonu yapıldı. Ağrı şid-detini belirlemek için görsel analog skalası (Visual Analogue Scale) (VAS) uygulandı. VAS ile sinir ileti bulguları enjeksiyon öncesi ve 3 ay sonrası karşılaştırıldı.Bulgular: VAS'a göre sağ el (n:56) enjeksiyon öncesi ortalama ağrı şiddeti 7.79±1.4 3 ay sonrası 3.29±1.9. Sol el (n:45) enjeksiyon öncesi ortalama ağrı şiddeti 7.71±1.2 3 ay sonrası 3.16±2.0 idi. Enjeksiyon sonrası, her iki elde median motor sinir distal latansı istatistiksel olarak anlamlı bulundu (p<0.001). Enjeksiyon sonrası her iki elde median motor hızları istatistiksel olarak anlamsızdı. Enjeksiyon sonrası, her iki elde median duysal distal latansı, amplütüd ve hızı istatistiksel olarak anlamlı bulundu. Sonuçlar: Bizim çalışmamız gösterdi ki hafif şiddetteki karpal tünel sendromunda lokal kortikosteroid enjeksiyon tedavisi sübjektif yakınmalar ve elektrofizyolojik bulgular üzerine etkilidir. Non-dominant elde düzelme, diğer ele göre daha fazla olduğundan dolayı lokal enjeksiyon ile beraber eli nötral pozisyonda tutacak splintler kullanılmalı ve el istirahati yapılmalıdır.Anahtar kelimeler: Karpal tünel sendromu, Novel metod, steroid enjeksiyonu, ağrı şiddeti, sinir ileti çalışmaları ABSTRACT Objective: The aim of the present study is to investigate the effects of local steroid injection therapy with the Novel method on subjective patient complaints and electrophysiological investigations at the end of 3 months.Methods: 101 hands of 59 subjects (5 men and 54 women) with mild carpal tunnel syndrome received steroid injection with the Novel technique. Visual Analogue Scale (VAS) was used to determine the severity of pain. Nerve conduction findings obtained prior to and 3 months after the injection were compared using the VAS.Results: According to the VAS, mean pain severity for the right hand (n:56) was 7.79±1.4 before the injection, and 3.29±1.9 at 3 months. Mean pain severity for the left hand (n=45) was 7.71±1.2 before the injection, and 3.16±2.0 at 3 months. Median motor nerve distal latency was statistically significant for both hands after the injection (p<0.001). Median motor velocity was statistically non-significant in both hands after the injection. After the injection, median sensory distal latency, amplitude and velocity were statistically significant for both hands. Conclusion:The present study showed the efficacy of local steroid injection therapy on subjective complaints and electrophysiological findings in mild carpal tunnel syndrome. Because the improvement is greater in the non-dominant hand compared to the other, splints should be used to keep the hand in neutral position and hand rest should be employed in addition to the local injection.

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Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome

Cited by 55 publications

References 17 publications

Prospective Comparison of the Six-Item Carpal Tunnel Symptoms Scale and Portable Nerve Conduction Testing in Measuring the Outcomes of Treatment of Carpal Tunnel Syndrome with Steroid Injection

Prospective Comparison of the Six-Item Carpal Tunnel Symptoms Scale and Portable Nerve Conduction Testing in Measuring the Outcomes of Treatment of Carpal Tunnel Syndrome with Steroid Injection

Endoscopic Carpal Tunnel Release Is Preferred Over Mini-open Despite Similar Outcome: A Randomized Trial

The effect of steroid injection by Novel method in carpal tunnel syndrome on pain severity and electrophysiological findings

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