Carpal Tunnel Syndrome(CTS)
Conditions
Keywords
carpal tunnel syndrome, local steroid injection, sonography, sonography-guided
Brief summary
Purpose: To compare the outcome between sonography-guided steroid injection and direct steroid injection on carpal tunnel syndrome(CTS).
Detailed description
Material and methods: We have enrolled 26 ideopathic carpal tunnel syndrome patients (minimal to moderate according to Padua's classification).Thirteen patients were allocated in sonography approach group( sonography-guided local wrist injection, SAG) and the 13 patients were placed in direct approach group(direct local injection without using sonography, DAG). One , 3 and 6 months later after injection, we performed the outcome measures, including Boston symptom and functional scale, QuickDASH, nerve conduction study and sonography. If the patients receive the second injections, we will follow their treatment outcome by phone regularly at 1,3 and 6 months after first injection. If the patients were referred to surgery, the failures of local injection were considered and we will stop follow up them. After performing all assessment, we will compare the outcomes between the two groups.
Interventions
DRUGbetamethasone
Inject betamethasone on the wrist for patient with carpal tunnel syndrome with sonography- guided, directly.
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* with \>2 following symptoms : 1. disrupt sleep result in nocturnal paresthesia. 2. symptoms release by shaking hand. 3. pain and paresthesia during grasping. 4. any sensory symptom on first, 2th, 3th and partial 4th fingers. * symptoms \>1month. * Padua's classification : minimal, mild, moderate) * meet one of three diagnosis criteria of carpal tunnel syndrome.
Exclusion criteria
* any history can cause periphery nerve disease. * affected side had fracture or paralysis. * had accepted operation for carpal tunnel syndrome before. * pregnant * wrist or hand sprain, ulnar nerve disease cervical nerve root disease, multiple neuropathy or nerve anastomosis. * Padua's classification: severe, extreme. * ultrasonography show space occupying. * patient taking anticoagulants. * severe systemic disease. * wrist's skin or wrist joint has infection. * can't complete the 6 months' follow up. * allergy to steroid. * has cognition disorder.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| QuickDASH | Change from Baseline data at 6 weeks |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Record the neurological symptoms perceived by patient after injection according to their describtion | Change from Baseline data at 6 weeks | — |
| Semmes-Weinstein Monofilament test(SWMT) | Change from Baseline data at 6 weeks | — |
| Chinese version of Boston symptom and function scale for carpal tunnel syndrome, SS & FS | Change from Baseline data at 6 weeks | — |
| Nerve conduction study done on the affected hand using Necolet Viking Quest | Change from Baseline data at 6 weeks | We will record the latency, amplitude and conduction velocity retrieved from nerve conduction study of both motor neurons and sensory neuron |
| Sonography examination done with patients sitting, elbow flexion and forearm supination placing on table | Change from Baseline data at 6 weeks | The test will done twice and will record the average data of both the cross-section area and the bowing distance of transverse ligament of wrist. |
| 2-Point Discrimination test on 2nd digit | Change from Baseline data at 6 weeks | — |
Outcome results
None listed