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Short-Term Effectiveness of Ultrasound-Guided Corticosteroid Hydrodissection

Not Applicable
Completed
Conditions
Carpal Tunnel Syndrome
Interventions
Other: Corticosteroid Hydrodissection
Other: Corticosteroid Injection
Registration Number
NCT04848324
Lead Sponsor
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Brief Summary

Aim: Steroid injections are remarkably effective as a treatment for carpal tunnel syndrome (CTS) in the short term. The aim of this study was to determine whether hydrodissection would provide an additional clinical effect when used along with a corticosteroid in the short term.

Methods: A prospective cohort of patients with CTS were retrospectively evaluated. 28 patients were selected randomly who received ultrasound (US)-guided triamcinolone hydrodissection (3 mL) as intervention group and received US-guided triamcinolone injection (1 mL) as control group, from the data (case-control ratio 1:1). Outcome measures were the Boston Carpal Tunnel Questionnaire (BCTQ), hand grip strength (HGS), fhe cross-sectional area (CSA) of the median nerve and Short Form 12 (SF-12). Assessments were recorded at baseline, 1 and 4 weeks after injection.

Detailed Description

Background: Steroid injections are remarkably effective as a treatment for carpal tunnel syndrome (CTS) in the short term.

Aim: To determine whether hydrodissection would provide an additional clinical effect when used along with a corticosteroid in the short term.

Methods: A prospective cohort of patients with CTS were retrospectively evaluated. 28 patients were selected randomly who received ultrasound (US)-guided triamcinolone hydrodissection (3 mL) as intervention group and received US-guided triamcinolone injection (1 mL) as control group, from the data (case-control ratio 1:1). Outcome measures were the Boston Carpal Tunnel Questionnaire (BCTQ), hand grip strength (HGS), fhe cross-sectional area (CSA) of the median nerve and Short Form 12 (SF-12). Assessments were recorded at baseline, 1 and 4 weeks after injection.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
28
Inclusion Criteria
  1. aged between 18-65
  2. clinically diagnosed with CTS
  3. electrophysiologically confirmed mild-to-moderate CTS
  4. having typical CTS symptoms for at least 3 months
  5. not benefiting from splinting and resting.
Exclusion Criteria
  1. electrophysiologically diagnosed with severe CTS
  2. surgery history for CTS
  3. presence of metabolic, endocrine and neoplastic disorders
  4. presence of other neurological disorders (such as plexopathy, cervical radiculopathy, proximal median or ulnar neuropathy, polyneuropathy and mononeuritis multiplex)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Intervention groupCorticosteroid Hydrodissection14 patients (14 hands) who received US-guided corticosteroid hydrodissection
Control groupCorticosteroid Injection14 patients (14 hands) who received US-guided corticosteroid injection
Primary Outcome Measures
NameTimeMethod
Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)baseline, change from baseline BCTQ at 1 and 4 weeks after injection

The Boston Carpal Tunnel Questionnaire (BCTQ) consisting of two subscales (Symptom Severity Scale (SSS) and Functional Status Scale (FSS)) was filled out by the patient him/herself. Both subscales of BCTQ are scored between 1 and 5, and higher scores illustrate a greater degree of disability. The Turkish validity of the questionnaire was demonstrated.

Hand grip strength (HGS)baseline, change from baseline HGS at 1 and 4 weeks after injection

The Standard Jamar Dynamometer was used to measure HGS. The patients were placed in a sitting position with the forearm in a neutral position and the elbow in 90 ° flexion. Three consecutive measurements were performed and the average value of the measurements were noted. Studies have shown that the Jamar dynamometer has high validity and reliability and is considered to be the gold standard for evaluating HGS

Cross-Sectional Area of the Median Nervebaseline, change from baseline CSA at 1 and 4 weeks after injection

The cross-sectional area (CSA) of the median nerve was measured at the scaphoid-pisiform level by using US since the swelling of the median nerve is a reliable measure for post-injection follow-up at this level (Figure 3). Three measurements were done and averaged for analysis.

Secondary Outcome Measures
NameTimeMethod
Short Form 12 (SF-12)baseline, change from baseline SF-12 at 1 and 4 weeks after injection

Quality of life was assessed with the Turkish version of Short Form 12 (SF-12). A physical component score and a mental component score are obtained from the SF-12. Higher scores show better outcomes.

Trial Locations

Locations (1)

Merve Orucu Atar

🇹🇷

Ankara, Cankaya, Turkey

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