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Comparison of Surgical Decompression and Local Steroid Injection in the treatment of Carpal Tunnel Syndrome


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1 Department of Surgery/College of Medicine/Tikrit University/Tikrit, Iraq
     

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Carpal tunnel syndrome (CTS) is considered the most common of all entrapment neuropathies cause significant symptoms that interfere with normal life of the patients including parasthesia, numbness, weakness of thumb abduction. These symptoms might awake the patient at night. CTS can be treated by surgical and non surgical methods, however there is no consensus on the most effective method of treatment. Non surgical methods include (splintage, U/S, local injection). The aim of our study to compare one of the most efficient and safe conservative methods in the treatment of CTS with the most popular known method by surgical release of the median nerve at the carpal tunnel. In our study, 48 patients were randomly allocated 24 patients received local corticosteroid injection and 24 patients were treated by surgical method. All were diagnosed clinically and confirmed by electrophysiological study. The final results have shown that the injection group had short term improvement but the surgical method proved to be the most efficient method for long term final treatment.

Keywords

Carpal Tunnel Syndrome, Surgical Decomposition, Steroid.
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  • American Academy of Orthopaedic Surgeons (AAOS). Clinical practice guideline on the treatment of carpal tunnel syndrome. National Guideline Clearinghouse. http://www.guidelines.gov/content.aspx?id=13304.(25Feb2012, date last accessed).
  • Manente G, Torrieri F, Di Blasio F, Staniscia T, Romano F, Uncini A. An innovative hand brace for carpal tunnel syndrome: a randomized clinical trail. Muscle Nerve 2001; 24:1020-5.
  • Chang MH, Chiang HT, Lee SS, Ger LP, Lo YK. Oral drug of choice in carpal tunnel syndrome. Neurology 1998; 51:390-3.
  • Ly-Pen D, Andreu JL. Treatment of carpal tunnel syndrome. Med Clin 2005; 125:585-9.
  • Girlanda P, Dattola R, Venuto C, Mangiapane R, Nicolosi C, Messina C. Local steroid treatment in idiopathic carpal tunnel syndrome:short and long –term efficacy. J Neurol 1993; 240:187-90.
  • Dammers JW, Veering MM, Vermeulen M. Injection with methylpredniusolone proximal to the carpal tunnel: randomized double blind trail. Br Med J 1999; 319:884-6.
  • Gelberman RH, Aronson D, Weisman MH. Carpal-tunnel syndrome. Results of a prospective trail of steroid injection and splinting. J Bone Joint Surg Am 1980; 62:1181-4.
  • Verdugo RJ, Salinas RS, Castillo J, Cea JG. Surgiucal versus non surgical treatment for carpal tunnel syndrome: Cochrane Database Syst Rev 2003; 3:CD001552.
  • Ly-Pen D, Andreu JL, De Blas G, Sa nchez-Olaso A, Milla n I.Surgical decompression versus local steroid injection in carpal tunnel syndrome: a one year, prospective, randomized, open, controlled trail. Arthritis Rheum 2005; 52:612-9.
  • Hui ACF, Wong S. Surgery versus steroid injection in carpal tunnel syndrome: comment on the article by Ly-Pen et al. Arthritis Rheum 2005; 52:2578.
  • Andre u JL, Ly-Pen D. Surgery versus steroid injection in carpal tunnel syndrome; comment on the article by Ly-Pen et al.Reply. Arthritis Rheum 2005; 52:2578-9.
  • Kimura J. Electrodiagnosis in Diseases of Nerve and Muscle: Principles andpractice, third ed. Oxford University press, 2001.
  • Serra JM, Benito JR, Monner J. Carpal tunnel release with short incision. PlastReconstrSurg 1997; 99:129-35.
  • Lee WP, Strickland JW. Safe carpal tunnel release via a limited palmar incision. PlastReconstrSurg 1998; 101:418-24.
  • Jugovac I, Burgic N, Micovic V et al. Carpal tunnel release by limited palmar incision vs traditional open technique: randomized controlled trail. Croat Med J 2002; 43:33-6

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  • Comparison of Surgical Decompression and Local Steroid Injection in the treatment of Carpal Tunnel Syndrome

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Authors

Wheab Faraj Dawood
Department of Surgery/College of Medicine/Tikrit University/Tikrit, Iraq
Zahid Abdul-Hameed Ahmed
Department of Surgery/College of Medicine/Tikrit University/Tikrit, Iraq
Waleed Rifaat Ezzat
Department of Surgery/College of Medicine/Tikrit University/Tikrit, Iraq

Abstract


Carpal tunnel syndrome (CTS) is considered the most common of all entrapment neuropathies cause significant symptoms that interfere with normal life of the patients including parasthesia, numbness, weakness of thumb abduction. These symptoms might awake the patient at night. CTS can be treated by surgical and non surgical methods, however there is no consensus on the most effective method of treatment. Non surgical methods include (splintage, U/S, local injection). The aim of our study to compare one of the most efficient and safe conservative methods in the treatment of CTS with the most popular known method by surgical release of the median nerve at the carpal tunnel. In our study, 48 patients were randomly allocated 24 patients received local corticosteroid injection and 24 patients were treated by surgical method. All were diagnosed clinically and confirmed by electrophysiological study. The final results have shown that the injection group had short term improvement but the surgical method proved to be the most efficient method for long term final treatment.

Keywords


Carpal Tunnel Syndrome, Surgical Decomposition, Steroid.

References