Multicenter randomized trial of carpal tunnel release with ultrasound guidance versus mini-open technique.
Expert Rev Med Devices
; 20(7): 597-605, 2023 Jul.
Article
en En
| MEDLINE
| ID: mdl-37254502
ABSTRACT
BACKGROUND:
Comparative studies of carpal tunnel release with ultrasound guidance (CTR-US) vs. mini-open CTR (mOCTR) are limited, prompting development of this randomized trial to compare efficacy and safety of these techniques. RESEARCH DESIGN ANDMETHODS:
Patients were randomized (21) to CTR-US or mOCTR, treated by experienced hand surgeons (median previous cases 12 CTR-US; 1000 mOCTR), and followed for 3 months.RESULTS:
Among 149 randomized patients, 122 received CTR-US (n = 94) or mOCTR (n = 28). Mean incision length was 6 ± 2 mm in the wrist (CTR-US) vs. 22 ± 7 mm in the palm (mOCTR) (p < 0.001). Median time to return to daily activities (2 vs. 2 days; p = 0.81) and work (3 vs. 4 days; p = 0.61) were similar. Both groups reported statistically significant and clinically important improvements in Boston Carpal Tunnel Questionnaire Symptom Severity and Functional Status Scales, Numeric Pain Scale, and EuroQoL-5 Dimension 5-Level, with no statistical differences between groups. Freedom from wound sensitivity and pain favored CTR-US (61.1% vs. 17.9%; p < 0.001). Adverse event rates were low in each group (2.1% vs. 3.6%; p = 0.55).CONCLUSIONS:
The efficacy and safety of CTR-US were comparable to mOCTR despite less previous surgical experience with CTR-US. The choice of CTR technique should be determined by shared decision-making between patient and physician. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov identifier is NCT05405218.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Síndrome del Túnel Carpiano
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Expert Rev Med Devices
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
TERAPEUTICA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos