| Abstrakt: |
Background: Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, is considered as a socio economic issue that reduces work productivity and increases disability. Aim of the Work: to compare the effect of Platelet- Rich Plasma (PRP), corticosteroids (CS) and perineural Dextrose 5 % in water (D5W) local injections for the treatment of idiopathic mild and moderate CTS. Patients and Methods: A prospective study was performed on 60 median nerves of 60 patients. They were diagnosed as idiopathic CTS and classified randomly into 3 groups (each contains 20 patients) according to the treatment program received: group I (ultrasound guided CS injection), group II (ultrasound guided perineural Dextrose 5% injection) and group III (ultrasound guided PRP injection). Results: Ultrasound guided local injection using single doses of CS, D5W, and PRP were very efficient as regards symptomatic and functional improvement, reducing distal motor latency (DML) and Peak sensory latency (PSL) of median nerve, as well as decreased Cross Section Area (CSA) of Median nerve (MN) and improving median nerve mobility for idiopathic mild to moderate CTS. For symptom and functional improvement, single injection of CS was more effective than that of PRP and D5W within 3 months post-injection. Moreover, PRP was slightly better than D5W. For reducing DML and PSL, CS was the most effective followed by PRP and then D5W at 3 months post injection. For reducing CSA, CS was the most effective followed by PRP and then D5W at 3 months post injection. For improving mobility of median nerve, D5W was the most effective at 3 months post injection followed by CS and PRP. Conclusion: Injection of CS, D5W and PRP had resulted in significant Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score reduction at 3 months post-injection in comparison to the BCTQ score at the baseline evaluation. All of the three studied groups (Corticosteroids, dextrose 5 % and PRP) have shown a great result regarding improving in clinical examination, clinical assessment scales, nerve conduction studies and improving in Neuromuscular Ultrasound results with favorable results of Corticosteroids group over Perineural dextrose 5 % group and PRP group. [ABSTRACT FROM AUTHOR] |
