A Controlled Trial Evaluating the Safety and Effectiveness of Ultrasound-Guided Looped Thread Carpal Tunnel Release
| Autor: | Anne Agur, Brian Rambaransingh, Robert S. Burnham, Eldon Loh, Larry Playfair, Shannon L. Roberts |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Wrist Joint
medicine.medical_specialty Percutaneous Less invasive Thread (computing) 030230 surgery law.invention 03 medical and health sciences Carpal ligament 0302 clinical medicine Randomized controlled trial law Carpal tunnel release Humans Medicine Orthopedics and Sports Medicine Ultrasonography Interventional Surgery Articles 030222 orthopedics business.industry Carpal Tunnel Syndrome Ultrasound guided Median Nerve Surgery Ligaments Articular business |
| Zdroj: | Hand (N Y) |
| ISSN: | 1558-9455 1558-9447 |
| Popis: | Background: Open carpal tunnel release typically requires several weeks of recovery. A less invasive, ultrasound-guided percutaneous technique of releasing the transverse carpal ligament using a thread (thread carpal tunnel release [TCTR]) has been described. To date, its clinical effectiveness and safety have been evaluated exclusively by the group that developed the technique, using a single outcome measure without a control comparison. The objective of this study was to independently evaluate the safety and effectiveness of TCTR using multiple outcome measures and a control comparison. Methods: A convenience sample of 20 participants with refractory moderate or severe carpal tunnel syndrome underwent TCTR of their most symptomatic hand. Outcome measures included pre-TCTR and 1-, 3-, and 6-month post-TCTR Boston questionnaire; pre-, 3-, and 6-month post-TCTR monofilament sensibility, strength, ultrasound, and electrodiagnostic testing; weekly post-TCTR phone interviews for 1 month; and satisfaction surveys at 3 and 6 months post-TCTR. Results: No complications were reported. During the month post-TCTR, significant prompt improvements in hand pain and dysfunction occurred. The following significant improvements were demonstrated in the treated versus control hand: Boston Questionnaire scores, median nerve distal motor latency, transcarpal tunnel motor and sensory conduction velocities and sensory nerve action potential amplitudes. No significant differences in sensibility, pinch or grip strength, median nerve cross-sectional area (CSA) at the carpal tunnel inlet, or wrist: forearm median nerve CSA ratio were documented between TCTR and control sides. Satisfaction with the TCTR procedure was high (85%-90%). Conclusions: This study supports previous reports that the TCTR procedure is safe and effective. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|