Final 1-Year Results of the TUTOR Randomized Trial Comparing Carpal Tunnel Release with Ultrasound Guidance to Mini-open Technique

Autor: Kyle R. Eberlin, MD, Benjamin P. Amis, MD, Thomas P. Berkbigler, MD, Christopher J. Dy, MD, MPH, Mark D. Fischer, MD, James L. Gluck, MD, F. Thomas D. Kaplan, MD, Thomas J. McDonald, MD, Larry E. Miller, PhD, PStat, Alexander Palmer, DO, Paul E. Perry, MD, Marc E. Walker, MD, MBA, James F. Watt, DO
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Plastic and Reconstructive Surgery, Global Open, Vol 12, Iss 3, p e5665 (2024)
Druh dokumentu: article
ISSN: 2169-7574
00000000
DOI: 10.1097/GOX.0000000000005665
Popis: Background:. Studies comparing carpal tunnel release with ultrasound guidance (CTR-US) to mini-open CTR (mOCTR) are limited. This randomized trial compared the efficacy and safety of these techniques. Methods:. In this multicenter randomized trial, patients were randomized (2:1) to unilateral CTR-US or mOCTR. Outcomes included Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), numeric pain scale (0–10), EuroQoL-5 Dimension 5-Level (EQ-5D-5L), scar outcomes, and complications over 1 year. Results:. Patients received CTR-US (n = 94) via wrist incision (mean 6 mm) or mOCTR (n = 28) via palmar incision (mean 22 mm). Comparing CTR-US with mOCTR, the mean changes in BCTQ-SSS (−1.8 versus -1.8; P = 0.96), BCTQ-FSS (−1.0 versus −1.0; P = 0.75), numeric pain scale (−3.9 versus −3.8; P = 0.74), and EQ-5D-5L (0.13 versus 0.12; P = 0.79) over 1 year were comparable between groups. Freedom from scar sensitivity or pain favored CTR-US (95% versus 74%; P = 0.005). Complications occurred in 2.1% versus 3.6% of patients (P = 0.55), all within 3 weeks postprocedure. There was one revision surgery in the CTR-US group, and no revisions for persistent or recurrent symptoms in either group. Conclusions:. CTR-US and mOCTR demonstrated similar improvement in carpal tunnel syndrome symptoms and quality of life with comparable low complication rates over 1 year of follow-up. CTR-US was performed with a smaller incision and associated with less scar discomfort.
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