Multicenter randomized trial of carpal tunnel release with ultrasound guidance versus mini-open technique

被引：10

作者：

Eberlin, Kyle R. ^{[1
]}

Amis, Benjamin P. ^{[2
]}

Berkbigler, Thomas P. ^{[3
]}

Dy, Christopher J. ^{[4
]}

Fischer, Mark D. ^{[5
]}

Gluck, James L. ^{[6
]}

Kaplan, F. Thomas D. ^{[7
]}

McDonald, Thomas J. ^{[8
]}

Miller, Larry E. ^{[9
,14
]}

Palmer, Alexander ^{[10
]}

Perry, Paul E. ^{[11
]}

Walker, Marc E. ^{[12
]}

Watt, James F. ^{[13
]}

机构：

[1] Massachusetts Gen Hosp, Boston, MA USA

[2] ATX Orthoped, Austin, TX USA

[3] Midwest Orthoped Grp, Farmington, MO USA

[4] Washington Univ, St Louis, MO USA

[5] Twin Cities Orthoped, Plymouth, MN USA

[6] Kansas Orthopaed Ctr, Wichita, KS USA

[7] Indiana Hand Shoulder, Indianapolis, IN USA

[8] Sierra Orthoped Inst, Sonora, CA USA

[9] Miller Sci, Johnson City, TN USA

[10] Sano Orthoped, Lees Summit, MO USA

[11] Tristate Orthopaed Surg, Newburgh, IN USA

[12] Univ Mississippi, Med Ctr, Jackson, MS USA

[13] Orthopaed Associates, Ft Walton Beach, FL USA

[14] Miller Sci, 3101 Browns Mill Rd, Ste 6, 311, Johnson City, TN 37604 USA

来源：

EXPERT REVIEW OF MEDICAL DEVICES | 2023年 / 20卷 / 07期

关键词：

Carpal tunnel release; carpal tunnel syndrome; randomized controlled trial; TUTOR; UltraGuideCTR; ultrasound; QUESTIONNAIRE;

D O I：

10.1080/17434440.2023.2218548

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Background: Comparative studies of carpal tunnel release with ultrasound guidance (CTR-US) vs. miniopen CTR (mOCTR) are limited, prompting development of this randomized trial to compare efficacy and safety of these techniques. Research design and methods: Patients were randomized (2:1) 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.

引用

页码：597 / 605

页数：9

共 24 条

[1] Patient Willingness to Pay for Faster Return to Work or Smaller Incisions [J].