These procedures would include carpal tunnel syndrome, trigger finger release, and first compartment releases in DeQuervain's syndrome. As CTS is the most commonly diagnosed compression neuropathy of the upper extremity, assessment of severity and treatment response is important crucial to determine the clinical outcomes.
Currently, physical examination and overall functional status as well as pre-op electrodiagnostic EDX testing are important in determining patient outcome scores and assessing the treatment response.
The physical properties of MN and surrounding tissue may be good biomarkers for this evaluation. SWE is a qualitative and quantitative method for measuring tissue stiffness. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.
Search for terms. Save this study. Warning You have reached the maximum number of saved studies Listing a study does not mean it has been evaluated by the U. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating.
Read our disclaimer for details. Last Update Posted : September 1, See Contacts and Locations. Study Description. Detailed Description:. The CiTRUS registry is an observational study designed to better understand the overall patient experience following a carpal tunnel release surgery using either the SX-One MicroKnife with ultrasound guidance or the traditional mini-open technique without ultrasound guidance.
The determination of which surgical technique to uses will be determined by the treating physician and the patient.
The patient registry outcomes are intended to help direct future clinical care, educate patients with carpal tunnel syndrome, and design future research. MedlinePlus related topics: Carpal Tunnel Syndrome. FDA Resources. Randomly allocated 20 patients with clinically diagnosed CTS to surgery and 20 to injection with 40mg methylprednisolone evaluating the results with the same global symptom scale GSS used in the study by Hui et al at 2, 4 and 12 weeks after treatment.
Improvements in mean GSS were identical at 2 and 4 weeks but by 12 weeks symptoms had started to recur in the injection group and the average scores were significantly better in the surgical group. This is therefore a very similar study to Hui et al with a similar conclusion.
This study tells us even less about what actually happened to the injected patients than Hui et al and we cannot tell whether all of the injected patients had relapsed by 12 weeks or only some of them - thus reducing the mean improvement in GSS. One injected patient had an episode of cellulitis but this settled with treatment. Randomised 57 patients one hand studied to surgery and 59 patients to a complex combination of non-surgical measures including splinting, non-steroidal anti-inflammatory drugs, hand therapy including ligament stretching and nerve and tendon gliding exercises , ergonomic interventions in the workplace and therapeutic ultrasound.
All of the patients had already failed a trial of splinting for their symptoms before entry. Surgery in this trial was carried out by a variety of surgeons with different techniques including both traditional open and endoscopic keyhole operations. Understanding this is vital to interpreting the results of this study because only 42 of the 57 patients randomised to surgery actually had the operation in the first three months of the trial, 6 of the patients allocated to conservative treatment never received any, and 19 of the 59 supposedly conservatively treated hands actually had surgery before the 12 month follow-up point.
The function score improved from a mean of 2. For the symptom severity score the change was from 2. A retrospective analysis was also carried out dividing the patients by the treatment actually received however and confirmed the difference between surgery and the conservative regime used here.
Note that local steroid injection was not a part of the non-surgical protocol in this trial and only one patient received a steroid injection during the study. Overall the results of this trial are not unexpected - the interventions used in the non-surgical arm include many treatments for which there was little prior evidence of efficacy and the patients were preselected for unresponsiveness to splinting - the only intervention used here which is supported by previous trial evidence - so the better results from surgery are not surprising.
What is perhaps surprising is that the results from surgery are not more different than they turned out to be compared to not operating. Randomly allocated 73 patients to 4 different oral medications - 16 to placebo, 16 to a diuretic trichlormethiazide 2mg daily , 18 to a non-steroidal anti-inflammatory drug tenoxicam 20 mg daily and 23 to a steroid prednisolone, 20 mg daily for first 2 weeks 10mg daily for second 2 weeks , each taken for 4 weeks.
Symptoms were assessed using the point global symptom scale at 2 and 4 weeks. The mean GSS score improved from This remains the only good quality trial comparing oral drug treatments. One of the best trials of traditional open vs endoscopic keyhole carpal tunnel surgery, notable for the use of very good outcome measures and very long 5 years and complete all but 2 patients who had died follow-up. One patient allocated to endoscopic surgery ended up having an open operation for technical reasons but essentially all patients received the planned treatment cf Jarvik above.
The short term results 3 month showed less pain in the endoscopic group but by 5 years there were no measurable differences between the two groups in any respect. The results of the study are equally interesting in what they tell us about the long term outcomes of carpal tunnel surgery in general, regardless of the technique used.
Five patients in total had to have their carpal tunnel surgery repeated because of recurrent symptoms. The authors seem to feel that all of these were probably true recurrences rather than primary failures. Eight patients 6. Dr Atroshi has also carried out a placebo controlled trial of local steroid injection with a 1 year blind follow-up. Flondell et al The first report of the outcome of this study appeared as an abstract to be presented at a meeting of the American College of Rheumatology in November It is however quite difficult to find that abstract on the ACR website it is number !
I am looking for ibuprofen. I am looking for bupivacaine. I am looking for local anesthesia. I am looking for Accepts healthy volunteers. I am looking for igf1. I am looking for growth hormone. I am looking for vitamin d. I am looking for igiv. I am looking for sugars. I am looking for propess. I am looking for dotatate. Advanced Filters. Found 80 clinical trials By relevance By last updated By most viewed.
It is unique to every trial and is generated based on a trials specific data eg.
0コメント