Comparison Efficacy of Triamcinolone and Wrist Splint in Severe Carpal Tunnel Syndrome in Pregnancy

Abstract

Introduction: Carpal tunnel syndrome (CTS) is entrapment of median nerve in carpal tunnel of the wrist. The main aim of this study was to compare the effectiveness of steroid injection and wrist splint in severe carpal tunnel syndrome in pregnancy. The cases were selected among pregnant women who referred to OB and GYN clinic in Yasuj city in South- west of Iran. Materials and methods: This study is a randomized clinical trial which was accomplished from December 2010 to June 2012 at S. Mofateh Clinic on 28 pregnant women. Standard electrodiagnostic techniques were performed on the women who had clinical symptoms of CTS in their hands, with positive Tinel and/or Phalen tests, for rule in/or out of CTS. The patients with severe CTS were randomly divided in 2 groups including triamcinolone injection (40 mg) and wrist splint in night for 6 weeks. Electrophysiologic parameters of median and ulnar nerves were recorded before and 2 months after the steroid injection and wrist splint. In cases of observing changes from severe to lower stages of the disease in electrodiagnostic studies, treatment was considered successful and otherwise failed. Results: Effectiveness of triamcinolone injection and wrist splint were 85. 7% and 90. 9%, respectively. There was no significant difference between treatments by steroid injection and wrist splint (p=0. 157). Also no correlation was observed between severe carpal tunnel syndrome and number of pregnancy. Conclusion: Triamcinolone injection or wrist splint are effective methods for treatment of severe CTS in pregnancy and therefore recommended instead of carpal tunnel release surgery.