Abstract
BackgroundTo compare the clinical effectiveness of ultrasound-guided needle release of the transverse carpal ligament (TCL) with and without corticosteroid injection in carpal tunnel syndrome (CTS).MethodsFrom June 2016 to June 2017, 49 CTS patients (50 wrists) were included in this study. Twenty-five wrists were treated with ultrasound-guided needle release of the TCL plus corticosteroid injection (group A), and 25 wrists were treated with single ultrasound-guided needle release of the TCL (group B). The following parameters were assessed and compared including postprocedure results according to relief of symptoms, ultrasound parameters (cross-sectional area of the median nerve at the levels of pisiform, flattening ratio of median nerve at the levels of the hamate bone, and the thicknesses of TCL on the cross-section at the level of the hamate bone), and electrophysiological parameters (distal motor latency and sensory conduction velocity).ResultsGroup A had higher overall excellent and good rate 3 months after the procedure than group B (84 vs 52%, P < 0.05). There were significant differences regarding the above ultrasonic and electrophysiological parameters between the baseline and postprocedure values in both groups (all P < 0.05). There were significant differences regarding the postprocedure values of above ultrasonic and electrophysiological parameters between the two groups (all P < 0.05). No complications such as infection or tendon rupture were noted. No procedures were converted to the open release.ConclusionsBoth techniques are effective in treating CTS. Ultrasound-guided needle release of the TCL with corticosteroid injection had better treatment benefits than single ultrasound-guided needle release of the TCL in treating CTS.
Highlights
To compare the clinical effectiveness of ultrasound-guided needle release of the transverse carpal ligament (TCL) with and without corticosteroid injection in carpal tunnel syndrome (CTS)
From June 2016 to June 2017, 49 early-to-middle-stage CTS patients (50 wrists) treated by ultrasound-guided needle release of the TCL with and without corticosteroid injection at our hospital were included in this study
25 wrists treated with ultrasound-guided needle release of the TCL plus corticosteroid injection and 25 wrists treated with single ultrasound-guided needle release of the TCL
Summary
To compare the clinical effectiveness of ultrasound-guided needle release of the transverse carpal ligament (TCL) with and without corticosteroid injection in carpal tunnel syndrome (CTS). Carpal tunnel syndrome (CTS) is the most common form of peripheral compressive neuropathy [1]. It is caused by compression of the median nerve at the wrist [2]. The development of high-resolution ultrasound scanning allows detailed visualization of the anatomical structures of carpal tunnel, including the median nerve, flexor tendons, and transverse carpal ligament (flexor retinaculum) as well as at-risk structures, such as the ulnar artery and the superficial palmar arch [12]
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