Corticosteroid Injection as a Predictor of Outcome in Carpal Tunnel Release
This study will investigate whether symptomatic improvement following carpal tunnel corticosteroid injection can be correlated to symptomatic improvement following carpal tunnel release and therefore serve as a prognostic indicator.
Clinical question: Does response to corticosteroid injection in CTS predict outcomes of surgical treatment?
- Can we confirm previous retrospectively collected data that a certain percentage of conservatively managed patients with steroid injection will avoid surgery, and that patients who undergo surgery will have better outcomes than those who do not.
- Are there differences between worker's compensation and non-worker's compensation patients with regard to the primary clinical question?
- What are Carpal Tunnel Release outcomes for the subset of patients with negative electrophysiologic studies?
- What are the outcomes of patients who undergo carpal tunnel release vs. those who choose not to undergo carpal tunnel release?
A prospective cohort design study is the appropriate study design in order to measure the association between a predictor (response to injection) and outcome (response to surgery).
|Carpal Tunnel Syndrome||Other: Corticosteroid Injection- 1ml of Betamethasone and 1 ml of 1% Lidocaine|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Corticosteroid Injection as a Predictor of Outcome in Carpal Tunnel Release|
|Study Start Date:||December 2007|
|Study Completion Date:||March 2011|
|Primary Completion Date:||March 2011 (Final data collection date for primary outcome measure)|
Those patients who receive corticosteroid injections for carpal tunnel syndrome
Other: Corticosteroid Injection- 1ml of Betamethasone and 1 ml of 1% Lidocaine
Patients will receive a carpal tunnel injection of 1 mg of betamethasone and 1 mL of 1% lidocaine will be infiltrated by small gauge (ie. 25- or 27-gauge) needle via attending surgeon preference. These are routinely performed by injecting 1cm proximal to distal wrist crease just ulnar to palmaris longus tendon although multiple techniques have been described. Elicitation of median nerve symptoms during needle placement requires redirecting needle prior to injection to avoid median nerve infiltration.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00655915
|United States, Tennessee|
|Vanderbilt Hand & Upper Extremity Center|
|Nashville, Tennessee, United States, 37232-8828|
|Principal Investigator:||Jeffry T Watson, M.D.||Vanderbilt University|