Post-Operative Splinting After Short-Incision Carpal Tunnel Release: a Prospective Study

Study Description

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

This research study is for patients who are schedule to have carpal tunnel release surgery. The investigators have developed this study in order to determine if post-operative splinting is effective in improvement of patient outcomes after this surgical procedure. The study is being conducted under the direction of Huey Tien, MD. The purpose of this study is to determine if post-operative splinting is effective in improving patient outcomes after having short-incision carpal tunnel release. The investigators will randomize each patient into group 1, splinting after surgery or group 2 no splinting after surgery. Each group will have the same outcome measurements done to determine the best outcome of the two groups.

Condition or disease	Intervention/treatment
Carpal Tunnel Syndrome	Behavioral: Splinting

Detailed Description:

Your participation in this study will last for five office visits of approximately 30 minutes each. If you decide to participate in this study, we would first have you come to clinic where you would undergo some standard measurements. This includes measuring grip and key pinch strength and completing a patient questionnaire. During your visits we will scan the cross-sectional area of the median nerve at the pisiform bone level to determine the level of CTS with the Ultrasound Biomiscroscopy machine (Vevo 2100). This is a new technique with a machine similar to a regular ultrasound machine. The primary difference is that the frequency of soundwaves is higher than a standard ultrasound machine. There are no known significant risks associated with the use of this machine. At this time the machine is experimental, and is not currently approved by the FDA for clinical use. However, this device is not considered to pose significant risk. Candidates for this study must have been diagnosed with single carpal tunnel syndrome and are going to receive nerve decompression with short incision, over the age of 18, and able to give informed consent to participate in a research study.

Study Design

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Study Type :	Observational [Patient Registry]
Estimated Enrollment :	40 participants
Observational Model:	Cohort
Time Perspective:	Prospective
Target Follow-Up Duration:	6 Months
Official Title:	Post-Operative Splinting After Short-Incision Carpal Tunnel Release: a Prospective, Randomized Study
Study Start Date :	September 2012
Estimated Primary Completion Date :	September 2019
Estimated Study Completion Date :	September 2019

Groups and Cohorts

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Group/Cohort	Intervention/treatment
Splinting After Surgery; This group will be fitted for a splint and given instructions on wearing their splint after their short-incision Carpal Tunnel Release	Behavioral: Splinting; One group will have their wrist splinted after their carpal tunnel release surgery.
No Splinting After Surgery; This group will not be splinted after the short-incision carpal tunnel release

Outcome Measures

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. Ultrasound Biomicroscopy of the cross section area of the median nerve at the pisiform level [ Time Frame: Up to two years ]
   This is a high resolution ultrasound used to determine the distance between the surface and the median nerve. This device is a research device not approved for clinical use, but is considered a non-significant risk (NSR) device. This machine is just like a regular ultrasound machine. The primary difference is that the frequence of the soundwaves is higher than a standard ultrasound machine. At this time, the machine is experimental, and it is not currently approved by the FDA for clinical use. However, this same technology is used in similar devices by opthamologists to image retinas. It has been used on hudnreds of humans for research studies.

Secondary Outcome Measures :

1. Key Pinch Strength [ Time Frame: Up to two years ]
2. Grip Strength [ Time Frame: Up to two years ]
3. DASH questionnaire [ Time Frame: Up to two years ]

Eligibility Criteria

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

We are looking for patients who are old enough to give informed consent who are preparing to have nerve decompression with short incision for their carpal tunnel syndrome.

Criteria

Inclusion Criteria:

• Patients who were diagnosed with carpal tunnel syndrome and are going to receive nerve decompression with short incision
• The Criteria of CTS
• Numbness, tingling, pain and night symptoms in median nerve distribution
• Positive Tinel signs over the median nerve at the Carpal Tunnel
• Negative Tinel signs at the Supraclavicular and Infraclavicular areas
• Positive Carpal Tunnel Tests
• Electrophysiological changes (confirmed with NCT)
• Over the age of 18
• Ability to give informed consent to participate in a research study

Exclusion Criteria:

• Patients with peripheral neuropathy of the median nerve secondary to trauma, external compressions (tumours, bone malunion) or other non-compressive causes.
• Patients with the presence of Thoracic Outlet Syndrome (Tinel must be negative at the Supraclavicular and Infraclavicular areas)
• Patients with the presence of Cervical Disc disease
• Patients with another site of compression (such as pronator teres compression)
• Patients who have had previous carpal tunnel release on the same hand
• Patients under the age of 18

Contacts and Locations

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Kentucky
Christine M. Kleinert Institute for Hand and Microsurgery	Recruiting
Louisville, Kentucky, United States, 40202
Contact: Millicent Horn, BS 502-562-0307 mhorn@cmki.org
Principal Investigator: Huey Tien, MD
Kleinert, Kutz & Associates	Recruiting
Louisville, Kentucky, United States, 40202
Contact: Ross Gibson, BA 502-562-0307 rgibson@cmki.org
Principal Investigator: Huey Tien, MD
Sub-Investigator: Christiana Savvidou, MD

Sponsors and Collaborators

Christine M. Kleinert Institute for Hand and Microsurgery

Investigators

Principal Investigator:	Huey Tien, MD	Christine M. Kleinert Institute for Hand and Microsurgery
Study Chair:	Millicent L Horn, BS	Christine M. Kleinert Institute for Hand and Microsurgery

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Responsible Party:	Christine M. Kleinert Institute for Hand and Microsurgery
ClinicalTrials.gov Identifier:	NCT01897272 History of Changes
Other Study ID Numbers:	12.0416
First Posted:	July 11, 2013
Last Update Posted:	January 25, 2018
Last Verified:	January 2018

Keywords provided by Christine M. Kleinert Institute for Hand and Microsurgery:

carpal tunnel syndrome; splinting; nerve decompression

Additional relevant MeSH terms:

Carpal Tunnel Syndrome; Median Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases	Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries