【摘 要】
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BACKGROUND AND OBJECTIVETreatment for carpal tunnel syndrome (CTS) may include splinting, corticosteroid injections and/or surgery. Electrodiagnostic (EDX) tests to confirm this diagnosis can be negat
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BACKGROUND AND OBJECTIVETreatment for carpal tunnel syndrome (CTS) may include splinting, corticosteroid injections and/or surgery. Electrodiagnostic (EDX) tests to confirm this diagnosis can be negative in up to 15% of patients. This study was designed to determine whether surgical decompression can effectively treat those with clinically positive, but EDX negative CTS.
METHODSSubjects were adult patients referred with symptoms of CTS, with normal EDX results. The patients were randomly assigned to surgical decompression or nonsurgical treatment, with the latter including nocturnal wrist splinting or local corticoid injections. Outcomes were measured with a six-point scale for perceived improvement, as well as the Boston Carpal Tunnel Questionnaire, completed at baseline and at six-month follow-up.
RESULTSAt six-month follow-up, more patients in the surgery group (70%) than in the non-surgery group (35.3%) reported important improvement (P＝0.02). In addition, complete symptom relief was reported by 39.4% of the surgery group and zero percent of the non-surgery group (P＝0.003).
CONCLUSIONThis study provides evidence that most patients with clinically defined carpal tunnel syndrome and normal electrodiagnostic study results can benefit from carpal tunnel release surgery.
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