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Intrasurgical use of steroids oncarpal tunnel syndrome: a randomized,prospective, double-blindcontrolled study
Authors:R. Padua  L. Padua  R. Bondì  A. Campi  E. Ceccarelli  S. Padua
Affiliation:(1) Orthopaedics Department, San Giacomo Hospital, Via P.S. Mancini 2, I-00196 Rome, Italy;(2) Institute of Neurology, Catholic University, Rome, Italy;(3) Isola Tiberina, A.Fa.R. Fatebenefratelli Hospital, Rome, Italy;(4) Department of Orthopaedics, Catholic University, Rome, Italy;(5) Department of Orthopaedics, Bambin Gesù Hospital, Rome, Italy;(6) Department of Medical and Surgical Specialties, University of Perugia, Italy
Abstract:
We studied steroid irrigation of the median nerve during surgical decompression in carpal tunnel syndrome through a prospective randomized controlled study. After sample size calculation, 20 patients were randomized into two groups: one group had a release of the transverse carpal ligament alone, and the other one had a release associated with steroid irrigation of the median nerve. The patients were evaluated preoperatively and postoperatively at 15 days and 2 months through a widely used and validated patient-oriented measure (the Carpal tunnel questionnaire) and through neurophysiological evaluation. The follow-up assessment showed significant differences in the postoperative evolution between the two groups with regard to symptoms: symptoms were less in the steroid-treated group both at 15 days (p>0.035; z=−2.9) and at two months (p<0.005; z=−2.8). This suggests that steroid irrigation of the median nerve offers benefit compared with the transverse carpal ligament release alone. This study provides clear evidence of the use-fulness of the procedure in the post-operative evolution of symptoms.
Keywords:Carpal tunnel questionnaire  Carpal tunnel syndrome  Neurophysiologic evaluation  Randomized controlled trial  Steroids
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