The Value of Using Operative Release Vs. Local Corticosteroid Injection in The Treatment of Entrapment Syndrome of The Median Nerve at The Wrist
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Aim of the study: To assess the value of using operative release of carpal tunnel vs. local corticosteroid injection to treat moderate cases of carpal tunnel syndrome(CTS) .
Patients and method : A prospective randomized trial of 42 patients with symptoms of entrapment of the median nerve of a moderate degree at the wrist during the period between march 2022 and march 2024.Patients were divided into two group , one group treated by local steroid injection(Group 1) and the other group treated by open carpal tunnel release(Group 2). Global Symptoms Score(GSS) was used for evaluation at baseline , one month, three months and six months.
Results:21 patients treated by local steroid injection in group 1(LSI) and 21 patients treated by open carpal tunnel release (OCTR) in group 2.The mean age for patients in group 1 was 40.6 years and mean age for patients in group 2 was 41.1 years with no statistical significant difference regarding age, sex distribution, side of hand affection, and other clinical symptoms(hand pain and nocturnal paresthesia) and clinical tests ( p value >0.05).Baseline mean GSS was 31.3 for group 1 and 31.16 in group 2 , which was statically insignificant(p value >0.05).At one month mean GSS was 10.8 in LSI group and 11.33 in OCTR group ,This was without significant difference(p value >0.05).Follow -up at 3rd month revealed a mean GSS at 12.3 for group 1 and 10.33 for group 2 with p value >0.05. After 6 months mean GSS in group treated by OCTR was 7.3 and 21.5 for group treated by LSI(Group 1),there was a difference statistically significant (p value <0.05) and surgical treatment was better option for long term effect last up to six months.
Conclusion: Local steroid injection provide short-term efficacy extend up to three months while OCTR is more effective treatment for long-term symptomatic relief of moderate CTS ,which extend up to six months in this study.
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