Search Our Scientific Publications & Authors

J Hand Surg Am 2018 Dec 19. Epub 2018 Dec 19.

Veterans Affairs Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA; Department of Surgery, Stanford University, Palo Alto, CA.

Purpose: To evaluate facility-level variation in the use of services for patients with carpal tunnel syndrome (CTS) receiving care in the Veterans Health Administration (VHA).

Methods: A national cohort of VHA patients diagnosed with CTS during fiscal year 2013 was divided into nonsurgical and operative treatment groups for comparison. We assessed the use of 5 types of CTS-related services (electrodiagnostic studies [EDS], imaging, steroid injection, oral steroids, and therapeutic modalities) in the prediagnosis and postdiagnosis periods before any operative intervention at the patient and facility levels. Read More

Eur J Radiol 2018 Nov 24;108:172-176. Epub 2018 Sep 24.

Marmara University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey. Electronic address:

Purpose: To evaluate if there is a place for ultrasonography (US) and ultrasonographic elastography (UE) in the diagnosis and follow up of carpal tunnel syndrome treatment.

Materials And Methods: The study was performed on 25 patients (study group) and 17 healthy volunteers (control group). Measured US and UE criteria were median nerve area (MNA), proximal median nerve area (pMNA), difference between MNA and pMNA (dMNA) and strain values of carpal tunnel content (CTC) and median nerve (MN). Read More

Lancet 2018 10;392(10156):1423-1433

Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK; Haywood Academic Rheumatology Centre, Haywood Hospital, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Stoke-on-Trent, UK. Electronic address:

Background: To our knowledge, the comparative effectiveness of commonly used conservative treatments for carpal tunnel syndrome has not been evaluated previously in primary care. We aimed to compare the clinical and cost-effectiveness of night splints with a corticosteroid injection with regards to reducing symptoms and improving hand function in patients with mild or moderate carpal tunnel syndrome.

Methods: We did this randomised, open-label, pragmatic trial in adults (≥18 years) with mild or moderate carpal tunnel syndrome recruited from 25 primary and community musculoskeletal clinics and services. Read More

Lancet 2018 10;392(10156):1383-1384

Department of Clinical Sciences and Department of Orthopaedics, Lund University, Lund, Sweden; Department of Orthopaedics, Hässleholm-Kristianstad, Hässleholm SE 28125, Sweden. Electronic address:

Ann Neurol 2018 Oct 4;84(4):601-610. Epub 2018 Oct 4.

Department of Physical Medicine and Rehabilitation.

Objective: Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. Read More

Hand (N Y) 2018 Jul 1:1558944718787892. Epub 2018 Jul 1.

1 Western University, London, ON, Canada.

Background: The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy).

Methods: Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Read More

Acta Radiol 2018 Jan 1:284185118784977. Epub 2018 Jan 1.

1 Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Background Corticosteroid injections are a popular technique for carpal tunnel syndrome (CTS) treatment and are believed to provide rapid symptom relief. Purpose To use magnetic resonance diffusion tensor imaging (MR-DTI) to determine the association between diffusion values of the median nerve (MN) at several anatomic locations and symptom relief in patients with CTS following corticosteroid injection. Material and Methods MR-DTI was performed on 15 wrists of 12 patients with CTS before and two weeks after ultrasound-guided corticosteroid injections. Read More

Muscle Nerve 2018 Sep;58(3):402-406

Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Beitou District, Taipei City, 11217, Taiwan.

Introduction: The sonographic changes of the median nerve after steroid injection for carpal tunnel syndrome (CTS) still require investigation.

Methods: Sixty-two patients with CTS were included. The Boston Carpal Tunnel Questionnaire was administered, and ultrasonographic examinations were performed before and at 2, 6, and 12 weeks after steroid injection. Read More

J Hand Surg Am 2018 Jun 14;43(6):537-544. Epub 2018 Apr 14.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN. Electronic address:

Purpose: The optimal volume and dose of corticosteroid injections for treatment of carpal tunnel syndrome (CTS) have not yet been established. It is unknown whether the volume of injectate influences the outcome of carpal tunnel injection. The purpose of this study was to assess whether there is an association between the volume of injectate and subsequent intervention in the treatment of CTS. Read More

Arch Phys Med Rehabil 2018 Aug 5;99(8):1609-1622.e10. Epub 2018 Apr 5.

Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.

Objective: To present an evidence-based overview of the effectiveness of oral pain medication and corticosteroid injections to treat carpal tunnel syndrome (CTS).

Data Sources: The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database were searched for relevant systematic reviews and randomized controlled trials (RCTs).

Study Selection: Two reviewers independently applied the inclusion criteria to select potential studies. Read More

Adv Biomed Res 2018 16;7:22. Epub 2018 Feb 16.

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The aim of this study is to determine the predictive value of ultrasonography for results of local steroid injection in patients with carpal tunnel syndrome (CTS).

Materials And Methods: This prospective cohort study was conducted during a 1-year period in outpatient clinics of rehabilitation and physical medicine including 35 patients with moderate and severe CTS who receive ultrasonography-guided local steroid injection. The Boston self-assessment questionnaire and electrodiagnosis parameters were recorded at baseline, 1 month, and 3 months after therapy. Read More

J Hand Surg Asian Pac Vol 2018 Mar;23(1):71-75

† Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Background: Intramedullary fixation for distal radius fractures is reported to be free of hardware irritation and less invasive than other fixation methods. Some specific complications associated with intramedullary fixation, such as radial nerve sensory neuritis, have been reported, but no study has focused on the complication rates of intramedullary fixation for distal radius fractures in the elderly population. Furthermore, no studies have analyzed common complications, such as carpal tunnel syndrome and flexor tenosynovitis including trigger finger, among patients with distal radius fractures treated by intramedullary fixation based on a comprehensive complication checklist. Read More

Clin Interv Aging 2018 18;13:117-124. Epub 2018 Jan 18.

Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.

Background: Carpal tunnel syndrome (CTS) is commonly seen in elderly populations, in part due to increased presence of predisposing comorbidities as well as physiological changes. We aimed at comparing the effectiveness of different doses of steroid using the ultrasound-guided hydrodissection method in elderly patients with CTS.

Methods: We conducted a prospective, triple-blind, randomized, controlled trial in elderly patients with CTS. Read More

BMC Musculoskelet Disord 2018 01 25;19(1):32. Epub 2018 Jan 25.

Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Background: Recent studies have reported that radial extracorporeal shock wave therapy (rESWT) reduces pain and improves function in patients with mild to moderately severe carpal tunnel syndrome (CTS) compared to a placebo. However, most of those studies used multi-session rESWT combined with wrist support and evaluation of efficacy was limited to a maximum of 14 weeks.

Methods: The prospective randomized controlled trial compared efficacy in relieving pain and improving clinical function between single-dose rESWT and local corticosteroid injection (LCsI) over the mid-term (24 weeks). Read More

Acta Chir Orthop Traumatol Cech 2017 ;84(5):391-395

Kafkas Univercity, Department of Orthopedics and Traumatology, Faculty of Medicine, Kars, Turkey.

PURPOSE OF THE STUDY The purpose of the current study is to assess the efficacy of anti-adhesion gel on the symptom severity and functional outcomes after mini incision open surgery for carpal tunnel syndrom (CTS). MATERIAL AND METHODS A total of 200 CTS patients (154 women, 46 men) were included in this study. Group I (n = 100; 78 women, 22 men) did not receive local administration of anti-adhesion gel, while anti-adhesion gel consisting of hyaluronic acid-carboxymethylcellulose (Seprafilm®, SanofiBiosurgery, Bridgewater, NJ, USA) was locally applied to patients in Group II (n = 100; 76 women, 24 men). Read More

Turk J Med Sci 2017 Dec 19;47(6):1785-1790. Epub 2017 Dec 19.

Background/aim: This study aimed to compare the effectiveness of ultrasound (US)-guided injection versus blind injection of corticosteroids in the treatment of carpal tunnel syndrome (CTS). Materials and methods: This prospective, randomized clinical trial included patients with severe CTS based on clinical and electrophysiological criteria. The patients were evaluated for clinical and electrophysiological parameters at baseline and 4 weeks after treatment. Read More

Am J Phys Med Rehabil 2018 Jun;97(6):407-413

From the Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran (AB-G, NN, BF, GRR, TA, SE, PR); Physical Medicine and Rehabilitation Specialist With Subspecialty in Interventional Pain Management, Mission Pain and Spine, Mission Viejo, California (HRF); Clinical Development Research Center of Shahid Modarres Hospital, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (SAR); and Physical Medicine and Rehabilitation Research Center, Department of Physical Medicine and Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran (BE).

Objective: In this study, the clinical effectiveness of ultrasound-guided corticosteroid injection "above" versus "below" the median nerve for treatment of patients with mild to moderate carpal tunnel syndrome was compared.

Design: This prospective randomized double-blind clinical trial included 44 patients with mild to moderate carpal tunnel syndrome. The subjects were randomly assigned to two groups to receive ultrasound-guided injection of 40 mg of triamcinolone either "above" or "below" the involved median nerve. Read More

Bone Joint J 2017 Dec;99-B(12):1637-1642

Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea.

Aims: The aim of this study was to compare the efficacy of a corticosteroid injection for the treatment of carpal tunnel syndrome (CTS) in patients with and without Raynaud's phenomenon.

Patients And Methods: In a prospective study, 139 patients with CTS were treated with a corticosteroid injection (10 mg triamcinolone acetonide); 34 had Raynaud's phenomenon and 105 did not (control group). Grip strength, perception of touch with a Semmes-Weinstein monofilament and the Boston Carpal Tunnel Questionnaires (BCTQ) were assessed at baseline and at six, 12 and 24 weeks after the injection. Read More

Hand (N Y) 2017 Nov 1:1558944717743597. Epub 2017 Nov 1.

1 NYU Langone Orthopedic Hospital, New York, USA.

Background: Over 500 000 carpal tunnel releases costing over $2 billion are performed each year in the United States. The study's purpose is to perform a cost-minimizing analysis to identify the least costly strategy for carpal tunnel syndrome treatment utilizing existing success rates based on previously reported literature.

Methods: We evaluate the expected cost of various treatment strategies based on the likelihood of further treatments: (1) a single steroid injection followed by surgical release; (2) up to 2 steroid injections before surgical release; (3) 3 steroid injections before surgery, and (4) immediate surgical release. Read More

Arthritis Care Res (Hoboken) 2018 Nov;70(11):1717-1718

University of South Carolina School of Medicine, Columbia, SC.

Int J Rheum Dis 2018 Jan 13;21(1):102-107. Epub 2017 Sep 13.

Integrated Diagnostic and Medical Centre, Tung Wah Group of Hospitals, Hong Kong, China.

Aim: We conducted a prospective randomized parallel clinical trial comparing the efficacy of local steroid injection and nocturnal wrist splinting in patients with carpal tunnel syndrome (CTS).

Methods: The well-validated and disease-specific Boston Carpal Tunnel Questionnaire (BCTQ) was employed and its score at 4 weeks after treatment was used as the primary outcome measure. Important secondary outcomes included patient satisfaction, the change of an objective finger dexterity test and the side effects. Read More

Skeletal Radiol 2017 Nov 2;46(11):1521-1530. Epub 2017 Aug 2.

Department of Rehabilitation Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon, 34943, South Korea.

Objective: To determine the ultrasonographic changes after steroid injection in carpal tunnel syndrome (CTS) and to evaluate the diagnostic value of ultrasound in post-treatment examination with clinical correlation.

Materials And Methods: Twenty-seven wrists with idiopathic CTS after a single injection of 40 mg of prednisolone hydrochloride were prospectively studied using a high-resolution ultrasound. Axial images of the wrists were obtained at the level of the distal radius, pisiform and hamate prior to and 1, 4 and 8 weeks after steroid injection. Read More

PLoS One 2017 20;12(7):e0181631. Epub 2017 Jul 20.

Institute of Bone and Joint Research, Kolling Institute, and University of Sydney, Sydney, New South Wales.

Objective: Evaluate general practitioner (GP) management of tennis elbow (TE) in Australia.

Methods: Data about the management of TE by GPs from 2000 to 2015 were extracted from the Bettering the Evaluation of Care of Health program database. Patient and GP characteristics and encounter management data were classified by the International Classification of Primary Care, version 2, and reported using descriptive statistics with point estimates and 95% confidence intervals. Read More

J Hand Surg Asian Pac Vol 2017 Jun;22(2):194-199

* Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Background: The purpose of this study was to identify predictive factors of poor response to intra-flexoral sheath corticosteroid injection, as well as to identify factors associated with patients' decisions to undergo surgical treatment.

Methods: Data from 112 patients who received steroid injection treatment for trigger finger were reviewed retrospectively. Logistic regression was used to assess the prognostic value of factors assumed to affect prognosis (age, sex, underlying disease, history of illness, presence of carpal tunnel syndrome, multiple digit involvement, and pre- and post-operative disability scores). Read More

Pilot Feasibility Stud 2017 24;3:20. Epub 2017 Apr 24.

Royal College of Surgeons Surgical Intervention Trials Unit, NDORMS, University of Oxford, Oxford, UK.

Background: Carpal tunnel syndrome (CTS) is the commonest peripheral nerve disorder in the UK, with over 52,996 carpal tunnel decompressions performed in 2011. By 2030, this figure is estimated to double. Whilst evidence supports conservative measures for mild symptoms, and early surgery for severe symptoms, controversy remains over the most appropriate management for patients that present with moderate disease, with regard to early surgery or late surgery following steroid injection. Read More

Ortop Traumatol Rehabil 2017 Jan;19(1):1-8

Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.

Carpal Tunnel Syndrome (CTS) is the most common form of entrapment neuropathy. Several authors have investigated the anatomical and pathophysiological features of CTS and have identified several parameters that, in combination, play a significant role in its pathophysiology. Advancement in biological research on CTS has enabled the advent of efficient diagnostic techniques such as provocative tests and nerve conduction studies. Read More

Acta Neurol Scand 2017 Oct 22;136(4):365-371. Epub 2017 Feb 22.

Department of Physical Medicine, Alzahra Hospital, Isfahan, Iran.

Objectives: A number of studies have demonstrated the neuroprotective effects of progesterone and its influence on the recovery after neural injury. Few studies investigated the efficacy of local progesterone in carpal tunnel syndrome. The objective of this study was to compare the long-term effects of progesterone vs corticosteroid local injections in patients with mild and moderate carpal tunnel syndrome. Read More

Arch Phys Med Rehabil 2017 05 14;98(5):947-956. Epub 2017 Feb 14.

Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Yang Ming University, Taipei, Taiwan. Electronic address:

Objective: To compare the effectiveness of local steroid injection plus splinting with that of local steroid injection alone using clinical and electrophysiological parameters in patients with carpal tunnel syndrome (CTS).

Design: Randomized controlled study with 12 weeks of follow-up.

Setting: Tertiary care center. Read More

Neurol Med Chir (Tokyo) 2017 Apr 2;57(4):172-183. Epub 2017 Feb 2.

Department of Neurosurgery, Kagawa Rosai Hospital.

Idiopathic carpal tunnel syndrome (CTS) is a common complaint, reflecting entrapment neuropathy of the upper extremity. CTS produces symptoms similar to those of other conditions, such as cervical spondylosis or ischemic or neoplastic intracranial disease. Because of these overlaps, patients with CTS are often referred to a neurosurgeon. Read More

J Back Musculoskelet Rehabil 2017 ;30(3):435-440

Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Background: Carpal tunnel syndrome (CTS) is a commonly seen peripheral nerve mononeuropathy. Corticosteroid injection within the carpal tunnel is among the conservative treatment options. The exact mechanism of action of steroids is not fully clear; decreased inflammation surrounding nerves or tendons is thought to be the main effect. Read More

J Hand Surg Eur Vol 2017 Mar 27;42(3):275-280. Epub 2016 Oct 27.

2 Kent and Canterbury Hospital, Canterbury, UK.

Repeated local corticosteroid injections have become a common mode of treatment for carpal tunnel syndrome, despite an existing recommendation that no more than three injections should be given. We studied the clinical outcomes in 254 patients who initially opted for a corticosteroid injection into their carpal canal during 2007. Follow-up records of treatment were obtained for 157 patients of whom 41% had proceeded to surgery by 2015. Read More

Plast Reconstr Surg 2016 Nov;138(5):1041-1049

Ann Arbor, Mich. From the Department of Surgery, Section of Plastic Surgery, University of Michigan Health System and VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School, and the University of Michigan Health System.

Background: The purpose of this study was to evaluate the impact of insurance type on use of diagnostic testing, treatments, and the efficiency of care for patients with carpal tunnel syndrome.

Methods: The 2009 to 2013 Truven MarketScan Databases were used to identify adult patients with carpal tunnel syndrome. Insurance type was categorized as fee-for-service versus capitated managed care. Read More

J Clin Neurophysiol 2017 Mar;34(2):107-113

*Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; †Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran; and ‡Tabriz University of Medical Sciences, Tabriz, Iran.

Purpose: The aim of this study was to compare the clinical and electrodiagnostic efficacy of ultrasound (US)-guided versus landmark (LM)-guided steroid injections in patients with carpal tunnel syndrome (CTS).

Methods: This randomized clinical trial included 47 patients (60 affected hands) with moderate CTS (30 hands in each group). All clinically suspected patients with CTS who met the inclusion criteria confirmed by electrodiagnostic tests were enrolled. Read More

BMC Musculoskelet Disord 2016 10 6;17(1):415. Epub 2016 Oct 6.

Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK.

Background: Patients diagnosed with idiopathic mild to moderate carpal tunnel syndrome (CTS) are usually managed in primary care and commonly treated with night splints and/or corticosteroid injection. The comparative effectiveness of these interventions has not been reliably established nor investigated in the medium and long term. The primary objective of this trial is to investigate whether corticosteroid injection is effective in reducing symptoms and improving hand function in mild to moderate CTS over 6 weeks when compared with night splints. Read More

Arthritis Care Res (Hoboken) 2017 07 8;69(7):1060-1065. Epub 2017 Jun 8.

Mayo Clinic, Rochester, Minnesota.

Objective: To compare the effectiveness of ultrasound-guided injections to blind injections in the treatment of carpal tunnel syndrome (CTS) in a large community-based cohort.

Methods: This study evaluated residents of Olmsted County, Minnesota, treated with a corticosteroid injection for CTS between 2001 and 2010. The proportion of patients receiving retreatment and the duration of retreatment-free survival between blind and ultrasound-guided injections were compared. Read More

PM R 2016 Sep 24;8(9S):S263-S264. Epub 2016 Sep 24.

VA Greater LA Health Care System/UCLA, Los Angeles, CA, United States.

J Hand Microsurg 2016 Apr;8(1):21-6

Vanderbilt University Medical Center, Vanderbilt Orthopaedic Institute, Nashville, Tennessee, United States.

Introduction: Carpal tunnel steroid injections (CTIs) have the potential risk of damaging underlying critical structures, including the median nerve (MN), radial artery (RA), and ulnar neurovascular bundle (UB). The purpose of this study was to analyze the safety of a volar radial (VR) and volar ulnar (VU) CTI, using standardized anatomical "safe zones."

Materials And Methods: This study was performed on 87 cadaveric arms using a percentage of the total wrist width as a guide for placement of a VR (30 and 33% of total wrist width) and VU (60 and 66% of total wrist width) injection. Read More

Turk Neurosurg 2017 ;27(3):447-452

Atatürk Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey.

Aim: To investigate the effectiveness of local steroid injection and surgical decompression in the treatment of patients with severe carpal tunnel syndrome (CTS) and also to compare short-term outcomes using clinical and electrophysiological criteria.

Material And Methods: The patients diagnosed as severe CTS were divided into two groups. Group 1 received local steroid injection and Group 2 underwent surgical decompression. Read More

J Hand Surg Eur Vol 2016 Nov 28;41(9):963-969. Epub 2016 Sep 28.

3 Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Diffuse peripheral nerve impairment is common in metabolic syndrome: in patients with metabolic syndrome and carpal tunnel syndrome this might affect the outcome of treatment by local corticosteroid injection. A total of 55 consecutive patients with carpal tunnel syndrome and metabolic syndrome treated with corticosteroid injection (10 mg triamcinolone acetonide) were age and sex matched with 55 control patients without metabolic syndrome. Grip strength, perception of touch with Semmes-Weinstein monofilaments and Boston Carpal Tunnel Questionnaires were assessed at the baseline and at 6, 12 and 24 weeks follow-up. Read More

J Hand Surg Am 2016 Jun 9;41(6):665-672.e1. Epub 2016 Apr 9.

Department of Surgery, Section of Plastic Surgery, Ann Arbor, MI; University of Michigan Medical School, Ann Arbor, MI.

Purpose: Given the lack of a reference standard diagnostic tool for carpal tunnel syndrome (CTS), we conducted a population-level analysis of patients undergoing carpal tunnel release to characterize the utilization of preoperative electrodiagnostic studies (EDS). Secondarily, we sought to determine the impact of EDS utilization on timeliness of surgery, number of preoperative physician visits, and costs.

Methods: The 2009-2013 Truven MarketScan databases were used to identify a national cohort of adult patients undergoing carpal tunnel release. Read More

J Fam Pract 2016 Feb;65(2):125-8

University of Iowa, Iowa City, IA, USA.

Yes. Injected corticosteroids reduce symptoms of carpal tunnel syndrome (CTS) more effectively than placebo or systemic steroids, but no better than anti-inflammatory medication and splinting, from one to 12 weeks after therapy. Read More

Adv Biomed Res 2016 8;5:16. Epub 2016 Feb 8.

Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The Study aimed to compare the effectiveness of two commonly used conservative treatments, splinting and local steroid injection in improving clinical and nerve conduction findings of the patients with severe carpal tunnel syndrome (CTS).

Materials And Methods: In this randomized control clinical trial, the patients with severe CTS selected and randomized in two interventional groups. Group A was prescribed to use full time neutral wrist splint and group B was injected with 40 mg Depo-Medrol and prescribed to use the full time neutral wrist splint for 12 weeks. Read More

J Back Musculoskelet Rehabil 2016 Aug;29(3):575-80

Department of Physical Medicine and Rehabilitation, Medicalpark Bahçelievler Hospital, Istanbul, Turkey.

Background/purpose: The purpose of this study was to evaluate the neuropathic symptoms after local steroid injection in CTS. Since 2001, neuropathic pain scales have been used in the assessment and follow-up of neuropathic pain. DN4 and LANSS pain questionnaires have been applied to groups, mostly consisted of radiculopathy and polyneuropathy cases, before and after various treatments and the results have been compared with the electrophysiologic findings. Read More

J Hand Surg Am 2016 Mar 7;41(3):367-373.e2. Epub 2016 Jan 7.

Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI.

Purpose: To conduct a population-level analysis of practice trends and probability of surgery based on the number of steroid injections for common hand conditions.

Methods: Patients aged at least 18 years receiving injection or surgery for carpal tunnel syndrome (CTS), trigger finger (TF), or de Quervain tenovaginitis (DQ) were identified for inclusion using the 2009 to 2013 Truven MarketScan databases. The researchers counted the number of injections performed and calculated the time between injection and operation for patients receiving both treatments. Read More

Przegl Lek 2016;73(7):520-4

The paper presents the etiology, diagnostics, management, treatment and prognosis of carpal tunnel syndrome. The mechanism of the median nerve compression as well as the predisposing factors that cause the syndrome are discussed, as well as the sequence of specific symptoms and the classification of the level of severity of disease. The diagnostic methods are presented with both the benefits and consequences of each method. Read More

J Clin Neurophysiol 2016 Apr;33(2):166-70

*Department of Neurology, Faculty of Medicine, Baskent University, Konya, Turkey; and †Department of Neurosurgery, Farabi Hospital, Veysel Karani Street, Selcuklu, Konya, Turkey.

Purpose: The optimal therapy for moderately severe carpal tunnel syndrome (CTS) remains unclear. In this study, the authors aimed at comparing the clinical and electrophysiologic recovery of CTS after local steroid injection and operation.

Methods: This is a clinical prospective study consisting of 100 patients with moderate CTS. Read More

Muscle Nerve 2016 Apr;53(4):662-3

Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Slovenia.

BMC Musculoskelet Disord 2015 Oct 26;16:322. Epub 2015 Oct 26.

Clinical research development center of Shahid Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The objective of this study was to compare the short-term effects of progesterone and corticosteroid local injections in the treatment of female patients with carpal tunnel syndrome.

Methods: A randomized clinical trial was used for this study, 60 hands with mild and moderate Carpal Tunnel Syndrome categorized in two groups were used for this study. Patients were treated with a single local injection of triamcinolone acetonide in one group and single local injection of 17-alpha hydroxy progesterone in the other group. Read More

Plast Reconstr Surg 2015 Oct;136(4):474e-9e

Philadelphia, Pa. From the Rothman Institute of Orthopedics at Thomas Jefferson University Hospital.

Background: Diabetic patients develop hand conditions that are managed with local corticosteroid injections. Injections can result in a transient elevation in serum glucose in diabetic patients. Hemoglobin A1c is the accepted measure of long-term plasma glucose control in diabetics (levels ≥7 percent reflect poor blood glucose control). Read More

J Hand Surg Eur Vol 2016 Feb 14;41(2):130-6. Epub 2015 Aug 14.

Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Canada.

Unlabelled: It has been suggested that treatment of carpal tunnel syndrome by local corticosteroid injection may prejudice the outcome of subsequent surgery. We identified patients who had proceeded directly to carpal tunnel surgery and patients who had initially been treated with one or more injections and then subsequently underwent carpal tunnel surgery on the same hand. Outcomes of surgery were evaluated using pre- and post-operative Boston carpal tunnel syndrome scales and an ordinal scale for overall satisfaction. Read More