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Open vs. Ultrasound-Guided Carpal Tunnel Release

6. september 2026 opdateret af: AUVA General Trauma Hospital Salzburg

Prospective Multicenter Trial Comparing Open Surgical Decompression Versus Minimally Invasive Ultrasound-Guided Carpal Tunnel Release

Carpal Tunnel Syndrome (CTS) is the most prevalent entrapment neuropathy. Open Surgical Carpal Tunnel Release (OSCTR) remains the gold standard, while minimally invasive Ultrasound-Guided Carpal Tunnel Release (USGCTR) offers potential advantages including reduced postoperative morbidity and faster recovery. This prospective, multicenter observational cohort study compares the clinical outcomes, patient-reported outcomes, and socioeconomic impact of USGCTR versus OSCTR. A total of 200 patients, with 100 patients per cohort, will be included. Patient assignment is based on the participating center's standard of care. Follow-up assessments are performed preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months after surgery.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Carpal Tunnel Syndrome (CTS) is the most common compression neuropathy of the median nerve. Open Surgical Carpal Tunnel Release (OSCTR) has been established as the clinical gold standard. However, the procedure is associated with a palmar incision and may result in scar pain, including pillar pain, and delayed return to manual activities.

Ultrasound-Guided Carpal Tunnel Release (USGCTR) is a minimally invasive technique that permits division of the flexor retinaculum under continuous sonographic visualization through a minimal incision at the distal forearm or wrist crease. Potential advantages include avoidance of a painful scar in the load-bearing area of the hand and potentially faster recovery.

The study aims to compare functional recovery and symptom relief following OSCTR versus USGCTR. Secondary objectives include comparison of postoperative pain, subjective outcome, return to work, patient satisfaction, and complication rates.

This is a prospective, multicenter observational cohort study. Patients are not randomized. Assignment to the two cohorts is determined by the participating treatment center and its respective standard procedure. Patients choose the treatment center based on referral by their previously treating neurologist or on personal information. The study team does not influence this decision. Both procedures are established standard procedures routinely performed at the respective institutions.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

200

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Østrig
      • Salzburg, Østrig, 5010
        • Rekruttering
        • AUVA General Trauma Hospital Salzburg
        • Kontakt:
        • Kontakt:
        • Underforsker:
          • Christoph Hirnsperger, Dr.
        • Ledende efterforsker:
          • Alexander Paszicsnyek, Dr.
        • Underforsker:
          • Thomas Hausner, Prim. Priv. Doz. Dr.
      • Salzburg, Østrig, 5020
        • Rekruttering
        • University Institute of Radiology, Paracelsus Medical Private University Salzburg
        • Kontakt:
        • Kontakt:
        • Underforsker:
          • Klaus Hergan, Prof. Dr.
        • Ledende efterforsker:
          • Christoph Knapitsch, Dr.
        • Underforsker:
          • Nikolaos Schörghofer, Dr.

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ja

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Participants will be recruited during routine clinical consultations at the outpatient clinics of the participating centers. Patients fulfilling the inclusion criteria will be informed about the study by their treating physicians. Participation is voluntary and does not affect the quality of medical care.

Beskrivelse

Inclusion Criteria:

  • Electrophysiologically verified Carpal Tunnel Syndrome by EMG/nerve conduction studies, with the examination not older than 6 months at the time of inclusion.
  • Previous documented and exhausted conservative treatment
  • Existing indication for surgery that has been discussed with the patient and the patient's explicit wish to undergo surgical treatment.
  • Ability to provide informed consent and written informed consent
  • Age ≥18 years.

Exclusion Criteria:

  • Previous surgery at the affected location or revision procedures.
  • Pre-existing nerve lesions of the upper extremity, including traumatic transections or proximal injuries.
  • Manifest polyneuropathy.
  • Foreseeable loss to follow-up, for example inability to contact the participant or insufficient compliance, before the critical 3-month follow-up.
  • Age under 18 years.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Open Surgical Carpal Tunnel Release (OSCTR)
Patients undergoing open surgical decompression at AUVA Unfallkrankenhaus Salzburg as the standard procedure of the participating center.
Procedure: Open Surgical Carpal Tunnel Release (OSCTR)
Open surgical decompression of the carpal tunnel (OSCTR) is performed at UKH Salzburg as the established standard surgical treatment for carpal tunnel syndrome. The procedure involves open surgical release of the flexor retinaculum. Intraoperative findings and immediate complications are documented.
Ultrasound-Guided Carpal Tunnel Release (USGCTR)
Patients undergoing minimally invasive ultrasound-guided carpal tunnel release at the University Institute of Radiology, Paracelsus Medical Private University Salzburg, as the standard procedure of the participating center.
Procedure: Ultrasound-Guided Carpal Tunnel Release (USGCTR)
Ultrasound-guided carpal tunnel release (USGCTR) is performed at the University Institute of Radiology of the Paracelsus Medical Private University. The minimally invasive procedure involves release of the flexor retinaculum under continuous sonographic visualization through a minimal incision at the distal forearm or wrist crease. Intraoperative findings and immediate complications are documented.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Boston Carpal Tunnel Questionnaire (BCTQ) Score
Tidsramme: Baseline to 3 months postoperatively
Mean difference in the change in the Boston Carpal Tunnel Questionnaire (BCTQ) score, combining the Symptom Severity Scale and Functional Status Scale, from the preoperative assessment (T0) to the 3-month postoperative assessment (T3).
Baseline to 3 months postoperatively

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain Intensity - Visual Analog Scale (VAS), 0-10
Tidsramme: Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
Change in pain intensity measured using the Visual Analog Scale (VAS), ranging from 0 to 10.
Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
Subjective Hand Function - Single Assessment Numeric Evaluation (SANE), 0-100%
Tidsramme: Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
Subjective hand function measured using the Single Assessment Numeric Evaluation (SANE), ranging from 0 to 100%.
Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
Time to Full Return to Work - Number of Days After Surgery
Tidsramme: Up to 3 months postoperatively
Number of days from surgery until full return to work.
Up to 3 months postoperatively
Postoperative Complications - Frequency of Wound Infection, Persistent Numbness, and Revision Surgery
Tidsramme: Within 12 months after surgery
Frequency of wound infections, persistent numbness, or required revision procedures.
Within 12 months after surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

AUVA General Trauma Hospital Salzburg

Samarbejdspartnere

Paracelsus Medical University
Salzburger Landeskliniken

Efterforskere

  • Studiestol: Thomas Hausner, Prim. Priv. Doz. Dr., AUVA General Trauma Hospital Salzburg

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2026

Primær færdiggørelse (Anslået)

30. juni 2028

Studieafslutning (Anslået)

1. juli 2028

Datoer for studieregistrering

Først indsendt

1. september 2026

Først indsendt, der opfyldte QC-kriterier

6. september 2026

Først opslået (Faktiske)

11. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

11. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CTS_USvsOS
  • 1070/2026 (Andet bevillings-/finansieringsnummer: Ethic committee Salzburg)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

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