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- Essai clinique NCT07814547
Open vs. Ultrasound-Guided Carpal Tunnel Release
Prospective Multicenter Trial Comparing Open Surgical Decompression Versus Minimally Invasive Ultrasound-Guided Carpal Tunnel Release
Aperçu de l'étude
Statut
Les conditions
Description détaillée
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.
Type d'étude
Inscription (Estimé)
Contacts et emplacements
Coordonnées de l'étude
- Nom: Alexander M.T. Paszicsnyek, Dr.
- Numéro de téléphone: +43 5939344211
- E-mail: alexander.paszicsnyek@auva.at
Sauvegarde des contacts de l'étude
- Nom: Nikolaos Schörghofer, Dr.
- Numéro de téléphone: +435725554901
- E-mail: n.schoerghofer@salk.at
Lieux d'étude
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Salzburg, L'Autriche, 5010
- Recrutement
- AUVA General Trauma Hospital Salzburg
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Contact:
- Alexander M.T. Paszicsnyek, Dr.
- Numéro de téléphone: +43 5939344211
- E-mail: alexander.paszicsnyek@auva.at
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Contact:
- Christoph Hirnsperger, Dr
- Numéro de téléphone: +4359393 44253
- E-mail: christoph.hirnsperger@auva.at
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Sous-enquêteur:
- Christoph Hirnsperger, Dr.
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Chercheur principal:
- Alexander Paszicsnyek, Dr.
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Sous-enquêteur:
- Thomas Hausner, Prim. Priv. Doz. Dr.
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Salzburg, L'Autriche, 5020
- Recrutement
- University Institute of Radiology, Paracelsus Medical Private University Salzburg
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Contact:
- Nikolaos Schörghofer, Dr.
- Numéro de téléphone: +435725554901
- E-mail: n.schoerghofer@salk.at
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Contact:
- Christoph Knaptisch, Dr.
- Numéro de téléphone: +43 5725554915
- E-mail: c.knapitsch@salk.at
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Sous-enquêteur:
- Klaus Hergan, Prof. Dr.
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Chercheur principal:
- Christoph Knapitsch, Dr.
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Sous-enquêteur:
- Nikolaos Schörghofer, Dr.
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Méthode d'échantillonnage
Population étudiée
La description
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.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
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Open Surgical Carpal Tunnel Release (OSCTR)
Patients undergoing open surgical decompression at AUVA Unfallkrankenhaus Salzburg as the standard procedure of the participating center.
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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.
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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.
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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.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in Boston Carpal Tunnel Questionnaire (BCTQ) Score
Délai: Baseline to 3 months postoperatively
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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).
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Baseline to 3 months postoperatively
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Pain Intensity - Visual Analog Scale (VAS), 0-10
Délai: Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
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Change in pain intensity measured using the Visual Analog Scale (VAS), ranging from 0 to 10.
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Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
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Subjective Hand Function - Single Assessment Numeric Evaluation (SANE), 0-100%
Délai: Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
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Subjective hand function measured using the Single Assessment Numeric Evaluation (SANE), ranging from 0 to 100%.
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Preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months postoperatively
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Time to Full Return to Work - Number of Days After Surgery
Délai: Up to 3 months postoperatively
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Number of days from surgery until full return to work.
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Up to 3 months postoperatively
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Postoperative Complications - Frequency of Wound Infection, Persistent Numbness, and Revision Surgery
Délai: Within 12 months after surgery
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Frequency of wound infections, persistent numbness, or required revision procedures.
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Within 12 months after surgery
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Thomas Hausner, Prim. Priv. Doz. Dr., AUVA General Trauma Hospital Salzburg
Publications et liens utiles
Publications générales
- Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJ. Endoscopic release for carpal tunnel syndrome. Cochrane Database Syst Rev. 2014 Jan 31;2014(1):CD008265. doi: 10.1002/14651858.CD008265.pub2.
- Colbert SH, Mackinnon SE. Nerve compressions in the upper extremity. Mo Med. 2008 Nov-Dec;105(6):527-35.
- Rotman MB, Donovan JP. Practical anatomy of the carpal tunnel. Hand Clin. 2002 May;18(2):219-30. doi: 10.1016/s0749-0712(01)00003-8.
- Honold S, Loizides A, Skalla E, Gruber L, Plaikner M, Gruber H. Minimally invasive ultrasound-guided carpal tunnel release: long-term clinical outcomes. Ultraschall Med. 2025 Sep 8. doi: 10.1055/a-2678-8214. Online ahead of print.
- Loizides A, Honold S, Skalla-Oberherber E, Gruber L, Loscher W, Moriggl B, Konschake M, Gruber H. Ultrasound-Guided Minimal Invasive Carpal Tunnel Release: An Optimized Algorithm. Cardiovasc Intervent Radiol. 2021 Jun;44(6):976-981. doi: 10.1007/s00270-021-02789-2. Epub 2021 Feb 24.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- CTS_USvsOS
- 1070/2026 (Autre subvention/numéro de financement: Ethic committee Salzburg)
Plan pour les données individuelles des participants (IPD)
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