Open vs. Ultrasound-Guided Carpal Tunnel Release
Prospective Multicenter Trial Comparing Open Surgical Decompression Versus Minimally Invasive Ultrasound-Guided Carpal Tunnel Release
調査の概要
状態
条件
詳細な説明
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.
研究の種類
入学 (推定)
連絡先と場所
研究連絡先
- 名前:Alexander M.T. Paszicsnyek, Dr.
- 電話番号:+43 5939344211
- メール:alexander.paszicsnyek@auva.at
研究連絡先のバックアップ
- 名前:Nikolaos Schörghofer, Dr.
- 電話番号:+435725554901
- メール:n.schoerghofer@salk.at
研究場所
-
-
-
Salzburg、オーストリア、5010
- 募集
- AUVA General Trauma Hospital Salzburg
-
コンタクト:
- Alexander M.T. Paszicsnyek, Dr.
- 電話番号:+43 5939344211
- メール:alexander.paszicsnyek@auva.at
-
コンタクト:
- Christoph Hirnsperger, Dr
- 電話番号:+4359393 44253
- メール:christoph.hirnsperger@auva.at
-
副調査官:
- Christoph Hirnsperger, Dr.
-
主任研究者:
- Alexander Paszicsnyek, Dr.
-
副調査官:
- Thomas Hausner, Prim. Priv. Doz. Dr.
-
Salzburg、オーストリア、5020
- 募集
- University Institute of Radiology, Paracelsus Medical Private University Salzburg
-
コンタクト:
- Nikolaos Schörghofer, Dr.
- 電話番号:+435725554901
- メール:n.schoerghofer@salk.at
-
コンタクト:
- Christoph Knaptisch, Dr.
- 電話番号:+43 5725554915
- メール:c.knapitsch@salk.at
-
副調査官:
- Klaus Hergan, Prof. Dr.
-
主任研究者:
- Christoph Knapitsch, Dr.
-
副調査官:
- Nikolaos Schörghofer, Dr.
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
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.
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
|
Open Surgical Carpal Tunnel Release (OSCTR)
Patients undergoing open surgical decompression at AUVA Unfallkrankenhaus Salzburg as the standard procedure of the participating center.
|
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.
|
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.
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Boston Carpal Tunnel Questionnaire (BCTQ) Score
時間枠: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
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Pain Intensity - Visual Analog Scale (VAS), 0-10
時間枠: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%
時間枠: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
時間枠: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
時間枠:Within 12 months after surgery
|
Frequency of wound infections, persistent numbness, or required revision procedures.
|
Within 12 months after surgery
|
協力者と研究者
捜査官
- スタディチェア:Thomas Hausner, Prim. Priv. Doz. Dr.、AUVA General Trauma Hospital Salzburg
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- CTS_USvsOS
- 1070/2026 (その他の助成金/資金番号:Ethic committee Salzburg)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。