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Open vs. Ultrasound-Guided Carpal Tunnel Release

6 september 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Geschat)

200

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

  • Oostenrijk
      • Salzburg, Oostenrijk, 5010
        • Werving
        • AUVA General Trauma Hospital Salzburg
        • Contact:
        • Contact:
        • Onderonderzoeker:
          • Christoph Hirnsperger, Dr.
        • Hoofdonderzoeker:
          • Alexander Paszicsnyek, Dr.
        • Onderonderzoeker:
          • Thomas Hausner, Prim. Priv. Doz. Dr.
      • Salzburg, Oostenrijk, 5020
        • Werving
        • University Institute of Radiology, Paracelsus Medical Private University Salzburg
        • Contact:
        • Contact:
        • Onderonderzoeker:
          • Klaus Hergan, Prof. Dr.
        • Hoofdonderzoeker:
          • Christoph Knapitsch, Dr.
        • Onderonderzoeker:
          • Nikolaos Schörghofer, Dr.

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Ja

Bemonsteringsmethode

Kanssteekproef

Studie Bevolking

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.

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Boston Carpal Tunnel Questionnaire (BCTQ) Score
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Pain Intensity - Visual Analog Scale (VAS), 0-10
Tijdsspanne: 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%
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: Within 12 months after surgery
Frequency of wound infections, persistent numbness, or required revision procedures.
Within 12 months after surgery

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

AUVA General Trauma Hospital Salzburg

Medewerkers

Paracelsus Medical University
Salzburger Landeskliniken

Onderzoekers

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

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 juni 2026

Primaire voltooiing (Geschat)

30 juni 2028

Studie voltooiing (Geschat)

1 juli 2028

Studieregistratiedata

Eerst ingediend

1 september 2026

Eerst ingediend dat voldeed aan de QC-criteria

6 september 2026

Eerst geplaatst (Werkelijk)

11 september 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

11 september 2026

Laatste update ingediend die voldeed aan QC-criteria

6 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • CTS_USvsOS
  • 1070/2026 (Ander subsidie-/financieringsnummer: Ethic committee Salzburg)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

ONBESLIST

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