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Open vs. Ultrasound-Guided Carpal Tunnel Release

6. september 2026 oppdatert av: 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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert 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.

Studietype

Observasjonsmessig

Registrering (Antatt)

200

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Østerrike
      • Salzburg, Østerrike, 5010
        • Rekruttering
        • AUVA General Trauma Hospital Salzburg
        • Ta kontakt med:
        • Ta kontakt med:
        • Underetterforsker:
          • Christoph Hirnsperger, Dr.
        • Hovedetterforsker:
          • Alexander Paszicsnyek, Dr.
        • Underetterforsker:
          • Thomas Hausner, Prim. Priv. Doz. Dr.
      • Salzburg, Østerrike, 5020
        • Rekruttering
        • University Institute of Radiology, Paracelsus Medical Private University Salzburg
        • Ta kontakt med:
        • Ta kontakt med:
        • Underetterforsker:
          • Klaus Hergan, Prof. Dr.
        • Hovedetterforsker:
          • Christoph Knapitsch, Dr.
        • Underetterforsker:
          • Nikolaos Schörghofer, Dr.

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Ja

Prøvetakingsmetode

Sannsynlighetsprøve

Studiepopulasjon

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Open Surgical Carpal Tunnel Release (OSCTR)
Patients undergoing open surgical decompression at AUVA Unfallkrankenhaus Salzburg as the standard procedure of the participating center.
Fremgangsmåte: 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.
Fremgangsmåte: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

AUVA General Trauma Hospital Salzburg

Samarbeidspartnere

Paracelsus Medical University
Salzburger Landeskliniken

Etterforskere

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

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. juni 2026

Primær fullføring (Antatt)

30. juni 2028

Studiet fullført (Antatt)

1. juli 2028

Datoer for studieregistrering

Først innsendt

1. september 2026

Først innsendt som oppfylte QC-kriteriene

6. september 2026

Først lagt ut (Faktiske)

11. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

11. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

6. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CTS_USvsOS
  • 1070/2026 (Annet stipend/finansieringsnummer: Ethic committee Salzburg)

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UBESLUTTE

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