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- Ensaio Clínico NCT07814547
Open vs. Ultrasound-Guided Carpal Tunnel Release
Prospective Multicenter Trial Comparing Open Surgical Decompression Versus Minimally Invasive Ultrasound-Guided Carpal Tunnel Release
Visão geral do estudo
Status
Condições
Descrição detalhada
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.
Tipo de estudo
Inscrição (Estimado)
Contactos e Locais
Contato de estudo
- Nome: Alexander M.T. Paszicsnyek, Dr.
- Número de telefone: +43 5939344211
- E-mail: alexander.paszicsnyek@auva.at
Estude backup de contato
- Nome: Nikolaos Schörghofer, Dr.
- Número de telefone: +435725554901
- E-mail: n.schoerghofer@salk.at
Locais de estudo
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Salzburg, Áustria, 5010
- Recrutamento
- AUVA General Trauma Hospital Salzburg
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Contato:
- Alexander M.T. Paszicsnyek, Dr.
- Número de telefone: +43 5939344211
- E-mail: alexander.paszicsnyek@auva.at
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Contato:
- Christoph Hirnsperger, Dr
- Número de telefone: +4359393 44253
- E-mail: christoph.hirnsperger@auva.at
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Subinvestigador:
- Christoph Hirnsperger, Dr.
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Investigador principal:
- Alexander Paszicsnyek, Dr.
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Subinvestigador:
- Thomas Hausner, Prim. Priv. Doz. Dr.
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Salzburg, Áustria, 5020
- Recrutamento
- University Institute of Radiology, Paracelsus Medical Private University Salzburg
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Contato:
- Nikolaos Schörghofer, Dr.
- Número de telefone: +435725554901
- E-mail: n.schoerghofer@salk.at
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Contato:
- Christoph Knaptisch, Dr.
- Número de telefone: +43 5725554915
- E-mail: c.knapitsch@salk.at
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Subinvestigador:
- Klaus Hergan, Prof. Dr.
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Investigador principal:
- Christoph Knapitsch, Dr.
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Subinvestigador:
- Nikolaos Schörghofer, Dr.
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
|---|---|
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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.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in Boston Carpal Tunnel Questionnaire (BCTQ) Score
Prazo: 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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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Pain Intensity - Visual Analog Scale (VAS), 0-10
Prazo: 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%
Prazo: 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
Prazo: 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
Prazo: 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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Colaboradores e Investigadores
Patrocinador
Investigadores
- Cadeira de estudo: Thomas Hausner, Prim. Priv. Doz. Dr., AUVA General Trauma Hospital Salzburg
Publicações e links úteis
Publicações Gerais
- 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.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- CTS_USvsOS
- 1070/2026 (Número de outro subsídio/financiamento: Ethic committee Salzburg)
Plano para dados de participantes individuais (IPD)
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