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Open vs. Ultrasound-Guided Carpal Tunnel Release

6 september 2026 uppdaterad 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.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Beräknad)

200

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

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Studieorter

  • Österrike
      • Salzburg, Österrike, 5010
        • Rekrytering
        • AUVA General Trauma Hospital Salzburg
        • Kontakt:
        • Kontakt:
        • Underutredare:
          • Christoph Hirnsperger, Dr.
        • Huvudutredare:
          • Alexander Paszicsnyek, Dr.
        • Underutredare:
          • Thomas Hausner, Prim. Priv. Doz. Dr.
      • Salzburg, Österrike, 5020
        • Rekrytering
        • University Institute of Radiology, Paracelsus Medical Private University Salzburg
        • Kontakt:
        • Kontakt:
        • Underutredare:
          • Klaus Hergan, Prof. Dr.
        • Huvudutredare:
          • Christoph Knapitsch, Dr.
        • Underutredare:
          • Nikolaos Schörghofer, Dr.

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Testmetod

Sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Boston Carpal Tunnel Questionnaire (BCTQ) Score
Tidsram: 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

Sekundära resultatmått

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

Samarbetspartners och utredare

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Sponsor

AUVA General Trauma Hospital Salzburg

Samarbetspartners

Paracelsus Medical University
Salzburger Landeskliniken

Utredare

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

Publikationer och användbara länkar

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Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 juni 2026

Primärt slutförande (Beräknad)

30 juni 2028

Avslutad studie (Beräknad)

1 juli 2028

Studieregistreringsdatum

Först inskickad

1 september 2026

Först inskickad som uppfyllde QC-kriterierna

6 september 2026

Första postat (Faktisk)

11 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

11 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

6 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CTS_USvsOS
  • 1070/2026 (Annat bidrag/finansieringsnummer: Ethic committee Salzburg)

Plan för individuella deltagardata (IPD)

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