Philip E Blazar1, W Emerson Floyd1, Carin H Han2, Tamara D Rozental3, Brandon E Earp1. 1. Department of Orthopaedic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. E-mail address for P.E. Blazar: pblazar@partners.org. E-mail address for W.E. Floyd: wfloyd@partners.org. E-mail address for B.E. Earp: bearp@partners.org. 2. 333 Harrison Street, Apartment #745, San Francisco, CA 94105. E-mail address: chhan902@gmail.com. 3. Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115. E-mail address: trozental@partners.org.
Abstract
BACKGROUND: Corticosteroid injections are commonly used in the treatment of carpal tunnel syndrome in adults. This study sought to determine success rates early on and at one year postoperatively of a single corticosteroid injection while identifying prognostic indicators for symptom recurrence and repeat intervention. METHODS: Fifty-four consecutive wrists in forty-nine patients with carpal tunnel syndrome treated with a single corticosteroid injection were prospectively enrolled. Demographic data and information on comorbidities were identified with a study-specific questionnaire. The Boston Carpal Tunnel Questionnaire was administered prior to injection. Patients returned to clinic at six weeks and were contacted at three, six, nine, and twelve months post-injection to determine symptom and intervention status. Kaplan-Meier analysis and Cox regression modeling were used to estimate recurrence rates and to identify predictors of symptom recurrence and repeat intervention. RESULTS: Fifty-four symptomatic wrists in forty-nine patients with a mean age of fifty-three years were included. Two patients (two wrists) were lost to follow-up. Patients reported symptom recurrence in thirty-one wrists at a median duration of 155 days post-injection. Nineteen wrists underwent carpal tunnel release at a median time of 181 days after the injection. No patient underwent a repeat injection. In our study, diabetic patients were at a 2.6-fold greater risk of reporting recurring symptoms within a one-year follow-up period. Survivorship free from symptom recurrence was 53% at six months and 31% at twelve months; survivorship from repeat intervention was 81% at six months and 66% at twelve months. CONCLUSIONS: A single injection achieved symptom relief in 79% of patients at six weeks; these results were maintained in 31% of patients at twelve months. Diabetic patients were at higher risk of symptom recurrence.
BACKGROUND: Corticosteroid injections are commonly used in the treatment of carpal tunnel syndrome in adults. This study sought to determine success rates early on and at one year postoperatively of a single corticosteroid injection while identifying prognostic indicators for symptom recurrence and repeat intervention. METHODS: Fifty-four consecutive wrists in forty-nine patients with carpal tunnel syndrome treated with a single corticosteroid injection were prospectively enrolled. Demographic data and information on comorbidities were identified with a study-specific questionnaire. The Boston Carpal Tunnel Questionnaire was administered prior to injection. Patients returned to clinic at six weeks and were contacted at three, six, nine, and twelve months post-injection to determine symptom and intervention status. Kaplan-Meier analysis and Cox regression modeling were used to estimate recurrence rates and to identify predictors of symptom recurrence and repeat intervention. RESULTS: Fifty-four symptomatic wrists in forty-nine patients with a mean age of fifty-three years were included. Two patients (two wrists) were lost to follow-up. Patients reported symptom recurrence in thirty-one wrists at a median duration of 155 days post-injection. Nineteen wrists underwent carpal tunnel release at a median time of 181 days after the injection. No patient underwent a repeat injection. In our study, diabeticpatients were at a 2.6-fold greater risk of reporting recurring symptoms within a one-year follow-up period. Survivorship free from symptom recurrence was 53% at six months and 31% at twelve months; survivorship from repeat intervention was 81% at six months and 66% at twelve months. CONCLUSIONS: A single injection achieved symptom relief in 79% of patients at six weeks; these results were maintained in 31% of patients at twelve months. Diabeticpatients were at higher risk of symptom recurrence.
Authors: Stefanie Evers; Andrew J Bryan; Thomas L Sanders; Tina Gunderson; Russell Gelfman; Peter C Amadio Journal: J Hand Surg Am Date: 2018-04-14 Impact factor: 2.230
Authors: Stefanie Evers; Andrew J Bryan; Thomas L Sanders; Tina Gunderson; Russell Gelfman; Peter C Amadio Journal: Plast Reconstr Surg Date: 2017-08 Impact factor: 4.730
Authors: Joost T P Kortlever; Anne-Britt Dekker; David Ring; Gregg A Vagner; Lee M Reichel; Arnold H Schuurman; J Henk Coert Journal: J Hand Microsurg Date: 2020-10-29