Abstract :
Objective: To compare the effectiveness of local steroid injection (LSI) and carpal tunnel release (CTR) operation for the treatment of carpal tunnel syndrome (CTS). Methodology: This is a prospective randomized clinical trial conducted at Khalifa Gul Nawaz Teaching Hospital and District Headquarters Teaching Hospital, Bannu from Feb. 2009 to Sept. 2011. Patients having CTS irrespective of gender, age and ethnicity, were included in this study. They were randomly assigned to two treatment groups by lottery method, LSI group, and open CTR group. Follow-up was done for a total period of 12 weeks. A standardized symptoms questionnaire, the Global Symptom Score (GSS) was used for baseline assessment as well as for outcome measurement. It rates symptoms on a scale from 0 to 50, where 0 indicates no symptoms and 50 indicates the most severe symptoms. Data were analyzed with SPSS 10. Results: Out of total 40 patients, there were 11(27.5%) males and 29(72.5%) females. The age of the patients ranged from 24-66 years (mean age 45.35+11.65). In 15 cases the age was 40 years and in 25 cases the age was 40 years. Out of 40 patients, 20 were assigned to LSI group and 20 to CTR group. The baseline mean GSS for LSI group was 34.80+8.15 and for CTR group 35.45+7.43. Two weeks after treatment, mean GSS for LSI group was 11.60+6.90 and for CTR group 12.50+7.28. Four weeks after treatment, mean GSS for LSI group was 9.85+6.39 and for CTR group 7.30+5.68. Twelve weeks after treatment, mean GSS for LSI group was 22.10+6.90 and for CTR 5.45+6.90. This trend shows that LSI has temporary effect on GSS in CTS whereas CTR has long-lasting effect. Conclusion: LSI gives only transient relief in CTS, whereas CTR operation provides long-lasting relief as shown in this short series of 40 patients with short-term follow-up of 12 weeks.
