TY - JOUR
T1 - Splinting vs surgery in the treatment of carpal tunnel syndrome - A randomized controlled trial
T2 - A randomized controlled trial
AU - Gerritsen, A.A.M.
AU - de Vet, H.C.W.
AU - Scholten, R.J.P.M.
AU - Bertelsmann, F.W.
AU - De Krom, M.C.T.F.
AU - Bouter, L.M.
PY - 2002/9/11
Y1 - 2002/9/11
N2 - Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical options. However, there is no consensus on the most effective method of treatment. To compare the short-term and long-term efficacy of splinting and surgery for relieving the symptoms of CTS. A randomized controlled trial conducted from October 1998 to April 2000 at 13 neurological outpatient clinics in the Netherlands. A total of 176 patients with clinically and electrophysiologically confirmed idiopathic CTS were assigned to wrist splinting during the night for at least 6 weeks (89 patients) or open carpal tunnel release (87 patients); 147 patients (84%) completed the final follow-up assessment 18 months after randomization. General improvement, number of nights waking up due to symptoms, and severity of symptoms. In the intention-to-treat analyses, surgery was more effective than splinting on all outcome measures. The success rates (based on general improvement) after 3 months were 80% for the surgery group (62/78 patients) vs 54% for the splinting group (46/86 patients), which is a difference of 26% (95% confidence interval [CI], 12%-40%; P <.001). After 18 months, the success rates increased to 90% for the surgery group (61/68 patients) vs 75% for the splinting group (59/79 patients), which is a difference of 15% (95% CI, 3%-27%; P =.02). However, by that time 41% of patients (32/79) in the splint group had also received the surgery treatment. Treatment with open carpal tunnel release surgery resulted in better outcomes than treatment with wrist splinting for patients with CTS
AB - Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical options. However, there is no consensus on the most effective method of treatment. To compare the short-term and long-term efficacy of splinting and surgery for relieving the symptoms of CTS. A randomized controlled trial conducted from October 1998 to April 2000 at 13 neurological outpatient clinics in the Netherlands. A total of 176 patients with clinically and electrophysiologically confirmed idiopathic CTS were assigned to wrist splinting during the night for at least 6 weeks (89 patients) or open carpal tunnel release (87 patients); 147 patients (84%) completed the final follow-up assessment 18 months after randomization. General improvement, number of nights waking up due to symptoms, and severity of symptoms. In the intention-to-treat analyses, surgery was more effective than splinting on all outcome measures. The success rates (based on general improvement) after 3 months were 80% for the surgery group (62/78 patients) vs 54% for the splinting group (46/86 patients), which is a difference of 26% (95% confidence interval [CI], 12%-40%; P <.001). After 18 months, the success rates increased to 90% for the surgery group (61/68 patients) vs 75% for the splinting group (59/79 patients), which is a difference of 15% (95% CI, 3%-27%; P =.02). However, by that time 41% of patients (32/79) in the splint group had also received the surgery treatment. Treatment with open carpal tunnel release surgery resulted in better outcomes than treatment with wrist splinting for patients with CTS
UR - http://www.scopus.com/inward/record.url?scp=0037063443&partnerID=8YFLogxK
U2 - https://doi.org/10.1001/jama.288.10.1245
DO - https://doi.org/10.1001/jama.288.10.1245
M3 - Article
C2 - 12215131
SN - 0098-7484
VL - 288
SP - 1245
EP - 1251
JO - JAMA
JF - JAMA
IS - 10
ER -