This is a prospective, open-label, parallel-group, randomized controlled trial to evaluate the postoperative outcome after carpal tunnel release by using mini CTS releaser and open method with duration of 6 months estimated. The study hypothesis is that mini CTS releaser can offer similar functional outcomes to the open approach and avoid the complications of the open surgery.
The current study is the first clinical trial of carpal tunnel syndrome treated by using a device - novel mini CTS releaser. The functional outcome and objective outcome will be recorded to prove the hypothesis that mini CTS releaser can offer similar functional outcomes to the open approach and decrease the complication rate in comparison of the open surgery. When patients visit, the research physician confirms whether the eligibility criteria are met, and the physician verbally explains the research theme, purpose, and method of execution. After the patient's consent, he should sign the subject consent. At baseline recruitment, a standardized in-person interview will be conducted by trained and certified study personnel according to structured questionnaires to obtain information on socio-demographic characteristics, habits of tobacco and alcohol use, peripheral blood sample will be also collected from each participant. All of the operated patients underwent a complete personal medical history review, detailed physical examination, as well as routine hematological tests. Patients will be randomized 1:1 to mini CTS releaser group or to open release group. There will be 35 individuals in each treatment arm. The planned follow-up time will be scheduled. Safety outcomes including adverse events and changes around surgical wound and neurologic sign will be recorded. Patients will be carefully observed and if any abnormality is noted, appropriate measures will be instituted. The surgical materials used are all certified by the Ministry of Health and Welfare in Taiwan. The possible side effects, such as infections or inflammatory reactions that may occur after surgery, will be given antibiotics or other appropriate treatments in accordance with standard medical procedures. Data of baseline characteristics will be described using means with standard deviations (SDs) or medians and interquartile ranges (IQRs), or both for continuous variables and using frequencies (percentages) for categorical variables. Mean morphological measures (and changes) will be computed as averages across participants within each treatment group. Between-group baseline comparisons will be based on 2 independent two sample t test or Wilcoxon Mann-Whitney test for quantitative variables, and chi-square test or Fisher's exact test for categorical variables. P values less than 0.05 will be adjusted for multiple comparisons using Bonferroni correction. All statistical analyses will be performed using SAS software Version 9.4 (SAS Institute Inc., Cary, North Carolina).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
41
Preoperative, 3 days, 2 weeks, 4 weeks and 24 weeks postoperatively
Kaohsiung Medical University Hospital
Kaohsiung City, Taiwan
Change from preoperative BCTQ SSS at 4 Weeks
The Symptom Severity Scale (SSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) is an 11-question patient-administered survey that rates the severity of the patient's carpal tunnel syndrome-specific symptoms on a scale of 1 (no symptoms) to 5 (worst symptoms)
Time frame: preoperative and 4 weeks after surgery
Operation time
Outcomes from both interventions will be measured with this symptom severity and functional status carpal tunnel specific scale.
Time frame: operation day
Wound size
Outcomes from both interventions will be measured with this symptom severity and functional status carpal tunnel specific scale.
Time frame: Preoperative, 3 days, 2 weeks, 4 weeks and 24 weeks after surgery
Grip/pinch strength
Outcomes from both interventions will be measured with this symptom severity and functional status carpal tunnel specific scale.
Time frame: Preoperative, 3 days, 2 weeks, 4 weeks and 24 weeks after surgery
Pain Scores on the Visual Analog Scale
Is a subjective assessment of pain. The Visual Analogue Scale (VAS) consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' and 'pain as bad as it could be'. The patient is asked to mark his pain level on the line between the two endpoints. The distance between 'no pain at all' and the mark then defines the subject's pain. \[0 (no pain), 10 (worst pain)\]
Time frame: Preoperative, 3 days, 2 weeks, 4 weeks and 24 weeks after surgery
Time off work
Differences in time off work between both procedures measured in days.
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Time frame: 24 weeks after surgery
Number of Participants with Adverse Events
Infection, secondary operation, scar hypertrophy, scar hyper-sensitivity, tenderness, and pillar pain
Time frame: 3 days, 2 weeks, 4 weeks and 24 weeks after surgery
two point discrimination test
Outcomes from both interventions will be measured with this symptom severity and functional status carpal tunnel specific scale.
Time frame: Preoperative, 3 days, 2 weeks, 4 weeks and 24 weeks after surgery
BCTQ SSS
The Symptom Severity Scale (SSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) is an 11-question patient-administered survey that rates the severity of the patient's carpal tunnel syndrome-specific symptoms on a scale of 1 (no symptoms) to 5 (worst symptoms).
Time frame: Preoperative, 3 days, 2 weeks, 4 weeks and 24 weeks after surgery