The aim of the study is to compare the effectiveness of ultrasound-guided betamethasone and 5% dextrose injection, which is routinely applied in clinical practice, in patients with mild and moderate carpal tunnel syndrome (CTS).
It is planned as an observational, single-center clinical study.A total of 28 patients diagnosed with mild-moderate carpal tunnel syndrome who meet the inclusion criteria will be included in the study.Patients who had been experiencing trigger finger symptoms for at least three month and who presented to the Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, affiliated with the Health Sciences University Faculty of Medicine. Patients will be divided into two groups. One group will receive 5% dextrose, the other group will receive 1 session of local injection by mixing Celeston chronodose \[1ml/3 mg betamethasone acetate+3,947 mg betamethasone disodium phosphate (equivalent to 3 mg betamethasone)\] and 1 ml 2% prilocaine. Evaluations will be made before injection, at weeks 4 and 12.
Study Type
OBSERVATIONAL
Enrollment
30
hydrodissection with %5 dextrose
perineural betamethasone injection
Ankara Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Ankara, Turkey (Türkiye)
Numeric rating scale - 10
The Numeric Rating Scale (NRS) is a simple and widely used tool for assessing pain intensity. Patients are asked to rate their pain on a scale from 0 to 10, where: 0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-9 = Severe pain 10 = Worst pain imaginable The patient selects the number that best represents their pain at last one week
Time frame: three months
boston carpal tunnel syndrome questionnaire
The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) is a disease-specific, patient-reported outcome measure used to assess symptom severity and functional status.1. Symptom Severity Scale (SSS) Contains 11 items Evaluates pain, numbness, tingling, weakness, nocturnal symptoms, and symptom frequency Each item is scored on a 5-point Likert scale (1 = no symptoms, 5 = very severe symptoms) 2\. Functional Status Scale (FSS) Contains 8 items Assesses difficulty in performing daily activities such as writing, buttoning clothes, holding a book, gripping a telephone, opening jars, and carrying grocery bags Each item is scored from 1 (no difficulty) to 5 (cannot perform the activity)
Time frame: three months
median nerve cross sectional area
Median nerve cross-sectional area (CSA) refers to the measured area of the median nerve in a transverse (axial) plane, most commonly assessed using high-resolution ultrasonography.CSA measurements were performed using ultrasound at the scaphoid - pisiform bone level in the wrist, with results recorded in mm². To minimize measurement error, each measurement was performed three times, and the average of the three measurements was used for analysis.
Time frame: three months
tinnel test positivity
Tinel test positivity refers to the reproduction of distal paresthesia in the distribution of a nerve following percussion over the nerve at a suspected site of compression. Definition of Positivity The test is considered positive when tapping elicits: Tingling "Pins and needles" sensation (paresthesia) Electric shock-like sensation radiating into the median nerve distribution (thumb, index finger, middle finger, and radial half of the ring finger).
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Time frame: three months
phalen test positivity
The Phalen test is performed by asking the patient to fully flex both wrists and maintain this position for approximately 60 seconds. This maneuver increases pressure within the carpal tunnel. Definition of Positivity The test is considered positive when the patient experiences: Numbness Tingling (paresthesia) Burning sensation Pain in the distribution of the median nerve (thumb, index finger, middle finger, and radial half of the ring finger) during the maneuver.
Time frame: three months
DuruÖz hand index
The Duruöz Hand Index (DHI) is a patient-reported outcome measure developed to assess functional disability of the hand.Structure The questionnaire consists of 18 items. It assesses hand-related functional activities such as: Turning a key Buttoning clothes Opening jars Carrying objects Using kitchen utensils Scoring Each item is scored on a 6-point Likert scale: 0 = Without difficulty 1. = With slight difficulty 2. = With moderate difficulty 3. = With great difficulty 4. = Nearly impossible 5. = Impossible The total score ranges from 0 to 90. Higher scores indicate greater functional impairment.
Time frame: three months