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Therapeutics
Surgery was associated with greater long term treatment success than wrist splinting in carpal tunnel syndrome

https://doi.org/10.1136/ebm.8.2.55

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    (2002) JAMA 288, 1245. Gerritsen AA, de Vet HC, Scholten RJ, et al.. Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial.. ;. :. –51.
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 QUESTION: In patients with carpal tunnel syndrome (CTS), what is the short term and long term effectiveness of wrist splinting and surgery?

    Design

    Randomised (allocation concealed*), blinded {data collectors, outcome assessors, and data analysts}†,* controlled trial with 18 months of follow up.

    Setting

    13 neurological outpatient clinics in the Netherlands.

    Patients

    176 patients ≥18 years of age (mean age 49 y, 81% women) with clinically and electrophysiologically confirmed idiopathic CTS. Exclusion criteria were previous treatment with splinting or surgery, history of wrist trauma or surgery, underlying causes of CTS, conditions emulating CTS, or severe thenar muscle atrophy. Follow up was 95% at 1 month and 84% at 18 months.

    Intervention

    89 patients were allocated to wrist splinting during the night for ≥6 weeks, and 87 were allocated to open carpal tunnel release surgery.

    Main outcome measures

    Patient self report of treatment success …

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    Footnotes

    • For correspondence: Dr A A Gerritsen, Institute for Research in Extramural Medicine, Amsterdam, The Netherlands.aam.gerritsen.emgo{at}med.vu.nl

    • Source of funding: Health Care Insurance Council of the Netherlands.

    • ↵*See glossary.

    • ↵†Information provided by author.