Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial
CONTEXT Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical options. However, there is no consensus on the most effective method of treatment. OBJECTIVE To compare the short-term and long-term efficacy of splinting and surgery for relieving the symptoms of CTS. DESIGN, SETTING,...
Gespeichert in:
| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2002-09, Vol.288 (10), p.1245-1251 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1251 |
|---|---|
| container_issue | 10 |
| container_start_page | 1245 |
| container_title | JAMA : the journal of the American Medical Association |
| container_volume | 288 |
| creator | Gerritsen, Annette A. M de Vet, Henrica C. W Scholten, Rob J. P. M Bertelsmann, Frits W de Krom, Marc C. T. F. M Bouter, Lex M |
| description | CONTEXT Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical
options. However, there is no consensus on the most effective method of treatment. OBJECTIVE To compare the short-term and long-term efficacy of splinting and surgery
for relieving the symptoms of CTS. DESIGN, SETTING, AND PATIENTS 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. MAIN OUTCOME MEASURES General improvement, number of nights waking up due to symptoms, and
severity of symptoms. RESULTS 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 |
| doi_str_mv | 10.1001/jama.288.10.1245 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_72066510</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>195279</ama_id><sourcerecordid>72066510</sourcerecordid><originalsourceid>FETCH-LOGICAL-a308t-6e7c62292333d2a6030c9717927fee07bc67f566fac9e769f1215b62a04c58743</originalsourceid><addsrcrecordid>eNpd0d1LwzAQAPAgipvTd32RIOhbZz7apPFtFL9gILj5arm16exI05m0wvzrjWwy8F4u3P04jhxC55SMKSH0dgUNjFmajn8LLE4O0JAmPI14otJDNCREpZGM03iATrxfkRCUy2M0oIzRhHI6RO-ztaltV9sl_vJ41ruldhtcW9x9aDx3GrpG2w63Fc7ArcHgeW-tNni2saVrG32HJ_gVbNk29bcucdbazrXGhOfc1WBO0VEFxuuzXR6ht4f7efYUTV8en7PJNAJO0i4SWhaCMcU45yUDQTgplKRSMVlpTeSiELJKhKigUFoKVdGw_0IwIHGRpDLmI3Sznbt27WevfZc3tS-0MWB12_tcMiJEQkmAV__gqu2dDbvljFIuuIhZQJc71C8aXeZrVzfgNvnftwVwvQPgCzCVA1vUfu-4opwTFdzF1oU77bsqYVLxH2xagro</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211363642</pqid></control><display><type>article</type><title>Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Gerritsen, Annette A. M ; de Vet, Henrica C. W ; Scholten, Rob J. P. M ; Bertelsmann, Frits W ; de Krom, Marc C. T. F. M ; Bouter, Lex M</creator><creatorcontrib>Gerritsen, Annette A. M ; de Vet, Henrica C. W ; Scholten, Rob J. P. M ; Bertelsmann, Frits W ; de Krom, Marc C. T. F. M ; Bouter, Lex M</creatorcontrib><description>CONTEXT Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical
options. However, there is no consensus on the most effective method of treatment. OBJECTIVE To compare the short-term and long-term efficacy of splinting and surgery
for relieving the symptoms of CTS. DESIGN, SETTING, AND PATIENTS 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. MAIN OUTCOME MEASURES General improvement, number of nights waking up due to symptoms, and
severity of symptoms. RESULTS 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. CONCLUSION Treatment with open carpal tunnel release surgery resulted in better
outcomes than treatment with wrist splinting for patients with CTS.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.288.10.1245</identifier><identifier>PMID: 12215131</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Biological and medical sciences ; Carpal tunnel syndrome ; Carpal Tunnel Syndrome - physiopathology ; Carpal Tunnel Syndrome - surgery ; Carpal Tunnel Syndrome - therapy ; Comparative studies ; Decompression, Surgical ; Effectiveness ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Nervous system involvement in other diseases. Miscellaneous ; Neurology ; Severity of Illness Index ; Splints ; Surgery ; Therapy ; Treatment Outcome</subject><ispartof>JAMA : the journal of the American Medical Association, 2002-09, Vol.288 (10), p.1245-1251</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright American Medical Association Sep 11, 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.288.10.1245$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.288.10.1245$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,315,781,785,3341,27929,27930,76494,76497</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13913309$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12215131$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerritsen, Annette A. M</creatorcontrib><creatorcontrib>de Vet, Henrica C. W</creatorcontrib><creatorcontrib>Scholten, Rob J. P. M</creatorcontrib><creatorcontrib>Bertelsmann, Frits W</creatorcontrib><creatorcontrib>de Krom, Marc C. T. F. M</creatorcontrib><creatorcontrib>Bouter, Lex M</creatorcontrib><title>Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical
options. However, there is no consensus on the most effective method of treatment. OBJECTIVE To compare the short-term and long-term efficacy of splinting and surgery
for relieving the symptoms of CTS. DESIGN, SETTING, AND PATIENTS 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. MAIN OUTCOME MEASURES General improvement, number of nights waking up due to symptoms, and
severity of symptoms. RESULTS 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. CONCLUSION Treatment with open carpal tunnel release surgery resulted in better
outcomes than treatment with wrist splinting for patients with CTS.</description><subject>Biological and medical sciences</subject><subject>Carpal tunnel syndrome</subject><subject>Carpal Tunnel Syndrome - physiopathology</subject><subject>Carpal Tunnel Syndrome - surgery</subject><subject>Carpal Tunnel Syndrome - therapy</subject><subject>Comparative studies</subject><subject>Decompression, Surgical</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system involvement in other diseases. Miscellaneous</subject><subject>Neurology</subject><subject>Severity of Illness Index</subject><subject>Splints</subject><subject>Surgery</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0d1LwzAQAPAgipvTd32RIOhbZz7apPFtFL9gILj5arm16exI05m0wvzrjWwy8F4u3P04jhxC55SMKSH0dgUNjFmajn8LLE4O0JAmPI14otJDNCREpZGM03iATrxfkRCUy2M0oIzRhHI6RO-ztaltV9sl_vJ41ruldhtcW9x9aDx3GrpG2w63Fc7ArcHgeW-tNni2saVrG32HJ_gVbNk29bcucdbazrXGhOfc1WBO0VEFxuuzXR6ht4f7efYUTV8en7PJNAJO0i4SWhaCMcU45yUDQTgplKRSMVlpTeSiELJKhKigUFoKVdGw_0IwIHGRpDLmI3Sznbt27WevfZc3tS-0MWB12_tcMiJEQkmAV__gqu2dDbvljFIuuIhZQJc71C8aXeZrVzfgNvnftwVwvQPgCzCVA1vUfu-4opwTFdzF1oU77bsqYVLxH2xagro</recordid><startdate>20020911</startdate><enddate>20020911</enddate><creator>Gerritsen, Annette A. M</creator><creator>de Vet, Henrica C. W</creator><creator>Scholten, Rob J. P. M</creator><creator>Bertelsmann, Frits W</creator><creator>de Krom, Marc C. T. F. M</creator><creator>Bouter, Lex M</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20020911</creationdate><title>Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial</title><author>Gerritsen, Annette A. M ; de Vet, Henrica C. W ; Scholten, Rob J. P. M ; Bertelsmann, Frits W ; de Krom, Marc C. T. F. M ; Bouter, Lex M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a308t-6e7c62292333d2a6030c9717927fee07bc67f566fac9e769f1215b62a04c58743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Biological and medical sciences</topic><topic>Carpal tunnel syndrome</topic><topic>Carpal Tunnel Syndrome - physiopathology</topic><topic>Carpal Tunnel Syndrome - surgery</topic><topic>Carpal Tunnel Syndrome - therapy</topic><topic>Comparative studies</topic><topic>Decompression, Surgical</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system involvement in other diseases. Miscellaneous</topic><topic>Neurology</topic><topic>Severity of Illness Index</topic><topic>Splints</topic><topic>Surgery</topic><topic>Therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gerritsen, Annette A. M</creatorcontrib><creatorcontrib>de Vet, Henrica C. W</creatorcontrib><creatorcontrib>Scholten, Rob J. P. M</creatorcontrib><creatorcontrib>Bertelsmann, Frits W</creatorcontrib><creatorcontrib>de Krom, Marc C. T. F. M</creatorcontrib><creatorcontrib>Bouter, Lex M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gerritsen, Annette A. M</au><au>de Vet, Henrica C. W</au><au>Scholten, Rob J. P. M</au><au>Bertelsmann, Frits W</au><au>de Krom, Marc C. T. F. M</au><au>Bouter, Lex M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2002-09-11</date><risdate>2002</risdate><volume>288</volume><issue>10</issue><spage>1245</spage><epage>1251</epage><pages>1245-1251</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical
options. However, there is no consensus on the most effective method of treatment. OBJECTIVE To compare the short-term and long-term efficacy of splinting and surgery
for relieving the symptoms of CTS. DESIGN, SETTING, AND PATIENTS 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. MAIN OUTCOME MEASURES General improvement, number of nights waking up due to symptoms, and
severity of symptoms. RESULTS 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. CONCLUSION Treatment with open carpal tunnel release surgery resulted in better
outcomes than treatment with wrist splinting for patients with CTS.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>12215131</pmid><doi>10.1001/jama.288.10.1245</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2002-09, Vol.288 (10), p.1245-1251 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72066510 |
| source | MEDLINE; American Medical Association Journals |
| subjects | Biological and medical sciences Carpal tunnel syndrome Carpal Tunnel Syndrome - physiopathology Carpal Tunnel Syndrome - surgery Carpal Tunnel Syndrome - therapy Comparative studies Decompression, Surgical Effectiveness Female Humans Male Medical sciences Middle Aged Nervous system involvement in other diseases. Miscellaneous Neurology Severity of Illness Index Splints Surgery Therapy Treatment Outcome |
| title | Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-13T08%3A21%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Splinting%20vs%20Surgery%20in%20the%20Treatment%20of%20Carpal%20Tunnel%20Syndrome:%20A%20Randomized%20Controlled%20Trial&rft.jtitle=JAMA%20:%20the%20journal%20of%20the%20American%20Medical%20Association&rft.au=Gerritsen,%20Annette%20A.%20M&rft.date=2002-09-11&rft.volume=288&rft.issue=10&rft.spage=1245&rft.epage=1251&rft.pages=1245-1251&rft.issn=0098-7484&rft.eissn=1538-3598&rft.coden=JAMAAP&rft_id=info:doi/10.1001/jama.288.10.1245&rft_dat=%3Cproquest_pubme%3E72066510%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=211363642&rft_id=info:pmid/12215131&rft_ama_id=195279&rfr_iscdi=true |