Accuracy of Carpal Tunnel Injection: A Prospective Evaluation of 756 Patients.

Hand : Official Journal of the American Association for Hand Surgery
David P GreenMichael T Fry

Abstract

Background: Corticosteroid injection into the carpal tunnel is both a diagnostic test and a therapeutic modality in the treatment of carpal tunnel syndrome. Many injection techniques are described in the literature. Improper placement of injection may result in damage to neurovascular structures in the carpal canal or decrease efficacy of the test and/or therapy. The purpose of this study is to determine if carpal tunnel injection using anatomic landmarks is reproducible and safe. A review of the senior author's injection technique is presented. Methods: Over 8 years, there were 756 attempted placements of a 25-gauge needle into the carpal tunnel in a simulated carpal tunnel injection prior to open carpal tunnel release. The needle was inserted at the wrist crease, just ulnar to palmaris longus. Open carpal tunnel release was subsequently performed, and position of the needle was recorded. Results: In 572 patients (75.7%), the needle was found to be in the carpal tunnel without penetration of contents. The needle was in the carpal tunnel but piercing the median nerve in 66 attempts (8.7%). The carpal tunnel was missed in 118 attempts (15.6%). Conclusions: This is the largest study looking at accuracy of carpal tunnel injection ...Continue Reading

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Citations

Aug 25, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Nimalan SanmugalingamAndoni P Toms
May 28, 2020·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Stefano BianchiPierre-Alexandre Poletti
Jan 20, 2021·The Journal of Bone and Joint Surgery. American Volume·Christopher J Dy
Oct 27, 2021·Hand : Official Journal of the American Association for Hand Surgery·Mina MeshkiniSeyedeh Tahereh Faezi

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