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Comparison of short- and long-axis nerve hydrodissection for carpal tunnel syndrome: A prospective randomized, single-blind trial
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  • Si-Ru Chen,
  • Tsung-Yen Ho,
  • Yu-Ping Shen,
  • Tsung-Ying Li,
  • Yu-Chi Su,
  • Liang-Cheng Chen,
  • Yung-Tsan Wu
Si-Ru Chen
Tri-Service General Hospital
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Tsung-Yen Ho
Tri-Service General Hospital
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Yu-Ping Shen
Tri-Service General Hospital
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Tsung-Ying Li
Tri-Service General Hospital
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Yu-Chi Su
Tri-Service General Hospital
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Liang-Cheng Chen
Tri-Service General Hospital
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Yung-Tsan Wu
Tri-Service General Hospital
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Abstract

Introduction This study is to compare the efficacy of two different methods of nerve hydrodissection (HD), called short- and long-axis injection, for patients with mild-to-moderate carpal tunnel syndrome (CTS). Methods Forty-seven patients with mild-to-moderate CTS were enrolled in a prospective, randomized, single-blinded, controlled trial (6 months follow-up). With ultrasound guidance, patients in both groups (short-axis or long-axis groups) were injected with normal saline (5 mL per session). Assessments were performed before and 2 weeks after the injection, as well as at 1, 3, and 6 months post-intervention. The primary outcome measure was the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score and secondary outcomes included the cross-sectional area of the median nerve and electrophysiological studies. Results Forty-four patients (21 wrists in the short-axis group and 23 wrists in the long-axis group) completed the study. Compared with the baseline, both groups showed improved BCTQ and cross-sectional area at all follow-up assessments (p<0.05). Moreover, the short-axis group had significant improvements in BCTQ-severity and BCTQ-function 1 month post-injection compared to the long-axis group (p = 0.031 and p = 0.023, respectively). Conclusion Both short- and long-axis HD were effective for patients with mild-to-moderate CTS; however, the short-axis HD conferred relatively better efficacy 1 month after the injection.