Porrata Humberto, Porrata Alejandro, Sosner Julian
Department of Physical Medicine and Rehabilitation, Saint Vincent Catholic Medical Centers of New York, Manhattan, New York, USA.
J Hand Ther. 2007 Jan-Mar;20(1):20-7; quiz 28. doi: 10.1197/j.jht.2006.10.001.
This study evaluated the treatment efficacy and patient satisfaction of a new hand traction device called C-TRAC in patients that failed conservative therapy for carpal tunnel syndrome (CTS). Patients were diagnosed with electromyography and nerve conduction studies. Only patients with a positive Phalens test and a Visual Analog Scale (VAS) of more than 5/10 were eligible for the study. The patients had tried nonsteroidal anti-inflammatory drugs (NSAIDS), resting hand splint during the night, acupuncture, and hand therapy for a minimum of four months. To test C-TRAC as the sole treatment for CTS, patients included in the study stopped all other forms of therapy (NSAIDS, hand therapy, acupuncture, massage, manipulations, and steroid injections). A group of 19 patients used C-TRAC hand traction device for 5 minutes three times daily for four weeks. After the four-week period the device was used as needed. The patients were followed up weekly for four weeks, then at seven months. VAS was used to assess pain, tingling, and numbness in the treated hand. The number of times patients woke up at night and satisfaction with the use of the device were also evaluated. The average VAS for pain decreased from 8.53 to 1.05. The average tingling decreased from 8.15 to 0.95. The average numbness decreased from 8.47 to 0.95. The average number of times patients woke up per night because of CTS symptoms decreased from 3.05 to 0.10. Patients showed significant improvement at four weeks and results were maintained at seven months follow-up. Fifteen patients (79%) rated their treatment as excellent and four (21%) as good and none (0%) as fair or poor.
This device is very effective and well tolerated in treatment of CTS in patients that failed conservative therapy.
本研究评估了一种名为C-TRAC的新型手部牵引装置对保守治疗失败的腕管综合征(CTS)患者的治疗效果及患者满意度。通过肌电图和神经传导研究对患者进行诊断。只有Phalen试验呈阳性且视觉模拟量表(VAS)评分超过5/10的患者才有资格参与本研究。这些患者至少尝试过非甾体抗炎药(NSAIDS)、夜间手部休息夹板、针灸和手部治疗四个月。为了测试C-TRAC作为CTS的唯一治疗方法,纳入研究的患者停止了所有其他形式的治疗(NSAIDS、手部治疗、针灸、按摩、手法治疗和类固醇注射)。一组19名患者每天使用C-TRAC手部牵引装置3次,每次5分钟,持续四周。四周后,根据需要使用该装置。对患者进行了四周的每周随访,然后在七个月时进行随访。使用VAS评估治疗手的疼痛、刺痛和麻木情况。还评估了患者夜间醒来的次数以及对该装置使用的满意度。疼痛的平均VAS评分从8.53降至1.05。平均刺痛评分从8.15降至0.95。平均麻木评分从8.47降至0.95。患者因CTS症状每晚醒来的平均次数从3.05降至0.10。患者在四周时显示出显著改善,并且在七个月的随访中结果得以维持。15名患者(79%)将他们的治疗评为优秀,4名(21%)评为良好,没有患者(0%)评为一般或差。
该装置在治疗保守治疗失败的CTS患者中非常有效且耐受性良好。