Faculty of Medicine , Tartu University Hospital, Tartu , Estonia .
Acta Orthop. 2014 Feb;85(1):102-6. doi: 10.3109/17453674.2013.867781. Epub 2013 Nov 29.
Failed closed treatment of carpal tunnel syndrome (CTS) is often followed by surgery. We investigated whether preoperative steroid injections could have a negative effect on the long-term outcome of the operation.
174 hands (164 patients) were operated on by a single surgeon at Tartu University Hospital in 2005. The patients were interviewed by telephone 5-6 years after the operation. Self-reported data were gathered retrospectively concerning the number of steroid injections received before the surgery and the perceived regression of symptoms (on a 100-point numeric rating scale) at the time of interview. The patients were also asked about the presence of specific symptoms of CTS if regression of their symptoms had not been complete.
93 of the 174 hands had complete regression of symptoms. Each additional injection was associated with an increased risk of occurrence of pain (RR = 1.1, 95% CI: 1.02-1-2), paresthesiae (RR = 1.1, CI: 1.1-1.2), and nocturnal awakenings (RR = 1.2, CI: 1.1-1.3). There was a weak association between the number of injections and the score given to regression of symptoms.
This is the first study to indicate that patients who received a greater number of local steroid injections preoperatively were more likely to have postoperative complaints associated with CTS.
腕管综合征（CTS）的闭合治疗失败后，通常需要手术。我们研究了术前皮质类固醇注射是否会对手术的长期结果产生负面影响。
2005 年，一位医生在塔尔图大学医院对 164 名患者的 174 只手进行了手术。术后 5-6 年通过电话对患者进行了访谈。回顾性收集了术前接受皮质类固醇注射的次数和症状缓解程度（100 分数字评分量表）的自我报告数据。如果症状没有完全缓解，还询问了患者是否存在 CTS 的特定症状。
174 只手中的 93 只手症状完全缓解。每次额外注射都会增加出现疼痛（RR = 1.1，95%CI：1.02-1.2）、感觉异常（RR = 1.1，CI：1.1-1.2）和夜间觉醒（RR = 1.2，CI：1.1-1.3）的风险。注射次数与症状缓解评分之间存在弱关联。
这是第一项表明术前接受更多局部皮质类固醇注射的患者术后更有可能出现与 CTS 相关的投诉的研究。
