Roh Y H, Lee B K, Baek J R, Park M H, Noh J H, Gong H S, Baek G H
1 Department of Orthopaedic Surgery, Gachon University School of Medicine, Incheon, Korea.
Current affiliation: Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
J Hand Surg Eur Vol. 2016 Nov;41(9):963-969. doi: 10.1177/1753193416654447. Epub 2016 Sep 28.
Diffuse peripheral nerve impairment is common in metabolic syndrome: in patients with metabolic syndrome and carpal tunnel syndrome this might affect the outcome of treatment by local corticosteroid injection. A total of 55 consecutive patients with carpal tunnel syndrome and metabolic syndrome treated with corticosteroid injection (10 mg triamcinolone acetonide) were age and sex matched with 55 control patients without metabolic syndrome. Grip strength, perception of touch with Semmes-Weinstein monofilaments and Boston Carpal Tunnel Questionnaires were assessed at the baseline and at 6, 12 and 24 weeks follow-up. The two groups had similar pre-operative grip strength and Boston Carpal Tunnel Questionnaire scores. The Boston Carpal Tunnel Questionnaire symptom and function scores of the metabolic syndrome group were significantly greater than the control group at 12 and 24 weeks follow-up. Except for significantly greater grip strength at the 12-week follow-up in the control group, there were no significant differences in grip strength between the groups. Semmes-Weinstein monofilament sensory index for the control group was significantly greater than that of the metabolic syndrome group throughout the 24-week follow-up. After 24 weeks, five patients (13%) in the control group and 13 patients (27%) in the metabolic syndrome group had had carpal tunnel surgery. Patients with metabolic syndrome are at risk for poor functional outcome and failure of treatment after corticosteroid injection for carpal tunnel syndrome.
Treatment benefits III.
弥漫性周围神经损伤在代谢综合征中很常见：在患有代谢综合征和腕管综合征的患者中，这可能会影响局部注射皮质类固醇治疗的效果。共有55例连续的患有腕管综合征和代谢综合征且接受皮质类固醇注射（10毫克曲安奈德）治疗的患者，在年龄和性别上与55例无代谢综合征的对照患者相匹配。在基线以及随访6周、12周和24周时评估握力、用Semmes-Weinstein单丝测定的触觉感知以及波士顿腕管综合征问卷。两组术前握力和波士顿腕管综合征问卷评分相似。在随访12周和24周时，代谢综合征组的波士顿腕管综合征问卷症状和功能评分显著高于对照组。除了对照组在随访12周时握力显著更大外，两组之间的握力没有显著差异。在整个24周的随访中，对照组的Semmes-Weinstein单丝感觉指数显著高于代谢综合征组。24周后，对照组有5例患者（13%）和代谢综合征组有13例患者（27%）接受了腕管手术。患有代谢综合征的患者在接受皮质类固醇注射治疗腕管综合征后，存在功能预后不良和治疗失败的风险。
治疗效益III级。
