A prospective study to assess the outcome of XXXX injections and wrist splinting for the treatment of @entity923 .

@entity923 @entity1 @entity5935 @entity479
Surgery is the definitive treatment for @entity923 . Conservative treatments, such as wrist splinting and @entity479 injections, are also effective for the relief of @entity923 , but their use remains controversial because they only offer long-term relief in a minority of @entity1 . A prospective study was performed to assess the role of @entity479 injections combined with wrist splinting for the management of @entity923 . A total of 73 @entity1 with 99 affected hands were studied. @entity1 presenting with known medical causes or muscle wasting were excluded. Diagnosis was made clinically and electrodiagnostic studies were performed only when equivocal clinical signs were present. Each @entity1 received up to three @entity5935 injections into the @entity923 and wore a neutral-position wrist splint continuously for 9 weeks. After that period, symptomatic @entity1 received an open @entity923 release, and those who remained asymptomatic were followed up regularly for at least 1 year. @entity1 who relapsed were scheduled for surgery. At a minimum follow-up of 1 year, seven @entity1 (9.6 percent) with 10 affected hands (10.1 percent) remained asymptomatic. This group had a significantly shorter duration of symptoms (2.9 months versus 8.35 months; p = 0.039, Mann-Whitney test) and significantly less sensory change (40 percent versus 72 percent; p = 0.048, Fisher's exact test) at presentation when compared with the group who had surgery. It is concluded that @entity479 injections and wrist splinting are effective for relief of @entity923 but have a long-term effect in only 10 percent of @entity1 . Symptom duration of less than 3 months and absence of sensory impairment at presentation were predictive of a lasting response to conservative treatment. It is suggested that selected @entity1 (i.e., with no thenar wasting or obvious underlying cause) presenting with mild to moderate @entity923 receive either a single @entity479 injection or wear a wrist splint for 3 weeks. This will allow identification of the 10 percent of @entity1 who respond well to conservative therapy and do not need surgery.
