الفهرس | Only 14 pages are availabe for public view |
Abstract Hydrodissection is a minimally invasive procedure of injecting fluid into anatomic spaces to facilitate dissection and adhesiolysis in peripheral nerve entrapments. ultrasound-guided injection of lidocaine and corticosteroids in patients with CTS and proposed the concept of nerve hydrodissection. Normal saline is injecting the material between the MN and transverse carpal ligament and underlying tendons, which may interrupt the adhesions of MN and reduce the symptoms. Median nerve hydrodissection is also useful in preventing unintentional direct injection to the nerve. The therapeutic effect of nerve hydrodissection is based on the theory that separating the compressed nerve from nearby soft tissue could decrease the risk of adhesion and chronic constriction injury. The near-nerve local insulin injection is thought to promote neuronal growth and regeneration, and could be important in restoring nerve function following metabolic or vascular damage. Local insulin injection may be of great potential benefit in the improvement of median nerve functions and regeneration in diabetes mellitus patients with mild to moderate CTS.The results of this clinical trial study showed that the Hydrodissection (10 ml of normal saline) of the median nerve is significantly effective in the treatment of mild to moderate carpal tunnel syndrome in patients with diabetes mellitus and alleviates the symptoms of CTS. Also the study showed that the local insulin injection (10 IU of NPH) alone is significantly effective in the management of mild to moderate carpal tunnel syndrome of diabetic patients, which shows significant response within two weeks of follow up. The study shows that Hydrodissection is slightly superior to insulin for treatment of CTS. Furthermore our current study compares the failure rate of both treatment modalities which implies that Hydrodissection group are less failure rate than insulin group, but this difference is insignificant due small sample size of both groups. |