This study compared the efficacy and safety of local corticosteroid injection (LCI) vs intramuscular (IM) corticosteroid injection in mild to moderate carpal tunnel syndrome (CTS). This is an open labeled, randomized controlled trial conducted during December 2021 to August 2023. Eighty-six patients with CTS were randomized in 1:1 ratio to receive either single 40 mg methylprednisolone (MP) injection at the wrist (LCI arm), or single 40 mg MP intramuscular injection (IM arm) in the deltoid. Primary outcome was absolute Symptom Severity Scale (SSS) at 3 months. Secondary outcomes were SSS score at 1-month, Functional Status Scale (FSS) score at 1 and 3 months, and recurrence at 3 months and injection site pain assessed on visual analog (VAS) scale. Median age was 45 (range 22 – 80) years, and 86 % were females. Baseline characteristics were comparable between groups. Mean SSS score at 3 months was similar in two arms (1.72 ± 0.71 vs 2.0 ± 0.93) with mean difference (MD) −0.03 (-0.31 to 0.25, p = 0.83) after adjusting for baseline SSS scores. LCI, however, resulted in significantly better SSS (1.48 ± 0.51 vs 1.88 ± 0.69, adjusted p = 0.04), and FSS scores (1.57 ± 0.44 vs 1.80 ± 0.66, adjusted p = 0.03) at 1 month compared to IM arm. Response rate (67.4 % vs 55.8 %; p = 0.30) and recurrence rate (17.1 % vs 22.6 %, p = 0.74) at 3 months were similar. Injection site pain was severe in LCI arm[median 5 (range 3 – 8) vs median 3 (range 2 – 6)]. In patients with mild to moderate CTS, LCI resulted in better improvement in the BCTQ scores at 1 month compared to IM steroid. However, 3-month’s outcome was similar. Intramuscular steroid injection was better tolerated.

中文翻译：

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腕管综合征患者局部与肌内类固醇注射的比较：一项前瞻性开放标签随机临床试验

本研究比较了局部皮质类固醇注射 (LCI) 与肌内 (IM) 皮质类固醇注射治疗轻至中度腕管综合征 (CTS) 的疗效和安全性。这是一项于 2021 年 12 月至 2023 年 8 月期间进行的开放标记、随机对照试验。86 名 CTS 患者按 1:1 的比例随机分配，接受腕部单次 40 mg 甲泼尼龙 (MP) 注射（LCI 臂），或在三角肌中单次 40 mg MP 肌内注射（IM 臂）。主要结果是 3 个月时的绝对症状严重程度量表 (SSS)。次要结局是 1 个月时的 SSS 评分、1 个月和 3 个月时的功能状态量表 (FSS) 评分、3 个月时的复发情况以及视觉模拟 (VAS) 量表评估的注射部位疼痛。中位年龄为 45 岁（范围 22 – 80 岁），其中 86% 为女性。各组之间的基线特征具有可比性。调整基线 SSS 评分后，3 个月时的平均 SSS 评分相似（1.72 ± 0.71 与 2.0 ± 0.93），平均差 (MD) -0.03（-0.31 至 0.25，p = 0.83）。然而，与 IM 组相比，1 个月时 LCI 的 SSS（1.48 ± 0.51 vs 1.88 ± 0.69，调整后的 p = 0.04）和 FSS 评分（1.57 ± 0.44 vs 1.80 ± 0.66，调整后的 p = 0.03）明显更好。 3 个月时的缓解率（67.4 % vs 55.8 %；p = 0.30）和复发率（17.1 % vs 22.6 %，p = 0.74）相似。 LCI 组的注射部位疼痛严重[中位数 5（范围 3 – 8）与中位数 3（范围 2 – 6）]。在患有轻度至中度 CTS 的患者中，与 IM 类固醇相比，LCI 在 1 个月时 BCTQ 评分得到了更好的改善。然而，3个月的结果是相似的。肌内类固醇注射的耐受性更好。