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Abstract This study was performed to evaluate the efficacy of platelet rich plasma (PRP) local injection compared to corticosteroids local injection in the wrist in the treatment of mild idiopathic carpal tunnel syndrome using VAS, BCTQ and NCS as outcome measures. Forty patients (35 females and 5 males) with mild idiopathic CTS with a mean age of 40.5±11.1years and a mean disease duration of 11.9±9.9 months were involved and divided into 2 groups: group (I): included 20 patients [17 females (85%) and 3 males (15%)] who received corticosteroids in the form of 1 ml of triamcinolone acetonide (40mg/ml) local injection in the wrist once with mean age of 41.5±11.3 years. group (ІІ): consisted of 20 patients [2 males (10%) and 18 females (90%)] who received 2 mL of PRP local injection once in the wrist with mean age of 39.1±11.2 years. The mean disease duration was 13.70±12.99 months in group I and 9.85±5.10 months in group II. Patients were diagnosed as CTS clinically by parathesia in lateral three and half fingers of the hand suggestive of CTS then performed a standard neurophysiological examination to confirm the diagnosis and to select mild cases according to The Padua’s Neurophysiologic Severity Scale (PNSS) for CTS. All patients were subjected to the following: Full history taking. Full detailed clinical examination. Clinical examination of the hand. Clinical assessment using VAS and BCTQ scores. Laboratory assessment and imaging for exclusion of secondary causes. Electrophysiological assessment in the form of nerve conduction studies of median and ulnar nerves. Boston Carpal Tunnel Questionnaire (BCTQ), Visual Analogue Scale (VAS) score and Nerve conduction studies (NCS) for median nerve were evaluated in both groups pretreatment and 3-months after the injection. No complications related to the local infiltrations were observed during the treatment and follow-up period. The results showed the following: • There was non-significant difference between both studied groups regarding VAS, BCTQ and median NCS before injection. • Improvement of median sensory conduction velocity was highly significant 3 months after corticosteroid injection • Significant improvement of median sensory peak latency and comparative median and ulnar sensory study at ring finger were observed 3 months after corticosteroid injection. • There was no statistically significant difference in the sensory and motor amplitude and also median nerve motor conduction study three months after corticosteroid injection. • There was highly significant improvement of median distal motor latency, median sensory peak latency and sensory conduction velocity 3 months after PRP injection. • There was significant improvement of comparative sensory study at ring finger 3 months after PRP injection. • Improvement of median motor conduction velocity and amplitude were not significant 3 months after injection of PRP. • There was significant improvement of VAS, symptoms severity scale and function disability scale 3 months after local injection of corticosteroids. Also, there was highly significant improvement in VAS, symptoms severity scale, function disability scale 3 months after PRP injection. • There was highly significant difference in median distal motor latency and sensory conduction velocity between both groups 3 months post injection with more improvement in PRP group • There was significant difference in median sensory peak latency between both groups 3 months post injection with better decrement in PRP group. • There was highly significant difference in VAS between both groups 3 months post injection with better results in group II. • Significant difference in both symptom severity scale and functional status scale between both groups 3-months post injection with better improvement of both scales in group II. |