“Intraoperative pillar corticosteroid injection”: does it improve clinical outcomes after carpal tunnel release surgery? A double-blind, randomized controlled study

The purpose of this study was to assess the therapeutic effects of intraoperative direct pillar corticosteroid injection in patients with carpal tunnel syndrome(CTS) who underwent open carpal tunnel release (OCTR) surgery. A prospective randomized controlled trial was conducted on 62 patients with carpal tunnel syndrome. Two intraoperative pillar injection solutions were compared: the lidocaine with triamcinolone acetonide and the lidocaine alone. Injections were administered at two points each at the scaphoid and trapezium bones in the radial pillar area, and at the hamate and pisiform bones in the ulna pillar area. Post-operatively, there were no significant differences in patient satisfaction, functional outcomes and pillar pain between the groups. Notably, the resolution time for pillar pain was prolonged in the steroid group. Conclusion Intraoperative corticosteroid pillar injection is not an effective option for preventing pillar pain symptoms. Level of evidence Level I.Trial registration The trial was registered in the Thai Clinical Trials Registry (TCTR) database. The identification number is TCTR20211130003, date of registration 30/11/2021.