Intraneural steroid injection as a complication in the management of
carpal tunnel syndrome. A report of three cases. McConnell-JR; Bush-DC Geisinger Medical Center, Department of Orthopaedics, Danville, PA 17822-1323. Clin-Orthop. 1990 Jan(250): 181-4 Steroid injection can provide symptomatic relief in patients with carpal tunnel syndrome (CTS). Its role should be limited to a diagnostic aid in cases in which symptoms are atypical, a temporizing agent in patients with severe symptoms either who are awaiting surgery or in whom spontaneous remission might be expected, and as a definitive treatment in patients who do not desire surgery. Injection should be performed using proper technique by physicians skilled in carpal tunnel surgery. A soluble preparation of dexamethasone is recommended. Immediate paresthesia in the median nerve distribution or exacerbation of symptoms beyond 48 hours following injection is suspect for inadvertent nerve injury; therefore, early surgical decompression is indicated.
Original Text by Clifford R. Wheeless, III, MD.
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