Pilot randomised controlled trial comparing C-Trac splints with Beta Wrist Braces for the management of carpal tunnel syndrome

Abstract

Introduction: The C-Trac splint has been designed to mechanically stretch the transverse carpal ligament and is advertised as an alternative to surgical Carpal Tunnel Decompression. The purpose of the study is to compare the effectiveness of the C-Trac splint with standard splinting in mild to moderate idiopathic carpal tunnel syndrome. Methods: This is a pilot parallel randomised controlled trial. Forty-nine patients with clinically and neurophysiologically proven carpal tunnel syndrome were randomised into the two treatment groups, C-Trac and Beta Wrist Brace, and reassessed clinically for one year. Results: Patients were generally satisfied with both splints, but two out of the 24 C-Trac patients developed problematic side effects possibly due to using the splint: De Quervains tenosynovitis and basal joint arthritic pain. There was no clinically relevant or statistically significant difference in the success and failure rates of the two splints by eight weeks, six months or at one year. Three of the 25 C-Trac splints (costing £130 each) used during the one-year study required replacement, compared with eight of the Beta Wrist Braces (costing approximately £10 each). Conclusions: These results suggest that C-Trac splint is not dissimilar in efficacy to a resting Beta Wrist Brace. The reported side effects raise questions as to the wisdom of its unregulated use.

Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome

“…The differential diagnosis assessment includes patient history, physical examination, and electrodiagnostic testing (motor and sensory nerve conduction). 2,6,[9][10][11][12][13][14][15][16][17][18][19][25][26][27][28][29] Current treatments for CTS still often require postoperative sick leave that exceeds 2 weeks, 10,13,21,24,26 and Dynasplint splinting uses a prolonged duration of passive, joint-specific, end-range (of motion) stretching with low loads of force. Dynamic splinting has been shown to reduce sick-leave time.…”

“…This is an investigation of a nonsurgical treatment for carpal tunnel syndrome (CTS) that has a suggested lifetime occurrence of 48 million patients in the United States. 1,[3][4][5][6][7][8][9]13,[16][17][18][19][20][21][22][23][24][26][27][28][29] CTS is defined as compression and/or entrapment of the median nerve as it traverses through the carpal tunnel that causes impairment of motor and/or sensory nerve conduction. The resulting symptoms include numbness, paresthesia, and pain in the median nerve distribution, occurring as a result of compression of the median nerve at the wrist, frequently due to hypertrophy or edema of the flexor synovium.…”