×
Home Current Archive Editorial board
News Contact
Review paper

Deflazacort and Nevridol 800 to prevent acute carpal tunnel syndrome in adult distal radius fractures

By
Luigi Meccariello Orcid logo
Luigi Meccariello
Contact Luigi Meccariello

Department of Orthopaedics and Traumatology, AORN San Pio Hospital , Benevento , Italy

Abstract

Aim
Acute carpal tunnel syndrome (ACTS) is a well-recognized and common condition following a distal radius fracture. The aim of this study was to test deflazacort associated with Nevridol®800 or deflazacort alone in order to prevent moderate or severe ACTS after the distal radius fracture in adults.
Methods
Sixty-four patients suffering from extraarticular wrist fractures were divided into three groups. The first group (n=26)
was treated by plaster cast. The second group (n=20) was treated by cast and deflazacort (heterocyclic glucocorticoids prodrug belonging to the class of oxazoline steroids) 30 mg/day for 15 days. The third group (n=18) was treated by cast and deflazacort 30 mg/ day for 15 days + Nevridol (food supplements) 800 mg a day for 40 days. The criteria to evaluate the patients were: the complication of ACTS, the duration of symptoms, the functional results were evaluated according to The Disabilities of the Arm, Shoulder and Hand (DASH) life correlated with wrist function by the Short Form 12 Health Survey (SF-12), and positive Tinel and Phalen test. The correlation between ACTS signs and volar tilt in the latero-lateral at X-rays in the three studied groups was assessed. The endpoints were set on 7 days, 15 days, 1 months, 2 months and 3 months after a trauma.
Results
In the first group, 12 of 26 (46.15%) and the second group 7 of 20 (35%) patients suffered from ACTS, while in the third
group only two of 18 (11%) patients (p=0.033). After 3 months of treatment, the third group had better results in DASH (p=0.034), SF-12 (p=0.044), Tinel (0.045) and Phalen (0.048) tests.
Conclusion
Deflazacort associated with Nevridol 800 may reduce the prevalence of postoperative median nerve dysfunction.

References

1.
Gillig JD, White SD, Rachel JN. Acute carpal tunnel syndrome: a review of current literature. Orthop Clin North Am. 2016;47:599–607.
2.
Holbrook HS, Hillesheim RA, Weller WJ. Acute carpal tunnel syndrome and median nerve neurapraxia: a review. Orthop Clin North Am. 2022;53:197–203.
3.
Leow JM, Clement ND, McQueen MM, Duckwhort A. The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius. Eur J Orthop Surg Traumatol. 2021;31:981–7.
4.
Lane JCE, Craig RS, Rees JL, MD G, Green J, Prieto-Alhambra D, et al. Serious postoperative complications and reoperation after carpal tunnel decompression surgery in England: a nationwide cohort analysis. Lancet Rheumatol. 2020;3:e49–57.
5.
Tosti R, Ilyas AM. Acute carpal tunnel syndrome. Orthop Clin North Am. 2012;43:459–65.
6.
Singh S, Sanna F, Singh N, Adhikari R, Kumar V. An unusual case of acute carpal tunnel syndrome. Cureus. 2021;13:e20852.
7.
Itsubo T, Hayashi M, Uchiyama S, Hirachi K, Minami A, Kato H. Differential onset patterns and causes of carpal tunnel syndrome after distal radius fracture: a retrospective study of 105 wrists. J Orthop Sci. 2010;15:518–23.
8.
Paolucci T, Piccinini G, Nusca SM, Marsilli G, Mannocci A, Torre G, et al. Efficacy of dietary supplement with nutraceutical composed combined with extremelylow-frequency electromagnetic fields in carpal tunnel syndrome. J Phys Ther Sci. 2018;30:777–84.
9.
Chang MH, Ger LP, Hsieh PF, Huang SY. A randomised clinical trial of oral steroids in the treatment of carpal tunnel syndrome: a long term follow up. J Neurol Neurosurg Psychiatry. 2002;73:710–4.
10.
Markham A, Deflazacort BHM. A review of its pharmacological properties and therapeutic efficacy. Drugs. 1995;50:317–33.
11.
Saviola G, Abdi Ali L, Shams Eddin S, Coppini A, Cavalieri F, Campostrini L, et al. Compared clinical efficacy and bone metabolic effects of low-dose deflazacort and methyl prednisolone in male inflammatory arthropathies: a 12-month open randomized pilot study. Rheumatology (Oxford. 2007;46:994–8.
12.
Geronimo G, A FC, L C, A S, U P. Treatment of carpal tunnel syndrome with alpha-lipoic acid. Eur Rev Med Pharmacol Sci. 2009;13:133–9.
13.
Stock LA, Brennan JC, Johnson AH, Gelfand J, Turcotte JJ, Jones C. Disparities in Hand Surgery Exist in Unexpected Populations. Cureus. 2023;15:e39736.
14.
Maempel JF, Jenkins PJ, McEachan JE. The relationship of mental health status to functional outcome and satisfaction after carpal tunnel release. J Hand Surg Eur. 2020;Vol:147–52.
15.
HR PF, AC C, VGN P, NR S. Diagnostic contradictions in carpal tunnel syndrome. Rev Bras Ortop (Sao Paulo. 2022;58:290–4.
16.
Elwakil W. Correlation between delayed carpal tunnel syndrome and carpal malalignment after distal radial fracture. J Orthop Surg Res. 2023;18(365).
17.
Lad SP, Nathan JK, Schubert RD, Boakye M. Trends in median, ulnar, radial, and brachioplexus nerve injuries in the United States. Neurosurgery. 2010;66:953–60.
18.
Bland JD, Rudolfer SM. Clinical surveillance of carpal tunnel syndrome in two areas of the United Kingdom, 1991-2001. J Neurol Neurosurg Psychiatry. 2003;74:1674–9.
19.
Medici A, Meccariello L, Rollo G, Nigris G, Mccabe SJ, Grubor P, et al. Does routine carpal tunnel release during fixation of distal radius fractures improve outcomes? Injury. 2017;48(Suppl 3).
20.
Reddy C, Patil AN, Suthar R, Sankhyan N, Sirari T, Kumar A, et al. Deflazacort dose optimization ands afety evaluation in Duchenne muscular dystrophy (DOSE): a randomized, double-blind non-inferiority trial. Eur J Paediatr Neurol. 2022;38:77–84.
21.
Ammon HPT, Wahal MA. Pharmacology of Curcuma longa. Planta Med. 1991;57:1–7.
22.
Funk JL, Oyarzo JN, Frye JB, Chen G, Lantz RC, Jolad SD, et al. Turmeric extracts containing curcuminoids prevent experimental rheumatoid arthritis. J Nat Prod. 2006;69:351–5.
23.
Maheshwari RK, Singh AK, Gaddipati J, Srimal RC. Multiple biological activities of curcumin: a short review. Life Sci. 2006;78:2081–7.
24.
Anand P, Kunnumakkara AB, Newman RA, Aggarwal BB. Bioavailability of curcumin: problems and promises. Mol Pharm. 2007;4:807–18.
25.
Pierro F, G R, Maio EA, G A, F F, S T. Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Meriva. nimesulide, and acetaminophen J Pain Res. 2013;6:201–5.
26.
Steigerwalt R, Nebbioso M, Appendino G, Belcaro G, Ciammaichella G, Cornelli U, et al. Meriva®, a lecithinized curcumin delivery system, in diabetic microangiopathy and retinopathy. Panminerva Med. 2012;54(Suppl 4):11–6.
27.
Mazzolani F. Pilot study of oral administration of a curcumin-phospholipid formulation for treatment of central serous chorioretinopathy. Clin Ophthalmol. 2012;6:801–6.
28.
Appendino G, Belcaro G, Cornelli U, Luzzi R, Togni S, Dugall M, et al. Potential role of curcumin phytosome (Meriva) in controlling the evolution of diabetic microangiopathy. A pilot study. Panminerva Med. 2011;53(Suppl 1):43–9.
29.
Dines KC, Cotter MA, Cameron NE. Effectiveness of natural oils as sources of gamma-linolenic acid to correct peripheral nerve conduction velocity abnormalities in diabetic rats: modulation by thromboxane A2 inhibition. Prostaglandins Leukot Essent Fatty Acids. 1996;55:159–65.
30.
Yang XY, Sun L, Xu P, Gong LL, Qiang GF, Zhang L, et al. Effects of salvianolic scid A on plantar microcirculation and peripheral nerve function in diabetic rats. Eur J Pharmacol. 2011;665:40–6.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.