Groningen Hand and Wrist Injection Therapy Trial (HAWITT).

Local injectiontherapy with corticosteroids is an accepted (initial) treatment modality for carpal tunnel syndrome (CTS), trigger finger (TF) and de Quervain's tenosynovitis (MdeQ), with reported longterm (1 year) efficacy of 50-90% (MdeQ and TF) and 50% (CTS). However, all available data originate from specialist clinical centres, no studies concerning effectiveness of this therapy have been performed so far in general practice.

The HAWITT intervention-study assesses the effectiveness, safety and feasibility of injectiontherapy with triamcinolon-acetonide (1ml=10mg) as compared to placebo-treatment (1ml NaCl 0,9%). Patients will be injected (double-blind) up to two times, after randomization, with either steroids or placebo. One week after each injection clinical findings used as outcome-measurements will be assessed by the treating general practitioner. Follow-up at 1, 3, 6, and 12 months post-treatment will consist of written questionnaires sent to the patient.

Thirty general practices in the northern part of the Netherlands will participate in the HAWITT-trial. A total of 120 patients will be included in the intervention-study (70 CTS, 50 TF/MdeQ). Patients will be followed up for one year; the total duration of the study will be three years (end of trial: December 2006).

Local injection therapy with 1ml of triamcinolonacetonide (10mg/ml) provided by a primary care physician is more effective than injection with 1ml NaCl (0,9%) for trigger finger, de Quervain's tenosynovitis and carpal tunnel syndrome.

N/A

1-2 local injections of 1 ml of triamcinolonacetonide (10mg/ml) versus 1 ml of NaCl 0,9% (placebo) one week after inclusion.