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. 2022 Aug 31;4(6):324-327.
doi: 10.1016/j.jhsg.2022.08.001. eCollection 2022 Nov.

Incidence of Carpal Tunnel Syndrome after Distal Radius Fracture

Margaret E Cooke  1 , Alex Gu  2 , Lauren E Wessel  3 , Alexander Koo  4 , Daniel A Osei  5 , Duretti T Fufa  5
Affiliations

Incidence of Carpal Tunnel Syndrome after Distal Radius Fracture

Margaret E Cooke et al. J Hand Surg Glob Online. .

Abstract

Purpose: Carpal tunnel syndrome (CTS) can present following distal radius fracture (DRF) and may progress to require carpal tunnel release (CTR). The primary aim of this study was to determine the incidence of CTS within 6 months of a DRF and the rate of CTR in this population.

Methods: We used the PearlDiver national insurance database to determine the incidence of CTS after DRF. Patients were identified by International Classification of Diseases-10 codes, and treatment modalities for DRF and CTS were determined by respective Current Procedural Terminology codes. Patients with less than 6 months of follow-up, bilateral DRF, or preexisting CTS were excluded. Patient demographic characteristics were recorded. The time from DRF diagnosis to CTS diagnosis and CTR was determined. A multivariable analysis was performed to determine the differences between patients who underwent a CTR compared with those who were treated conservatively.

Results: We identified 23,733 patients (6,015 men; 17,718 women) who sustained a DRF. Of these patients, 79.1% were treated nonsurgically and 20.9% underwent surgical fixation. In total, 9.2% (N = 2,179) were diagnosed with CTS in their ipsilateral extremity within 6 months of sustaining the DRF. Of the patients whose DRF was treated nonsurgically, 6.3% (N = 1,198) developed CTS and 2.9% (N = 546) required CTR. Of those patients whose DRF was treated surgically, 19.8% (N = 981) developed CTS and 13.3% (N = 661) required CTR. Of those patients with symptoms severe enough to warrant CTR, 18.5% required a second surgical intervention for the CTR.

Conclusions: Distal radius fractures severe enough to require surgical fixation are associated with a higher incidence of perioperative CTS. Accordingly, careful evaluation for and counseling on CTS during surgical fixation may decrease the chance of a second surgery. We have identified a cohort of patients with DRFs who may benefit from prophylactic CTR.

Type of study/level of evidence: Diagnostic IV.

Keywords: Carpal tunnel release; Carpal tunnel syndrome; Distal radius fracture; Retrospective.

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Figures

Figure 1
Figure 1
Flowchart representing the study population. Notably, 45.6% of patients treated nonsurgically for DRF that developed subsequent CTS required CTR, compared with 67.3% of patients treated surgically for DRF that developed CTS.
Figure 2
Figure 2
Pie-charts of the study population, comparing the development of CTS and progression to CTR within nonsurgical and surgical DRF cohorts.
See this image and copyright information in PMC

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