Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 5;6(3):308-312.
doi: 10.1016/j.jhsg.2024.01.004. eCollection 2024 May.

Incidence and Treatment of Carpal Tunnel Syndrome Following Distal Radius Fractures: A TriNetX Analysis of 39,603 Patients

Juliet Chung  1 , Yusuf Mahmoud  2 , Asif M Ilyas  3   4
Affiliations

Incidence and Treatment of Carpal Tunnel Syndrome Following Distal Radius Fractures: A TriNetX Analysis of 39,603 Patients

Juliet Chung et al. J Hand Surg Glob Online. .

Abstract

Purpose: Distal radius fractures (DRFs) are among the most common fractures and occur among all age groups. Carpal tunnel syndrome (CTS) is a known sequela of DRFs, but its incidence is poorly understood. This study was undertaken to determine the incidence of CTS following a DRF, with the hypothesis being that CTS occurs more commonly after nonsurgical treatment of a DRF.

Methods: The TriNetX US Collaborative Network was queried for all patients diagnosed with DRFs from January 2016 to December 2022. Cohorts were defined by inclusion and exclusion of the procedure Current Procedural Terminology codes into surgical and nonsurgical groups and subsequent ICD-10 diagnosis codes of CTS. Statistical analysis was performed to determine differences in management across the study period.

Results: A total of 39,603 patients met inclusion with a diagnosis of a DRF. The incidence of CTS within one year of a DRF was 5.3%. Among all DRF cases, 10,279 (26%) patients underwent surgical treatment, whereas 29,324 (74%) patients underwent nonsurgical treatment. The incidence of CTS in the surgical group was 1194 (12%), whereas the incidence of CTS in the nonsurgical group was 915 (3%). Patients undergoing surgical treatment for a DRF had a 9% risk of developing CTS, whereas patients undergoing nonsurgical treatment had a 5% risk. Among all the patients having been diagnosed with CTS, 63% of those with an operatively treated DRF underwent surgical release, whereas 23% of those with a nonoperatively treated DRF underwent surgical release for CTS.

Conclusions: Patients having undergone surgical treatment for DRF had a four times higher rate of developing CTS, compared with those having undergone nonsurgical treatment. Among patients who underwent surgical treatment of a DRF with the subsequent development of CTS, there was a nearly three times higher rate of surgical release of CTS.

Type of study/level of evidence: Prognostic III.

Keywords: Carpal tunnel syndrome; Distal radius; Fracture; TriNetX.

PubMed Disclaimer

Conflict of interest statement

No benefits in any form have been received or will be received related directly to this article.

Figures

Figure 1
Figure 1
Measures of CTS association between surgical and nonsurgical treatments for DRFs. The defined outcome used in this association was CTS with ICD-10 codes G56.01, G56.02, G56.11, and G56.12.
Figure 2
Figure 2
Measures of CTR association between surgical and nonsurgical treatments for DRFs with CTS. The defined outcome used in this association was CTR with CPT codes 29846, 64721, and 64708.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Shapiro L.M., Kamal R.N., Management of Distal Radius Fractures Work G Distal radius fracture clinical practice guidelines-updates and clinical implications. J Hand Surg Am. 2021;46(9):807–811. - PubMed
    1. Mauck B.M., Swigler C.W. Evidence-based review of distal radius fractures. Orthop Clin North Am. 2018;49(2):211–222. - PubMed
    1. Abramo A., Kopylov P., Geijer M., Tagil M. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures: a randomized study of 50 patients. Acta Orthop. 2009;80(4):478–485. - PMC - PubMed
    1. Karantana A., Downing N.D., Forward D.P., et al. Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods: a randomized controlled trial. J Bone Joint Surg Am. 2013;95(19):1737–1744. - PubMed
    1. Koenig K.M., Davis G.C., Grove M.R., Tosteson A.N., Koval K.J. Is early internal fixation preferred to cast treatment for well-reduced unstable distal radial fractures? J Bone Joint Surg Am. 2009;91(9):2086–2093. - PubMed