Carpal tunnel syndrome risk amplified by open reduction internal fixation surgery

Open reduction and internal fixation (ORIF) surgery for distal radius fractures (DRFs) appears to increase the risk of developing new-onset carpal tunnel syndrome (CTS), reports a recent study.

Researchers enrolled 1,454 patients (mean age, 54.79±16.73 years; 60.8 percent male) who underwent ORIF and 1,454 (mean age, 55.08±17.91 years; 60.66 percent male) who did not. Both groups were comparable in terms of comorbidities, such as hypertension, diabetes mellitus, hyperlipidaemia, osteoporosis, chronic renal failure and depression.

Thirty-two patients were eventually diagnosed with CTS while eight had trigger finger. No patient had both conditions. Nine patients, all in the case group, underwent carpal tunnel release after CTS diagnosis; none did so in the control group. Five cases of trigger finger were reported in the ORIF group and three in the control group.

In total, 19 CTS patients in the case group and four in the control group did not undergo carpal tunnel release. Overall, CTS occurred significantly more frequently in the ORIF group (adjusted hazard ratio [HR], 4.76, 95 percent confidence interval [CI], 1.62–14; p<0.01).

Notably, the presence of diabetes mellitus compounded this effect, further increasing the risk of both CTS (adjusted HR, 2.76, 95 percent CI, 1.04–6.36; p<0.05) and trigger finger (adjusted HR, 6.53, 95 percent CI, 1.56–27.34; p<0.05) after ORIF for DRF.

The researchers noted that “surgery-related factors should be considered for preventing the complications, such as decreasing intraoperative soft tissue dissection, retraction and accelerating soft tissue healing ability with early mobilization, especially for the patients with diabetes.”