Dupuytren's disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus

“…Diabetes mellitus increased the risk of Hand-Arm Vibration Syndrome by a factor of 1.5 and Duputyrens disease by a factor of 1.7 in a large cohort of miners [53] Another controlled study reported higher rate of Dupuytren's disease, tenosynovitis, carpal tunnel syndrome and reduced joint motion in patients with DM compare to patients without DM [53] . Several factors were associated with increased severity of the pathology including the use of insulin, older patients, longer duration of DM and microangiopathic changes [54] . Diabetic patients who undergo arthroscopic surgery for adhesive capsulitis of the shoulder have inferior results when compared to non-diabetic patients [55] .…”

Section: Upper Extremitymentioning

confidence: 99%

Diabetes and its negative impact on outcomes in orthopaedic surgery

Wukich

2015

WJO

110

103

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An estimated 285 million adults (aged 20-79 years) worldwide were diagnosed to have diabetes mellitus (DM) in 2010, and this number is projected to grow to 439 million adults by the year 2030. Orthopaedic surgeons, regardless of their subspecialty interest, will encounter patients with DM during their career since this epidemic involves both developed and emerging countries. Diabetes results in complications affecting multiple organ systems, potentially resulting in adverse outcomes after orthopaedic surgery. The purpose of this review is to discuss the pathophysiology of DM and its potential for impacting orthopaedic surgery patients. Diabetes adversely affects the outcome of all orthopaedic surgery subspecialties including foot and ankle, upper extremity, adult reconstructive, pediatrics, spine surgery and sports medicine. Poorly controlled diabetes negatively impacts bone, soft tissue, ligament and tendon healing. It is the complications of diabetes such as neuropathy, peripheral artery disease, and end stage renal disease which contributes to adverse outcomes. Well controlled diabetic patients without comorbidities have similar outcomes to patients without diabetes. Orthopaedic surgeons should utilize consultants who will assist in inpatient glycemic management as well as optimizing long term glycemic control.

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“…insulin resistance and impaired glucose tolerance) increase the susceptibility to nerve compression [13,14]. Previous studies [15][16][17], though not all [18], state that patients with DM benefit from CTR to the same extent as patients without DM.…”

Section: Diabetesmentioning

confidence: 99%

Outcome after carpal tunnel release: impact of factors related to metabolic syndrome

Zimmerman

Dahlin

Thomsen

et al. 2016

Journal of Plastic Surgery and Hand Surgery

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165-171. DOI: 10.1080165-171. DOI: 10. /2000656X.2016 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. In a retrospective observational study, we evaluated outcome after open carpal tunnel release focusing on factors related to the metabolic syndrome: diabetes, hypertension, obesity (BMI ≥ 30) and statin treatment. MethodsResults from 493 out of 962 patients (531/1044 hands) operated for CTS during 18 months that had filled in QuickDASH questionnaires before and one year after surgery were included in the study. ResultsPatients with diabetes (n=76) p<0.05). The odds of having a change in QuickDASH score <8 was 2.6 times higher in patients with polyneuropathy than in patients without polyneuropathy.Patients with hypertension, obesity or statin treatment had a similar improvement after surgery as patients without these factors. ConclusionsPatients with diabetes without neuropathy, as well as patients with hypertension, obesity or statin treatment, and CTS can expect the same effects of open carpal tunnel release as otherwise healthy patients. Patients with diabetic neuropathy and CTS did not experience the 3 same improvement as otherwise healthy patients and should be informed about the risk of an unsatisfactory outcome.Word count abstract: 242

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Dupuytren's disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus

Cited by 237 publications

References 11 publications

Increased median nerve latency at the carpal tunnel of patients with "trigger finger": Comparison of 62 patients and 13 controls

Increased median nerve latency at the carpal tunnel of patients with "trigger finger": Comparison of 62 patients and 13 controls

Diabetes and its negative impact on outcomes in orthopaedic surgery

Outcome after carpal tunnel release: impact of factors related to metabolic syndrome

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