Predictors of Acute Carpal Tunnel Syndrome Following ORIF of Distal Radius Fractures: A Matched Case–Control Study

Earp, Brandon E.; Mora, Ariana N.; Floyd, Waldo E.; Blazar, Philip E.

doi:10.1016/j.jhsg.2018.10.002

Cited by 12 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is a paucity of evidence that defines the epidemiology, presenting signs and symptoms and management of patients presenting with ACTS following a distal radius fracture. Studies have shown that AO Type-C fractures, open fractures, fracture translation and diabetes mellitus are risk factors for developing ACTS [16,17]. However, these studies investigated patients who developed ACTS following open reduction internal fixation (ORIF), which may represent a confounding factor for development of ACTS [18,19].…”

Section: Introductionmentioning

confidence: 99%

The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius

Leow

Clement

McQueen

et al. 2021

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Background Acute carpal tunnel syndrome (ACTS) is a known complication of distal radius fractures. This study aimed to document the demographics, range of presenting symptoms and risk factors of patients who develop ACTS following a fracture of the distal radius. Methods A retrospective review of 1189 patients with an acute distal radius fracture treated in the study centre over a one-year period were identified. Demographic and clinical variables were collected and compared between controls (did not develop ACTS) and those patients who did develop ACTS to identify factors associated with developing ACS. Results There were 51 (4.3%) distal radius fractures complicated by ACTS. The mean age of patients who developed ACTS was 56 years (range, 16–89) and 73% were female. The median time of onset post-injury was one week (range, 1–12). There was no association between patient background and comorbidities with the development of ACTS. AO-OTA Type C fractures had significantly increased rates of developing ACTS. Conclusion Four percent of distal radius fractures were complicated by ACTS. There was no association between patient background and comorbidities with the development of ACTS. AO-OTA type C complete articular fractures had a significantly higher rate of ACTS. A suggested treatment algorithm for patients presenting with ACTS has been presented. Level of evidence: III.

show abstract

Section: Introductionmentioning

confidence: 99%

The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius

Leow

Clement

McQueen

et al. 2021

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

show abstract

“…Baseline characteristics and clinical results between patients with high-and low-energy trauma were compared using Fisher exact test for categorical variables and t test for continuous variables. 3,15 P values of <.05 were considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant variables including age, sex, injury mechanism, injury details (open fracture, concomitant injury, polytrauma), and pre-existing median nerve dysfunction were selected based on previous similar studies. 3,15 Distal radius fractures were classified using the AO/Orthopaedic Trauma Association fracture classification by both authors. 16 To mitigate interobserver variability during analysis, all fractures were subsequently grouped as extra-articular (23.A) or intra-articular (partial articular [23.B] and complete articular [23.C]).…”

Section: Independent Variablesmentioning

confidence: 99%

“…Patients were indicated for endoscopic carpal tunnel release on the basis of clinical diagnosis of persistent median nerve dysfunction despite adequate reduction and elevation. 1,10,13,15 Median nerve dysfunction was diagnosed on the basis of the following: (1) acute or subacute onset of median nerve paresthesia, (2) numbness or sensory disturbance in the median nerve distribution of the injured extremity, or (3) the pre-existing carpal tunnel symptoms exacerbated by the injury. 2,5 All procedures under regional anesthesia were performed using a tourniquet (Video, available on the Journal's website at www.…”

Section: Surgical Techniquementioning

confidence: 99%

See 1 more Smart Citation

Surgical Technique for Concurrent Endoscopic Carpal Tunnel Release and Distal Radius Fracture Fixation Using the Flexor Carpi Radialis Approach: A Case Series

Bhashyam

Kao

2022

Journal of Hand Surgery Global Online

View full text Add to dashboard Cite

Purpose: Multiple prior studies have assessed the results of open approaches for concurrent carpal tunnel release with distal radius fracture fixation; however, less is known regarding the feasibility of endoscopic techniques, especially in the setting of high-energy trauma. In this study, we assessed the feasibility and results of concurrent endoscopic carpal tunnel release and distal radius fracture fixation using the flexor carpi radialis approach after high-and low-energy trauma. Methods: We performed a retrospective, single-surgeon study of 17 consecutive adult patients (aged >18 years) who underwent open reduction internal fixation of an acute distal radius fracture with concurrent endoscopic carpal tunnel release at a level 1 trauma center between April 2017 and October 2020. Recovery from median nerve dysfunction was assessed from patient charts at routinely scheduled postoperative follow-up visits (at 2 weeks, 4 weeks, 6 weeks, and 12 weeks). Results: The transverse carpal ligament could be visualized and released in all patients. All patients had a return of light touch sensibility with or without intermittent paresthesia by 12 weeks after surgery (the median time from surgery to recovery was 19 days [range, 12e82 days]). There were no patient reports or clinical examination evidence of palmar cutaneous branch, recurrent motor branch, or the third common digital nerve injury. Time to recovery was significantly different in the setting of high-versus low-energy trauma (26 days vs 18 days, respectively; P ¼ .02). Conclusions: In this study, we demonstrated that concurrent endoscopic carpal tunnel release using the flexor carpi radialis approach for distal radius fracture fixation in the settings of high-and low-energy trauma is safe from major complications and effective at releasing the transverse carpal ligament. Type of study/level of evidence: Therapeutic IV.

show abstract

“…Prophylactic carpal tunnel release (CTR) in patients with DRFs is not recommended. 104,105 Acute CTR should be done in patients with persistent and progressive features of acute CTS. 22,23,106,107 Delayed release of more than 36 hours has been associated with irreversible nerve damage, whereas patients released acutely regained full nerve function.…”

Section: Carpal Tunnel Release During Fracture Fixationmentioning

confidence: 99%

Distal radius fractures: current concepts

et al. 2021

View full text Add to dashboard Cite

Distal radius fractures (DRFs) are commonly encountered in the elderly population, secondary to low-energy injury mechanisms. In the younger population, DRFs are mainly secondary to high-energy trauma. Stable DRFs can be treated conservatively. However, in the elderly population group, DRFs are often unstable and are likely to benefit from surgical intervention. They are often compounded by comorbid medical conditions requiring optimisation. When treating the elderly group, one should be aware of sarcopaenia, as this may have a bearing on return to function. Recent literature reports an increasing trend in the surgical management of these fractures. Current classification systems fail to consistently guide the management of these fractures. Although evidence is still limited in guiding decision-making in the treatment of these fractures, one should consider the economic implications of prolonged immobilisation in young patients in addition to defined indications for surgery. Improvement in implants allows safe dorsal fixation in patients with dorsal comminution, with low complication rates reported. This narrative review summarises current trends and the body of evidence. Level of evidence: Level 5 Keywords: distal radius, fracture management, osteoporosis

show abstract

Predictors of Acute Carpal Tunnel Syndrome Following ORIF of Distal Radius Fractures: A Matched Case–Control Study

Cited by 12 publications

References 15 publications

The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius

The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius

Surgical Technique for Concurrent Endoscopic Carpal Tunnel Release and Distal Radius Fracture Fixation Using the Flexor Carpi Radialis Approach: A Case Series

Distal radius fractures: current concepts

Contact Info

Product

Resources

About