The association of late carpal tunnel syndrome with carpal misalignment following distal radius fracture in old Jordanian women
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20233256Keywords:
Distal radius fracture, Carpal tunnel syndrome, Late, Carpal misalignmentAbstract
Background: Late carpal tunnel syndrome following distal radius fracture is a frequent hazard especially after conservative management. Objective was to assess the association of radiological carpal alignment with the intensity of late carpal tunnel syndrome in old Jordanian women during 1 year of distal radius fracture.
Methods: Our retrospective investigation recruited 100 women, aged more than 50 years with unilateral distal radius fracture managed conservatively during one year of the fracture at Royal Jordanian Rehabilitation center, Jordan, between January 2021 to April 2023. Participants were split into 2 groups. Group I comprised of 50 patients with clinical features of late carpal tunnel syndrome (nocturnal or diurnal) and group II comprised of 50 women without clinical features. CTS-6 assessment tool score (1-6) was recorded to evaluate the intensity of the condition. Electrophysiological and radiological evaluation were performed to record carpal alignment. Student t-test was used to assess the variables.
Results: There was a remarkable discrepancy between groups in terms of the radiological variables of carpal alignment (The average of radio-capitate distance, volar tilt and volar prominence height were: -10.69 mm, -19.89 D angle and 1.45 mm, respectively in group I). There was a positive association between reduction in the variables of carpal alignment and the intensity of late CTS. Volar tilt was positively engaged in the late CTS. The threshold of the volar tilt was -19.41 D angle (p<0.005).
Conclusions: Modification of the carpal tunnel following distal radius fracture with carpal dorsal misalignment leads to late CTS. Reducing volar tilt and volar prominence height and radio-capitate distance are the main remarkable independent anticipators of late CTS in non-surgically treated distal radius fracture.
References
Walaa El. Correlation between delayed carpal tunnel syndrome and carpal malalignment after distal radial fracture. J Orthop Surg Res. 2023;18:365.
Brüske J, Niedźwiedź Z, Bednarski M. Acute carpal tunnel syndrome after distal radius fractures–long term results of surgical treatment with decompression and external fixator application. Chir Narzadow Ruchu Ortop Pol. 2002;67(1):47-53.
Niver GE, Ilyas AM. Carpal tunnel syndrome after distal radius fracture. Orthop Clin North Am. 2012;43: 521-7.
Margaret EC, Alex G, y Lauren YEW. Incidence of Carpal Tunnel Syndrome after Distal Radius Fracture. J Hand Surg Glob. 2022;4:324-7.
Pope D, Tang P. Carpal tunnel syndrome and distal radius fractures. Hand Clin. 2018;34(1):27-32.
Itsubo T, Hayashi M, Uchiyama S. Differential onset patterns and causes of carpal tunnel syndrome after distal radius fracture: a retrospective study of 105 wrists. J Orthop Sci. 2010;15:518-23.
Graham B. The Value Added by Electrodiagnostic Testing in the Diagnosis of Carpal Tunnel Syndrome. J Bone Joint Surg Am. 2008;90:2587-93.
Watanabe K. Carpal alignment in distal radius fractures following volar locking plate fixation. J Hand Surg Glob. 2019;1:10-4.
Toru S, Takafumi K, Tomoyuki K. Evaluation of the Existing Electrophysiological Severity Classifications in Carpal Tunnel Syndrome. J Clin Med. 2022;11(6): 1685.
Kentaro W. Carpal Alignment in Distal Radius Fractures Following Volar Locking Plate Fixation. J Hand Surg Glob. 2019;1:10-4.
Medici A, Meccariello L, Rollo G. Does routine carpal tunnel release during fixation of distal radius fractures improve outcomes? Injury. 2017;48(3):S30-3.
Watanabe K, Ota H. Carpal malalignment as a predictor of delayed carpal tunnel syndrome after Colles' fracture. Plast Reconstr Surg Glob. 2019;7(3): e2165.
Kim KH, Duell B, Munnangi S. Radiographic predictors of delayed carpal tunnel syndrome after distal radius fracture in the elderly. Hand. 2022;17(4):652-8.
