Pre- and post-operative comorbidities in idiopathic carpal tunnel syndrome: cervical arthritis, basal joint arthritis of the thumb, and trigger digit

Abstract

We retrospectively reviewed 633 hands in 362 patients who had idiopathic carpal tunnel syndrome and underwent carpal tunnel release between 1999 and 2009. Electrophysiological studies and simple radiographs of the wrist, cervical spine, and basal joint of the thumb were routinely checked, and patients were also assessed for the presence of trigger digit or de Quervain's disease before and after surgery. Among 362 patients, cervical arthritis was found in 253 patients (70%), and C5-C6 arthritis was the most common site. Basal joint arthritis of the thumb was observed in 216 (34%) of the 633 hands. Trigger digit or de Quervain's disease was observed in 85 of the 633 hands (13%) before surgery, and developed in 67 hands (11%) after surgery. Cervical arthritis, basal joint arthritis, and trigger digit commonly coexist with idiopathic carpal tunnel syndrome. Patient education about these disorders is very important when they coexist with idiopathic carpal tunnel syndrome.

Occurrence of trigger finger following carpal tunnel release

“…The development of TF in patients undergoing surgical treatment of CTS has been analyzed by various authors [Table 4]. [16171819202122232425262728] The reported incidence of TF after CTR is about 10%–20%, which is almost identical to the results of our study, and CTR has been attributed to acceleration of the development of TF in various studies.…”

Is carpal tunnel release associated with trigger finger?

“…We found a total of 224 papers, but only seven relevant studies emerged from the first pass and just four after the second pass [4][5][6][7] (Table 1). Unfortunately, none of the studies had a valid control group, and all raised questions related to the statistical analysis (confounding factors?…”

“…However, a relationship is possible, related to anatomy and biomechanics modifications after CTR (e.g. possible volar migration of the flexor tendons) [7,8] and/or to a coexisting disorder (with the same etiology) [4,6,9,10]. Checking for TF or pain at the A1 pulley is recommended before CTR.…”

The relationship of trigger finger and flexor tendon volar migration after carpal tunnel release

“…Carpal tunnel syndrome (CTS) and stenosing tenosynovitis or trigger finger (TF) are common. TF is associated with CTS (Ferree et al, 2014; Harada et al, 2005; Hayashi et al, 2005; Hombal and Owen, 1970; Kim et al, 2013; Kumar et al, 2009) and occurs more frequently after carpal tunnel release (CTR) (Harada et al, 2005; Hayashi et al, 2005; Hombal and Owen, 1970; King et al, 2013). Stahl et al (1997) reported that the lifetime incidence of trigger finger was 2.2% in nondiabetic adults older than 30 years and up to 10% in patients with insulin-dependent diabetes mellitus.…”

“…The incidence of TF associated with CTS has been reported to be 10.2% to 21% (Assmus, 2000; Hayashi et al, 2005; Kumar et al, 2009). The incidence of TF after CTR has been reported to be between 6.3% and 21.9% (Goshtasby et al, 2010; Harada et al, 2005; Hayashi et al, 2005; Hombal and Owen, 1970; Kim et al, 2013; King et al, 2013). Some studies have investigated the significance of variable risk factors predisposing patients to developing TF after CTR (Goshtasby et al, 2010; Harada et al, 2005; Hayashi et al, 2005).…”