The primary aim of this study is to use a national insurance database to determine the incidence of a new diagnosis of CTS within 6 months of a new diagnosis of a DRF and to determine the rate of CTR in this population. We hypothesize that patients who undergo surgical treatment for a DRF are more likely to develop CTS than those who undergo nonsurgical treatment for a DRF. Identifying patients at risk for developing CTS severe enough to warrant CTR would improve surgical decision-making regarding whether these patients should have a CTR simultaneously during DRF treatment. 3, 9 It has been debated whether prophylactic carpal tunnel release (CTR) should be performed for patients undergoing surgical treatment of DRFs and, if so, which population is at risk and at what timeframe. The incidence of CTS following open reduction internal fixation (ORIF) for a DRF has been reported to be between 1% and 22%. The proposed pathophysiology for delayed CTS following a DRF includes fracture malunion, chronically inflamed tenosynovium, volar callus formation, scar formation, and/or offending hardware.

In contrast, delayed CTS develop weeks after DRF, which is thought to be due to a change in the carpal tunnel anatomy after healing the fracture. High-energy trauma, multiple attempts at closed reduction, fracture displacement, fracture comminution, radiocarpal dislocations, polytrauma, and women younger than 48 years of age are reported risk factors for acute CTS following DRF. 6 The acutely elevated compartment pressure in the setting of a DRF is likely secondary to hematoma formation, fracture displacement, wrist immobilization, and/or soft tissue swelling. 5Īcute CTS develops within hours to days of sustaining a distal radius fracture and is thought to result from acutely elevated compartment pressure in the carpal tunnel. 3, 4 In 4% of cases, the symptomatology is transient and will resolve spontaneously.

1, 2 It may occur at the time of injury (acute) or after a delay of days to weeks (delayed). Carpal tunnel syndrome (CTS) is common following a distal radius fracture (DRF).

Carpal tunnel compartment