Purpose
To determine whether patients with diabetes mellitus (DM) are at greater risk for
developing postoperative trigger digits (TD) after carpal tunnel release (CTR) compared
with patients without diabetes.
Methods
A retrospective review of our electronic medical records identified all patients who
had undergone CTR by a single hand fellowship–trained surgeon from September 2007
through May 2012. For patients with DM, additional information regarding method of
disease control and hemoglobin A1c (HbA1c) level was recorded. We recorded HbA1c levels
3 months before and 3 months after CTR. The location and time to development of postoperative,
new-onset TD were recorded for each case. Statistical testing included chi-square
or Student t test and multivariate logistic regression analysis.
Results
Of the 1,217 CTRs, 214 had DM. Of the 1,003 CTRs in cases without DM, 3% developed
TD within 6 months of CTR and 4% within 1 year of CTR, compared with 8% and 10%, respectively,
for diabetic cases. A multivariate regression analysis revealed DM as a significant
risk factor for developing TD after CTR at 6 and 12 months. We found no significant
association between HbA1c level at the time of CTR and the likelihood of developing
TD.
Conclusions
The incidence of TD after CTR was higher in the diabetic population compared with
a nondiabetic cohort. The presence of DM rather than its severity was the most important
factor for developing TD. Preoperative counseling for patients with DM undergoing
CTR may alert them to the possibility of developing TD.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: December 23, 2013
Accepted:
October 25,
2013
Received:
March 20,
2013
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
