Advertisement

Relationship of Carpal Tunnel Release and New Onset Trigger Finger

Published:November 06, 2018DOI:https://doi.org/10.1016/j.jhsa.2018.10.003

      Purpose

      Carpal tunnel syndrome and trigger finger (TF) frequently present concomitantly; some studies suggest that carpal tunnel release (CTR) is a risk factor for the development of ipsilateral TF in the postoperative period. The primary objective of this study was to elucidate the relationship between CTR and the subsequent development of TF.

      Methods

      A retrospective study was conducted of 1,386 hands in 1,140 patients who underwent primary CTR at a tertiary referral center from July 2008 to June 2013. After exclusion of cases in which contralateral CTR was performed within the first postoperative year after ipsilateral CTR, conditional logistic regression was performed in 906 hands in 890 patients to determine the association between CTR and TF in the first postoperative year in the operative hand compared with the contralateral hand. Conditional logistic regression and Poisson regression were performed in 1,386 hands in 1,140 patients to examine the association between CTR and TF in the year before surgery compared with the year after surgery. Multivariable regression analysis was used to determine associated risk factors.

      Results

      Of 1,386 hands, a new TF was seen in 147 (10.6%) within 1 year before CTR and 81 (5.8%) within 1 year after CTR. The occurrence of postoperative TF was associated with 2.5 times higher odds in the operative hand compared with the contralateral hand in the conditional logistic regression model of 906 cases. However, the incidence of TF was associated with 0.5 times lower odds during the year after CTR compared with the year before CTR in both conditional logistic regression and Poisson regression models of 1,386 cases. Increased body mass index is statistically associated with TF after CTR, but the attributable risk is negligible.

      Conclusions

      There is a predisposition for these 2 common hand pathologies to present in the same hand; however, patients can be counseled that CTR does not cause new incidence of TF in the operative hand.

      Type of study/level of evidence

      Prognostic IV.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kim J.H.
        • Gong H.S.
        • Lee H.J.
        • Lee Y.H.
        • Rhee S.H.
        • Baek G.H.
        Pre- and post-operative comorbidities in idiopathic carpal tunnel syndrome: cervical arthritis, basal joint arthritis of the thumb, and trigger digit.
        J Hand Surg Eur Vol. 2013; 38: 50-56
        • Kumar P.
        • Chakrabarti I.
        Idiopathic carpal tunnel syndrome and trigger finger: is there an association?.
        J Hand Surg Eur Vol. 2009; 34: 58-59
        • Wessel L.E.
        • Fufa D.T.
        • Boyer M.I.
        • Calfee R.P.
        Epidemiology of carpal tunnel syndrome in patients with single versus multiple trigger digits.
        J Hand Surg Am. 2013; 38: 49-55
        • King B.A.
        • Stern P.J.
        • Kiefhaber T.R.
        The incidence of trigger finger or de Quervain’s tendinitis after carpal tunnel release.
        J Hand Surg Eur Vol. 2013; 38: 82-83
        • Hayashi M.
        • Uchiyama S.
        • Toriumi H.
        • Nakagawa H.
        • Kamimura M.
        • Miyasaka T.
        Carpal tunnel syndrome and development of trigger digit.
        J Clin Neurosci. 2005; 12: 39-41
        • Karalezli N.
        • Kütahya H.
        • Güleç A.
        • Toker S.
        • Karabörk H.
        • Ogun T.C.
        Transverse carpal ligament and forearm fascia release for the treatment of carpal tunnel syndrome change the entrance angle of flexor tendons to the A1 pulley: the relationship between carpal tunnel surgery and trigger finger occurrence.
        ScientificWorldJournal. 2013; 2013: 630617
        • Lee S.K.
        • Bae K.W.
        • Choy W.S.
        The relationship of trigger finger and flexor tendon volar migration after carpal tunnel release.
        J Hand Surg Eur Vol. 2014; 39: 694-698
        • Goshtasby P.H.
        • Wheeler D.R.
        • Moy O.J.
        Risk factors for trigger finger occurrence after carpal tunnel release.
        Hand Surg. 2010; 15: 81-87
        • Harada K.
        • Nakashima H.
        • Teramoto K.
        • Nagai T.
        • Hoshino S.
        • Yonemitsu H.
        Trigger digits-associated carpal tunnel syndrome: relationship between carpal tunnel release and trigger digits.
        Hand Surg. 2005; 10: 205-208
        • Hombal J.W.
        • Owen R.
        Carpal tunnel decompression and trigger digits.
        Hand. 1970; 2: 192-196
        • Lin F.Y.
        • Manrique O.J.
        • Lin C.L.
        • Cheng H.T.
        Incidence of trigger digits following carpal tunnel release: a nationwide, population-based retrospective cohort study.
        Medicine (Baltimore). 2017; 96: e7355
        • Moore J.S.
        Flexor tendon entrapment of the digits (trigger finger and trigger thumb).
        J Occup Environ Med. 2000; 42: 526-545
        • Sungpet A.
        • Suphachatwong C.
        • Kawinwonggowit V.
        Trigger digit and BMI.
        J Med Assoc Thai. 1999; 82: 1025-1027
        • Grandizio L.C.
        • Beck J.D.
        • Rutter M.R.
        • Graham J.
        • Klena J.C.
        The incidence of trigger digit after carpal tunnel release in diabetic and nondiabetic patients.
        J Hand Surg Am. 2014; 39: 280-285