Predictors of Carpal Tunnel Release After Open Distal Radius Fracture


The purpose of this investigation was to determine the incidence and identify the predictors of carpal tunnel release (CTR) after open fractures of the distal radius (DRF). Patients with clinical symptoms of persistent median nerve neuropathy that required CTR were analyzed for risk factors. One hundred thirty-nine open DRFs (107 grade I, 23 grade II, 9 grade III) met the inclusion criteria. The incidence of CTR was 13.7% in all open DRFs (19 out of 139). Multivariable logistic regression analysis identified four predictors: male sex [odds ratio (OR) = 8.8, p = .001], type III Gustilo and Anderson grade (OR = 6.2, p D .04), OTA fracture type C (OR = 3.8, p = .03), and the application of external fixation (OR = 14.0, p = .02). The probability of CTR, determined by preoperative variables, was 80% with three factors present and 2% with no risk factors. High-risk patients may be identified who may benefit from closer perioperative surveillance and possibly carpal tunnel release. (Journal of Surgical Orthopaedic Advances 26(4):227–232, 2017) Key words: carpal tunnel release, complications, distal radius fractures, median nerve compression, open fracture

Jaehon M. Kim, MD; Mitchel B. Harris, MD; David Zurakowski, PhD; Wanjun Liu, MD; Jesse B. Jupiter, MD; Joung Heon Kim, BS; and Mark S. Vrahas, MD