J. Nosewicz1, C. Cavallin1, C. Cheng2, A. Zacharek3 1Central Michigan University College Of Medicine,Mount Pleasant, MI, USA 2Central Michigan University,Department Of Mathematics,Mt. Pleasant, MI, USA 3Covenant Healthcare,Saginaw, MI, USA
Introduction: Carpal tunnel release (CTR) is associated with trigger digit development. Surgical approach to CTR has been inconsistently reported as an independent risk factor for postoperative trigger digit. This study aims to identify whether endoscopic (ECTR) or open carpal tunnel release (OCTR) will increase the risk of postoperative trigger digit. Furthermore, shared comorbidities of trigger digit and CTS will be evaluated as potential risk factors for trigger digit development following CTR.
Methods: 967 CTR procedures were evaluated for the development of trigger digit. Multivariate regression analysis was conducted to evaluate independent patient risk factors for trigger digit development. Patients were then stratified into an ECTR group and an OCTR group. Two logit models were conducted to test the association between patient risk factors and postoperative trigger digit within each surgical group.
Results: A total of 47 hands developed trigger digit following 967 carpal tunnel release procedures (4.9%). Regression analysis revealed no independent risk factors for postoperative trigger digit development, including surgical approach. Both the OCTR and ECTR groups were similar in baseline characteristics. There was no significant difference between ECTR and OCTR groups to develop trigger digit following CTR. Furthermore, the majority of risk factors were found to not be associated with postoperative trigger digit when evaluated within the ECTR or OCTR groups. Females were significantly more likely than males to develop trigger digit following OCTR, but were significantly less likely to develop trigger digit following ECTR.
Conclusion: OCTR may predispose females to develop trigger digit following surgery while ECTR may predispose males. Further studies evaluating gender differences in structural changes of the postoperative carpal tunnel are needed to support our findings.