gms | German Medical Science

Objectives/Interrogation: Carpal tunnel syndrome (CTS) is a common complication associated with distal radius fractures (DRFx). We performed a median nerve electrodiagnostic study before surgery. In addition, we have undergone endoscopic carpal tunnel release (ECTR) in the same setting as open reduction and internal fixation (ORIF) of the radius fractures, on the following cases who is developing CTS or is potentially present CTS. The purpose of this study was to report the outcome of ECTR concurrent with osteosynthesis for DRFx.

Methods: We retrospectively reviewed 10 (mean age, 65 years; 80% women) patients treated with DRFx between 2011 and 2015. Radiographs showed the following distribution in the AO/OTA classification system: one case of type A3, one case of C1, four cases of C2, and four cases of C3. The case of type A3 was an open fracture. We performed ECTR in the same setting as ORIF using a volar locking plate for DRFx. The clinical examination served to collect data on presence of numbness, preoperative abductor pollicis brevis-distal latency (APB-DL), range of motion at the final examination, radiographic evaluation, and complications. Average follow-up period was 7.7 months (range, 3-24 months).

Results and Conclusions: Eight of the 10 patients preoperatively complained the numbness of the affected hand. The preoperative APB-DL of the affected side was 5.1 (3.5 to 7.1) msec. We preoperatively diagnosed Four patients were preoperatively diagnosed to have CTS before the injury, four patients as acute onset CTS, and two patients as asymptomatic CTS on the basis of delayed APB-DL > 6.0 msec. Mean range of motion at the final follow-up was as follows: forearm 79° pronation/ 77° supination, and wrist 57° palmar flexion/ 62° dorsal flexion. The final radiographic measurements averaged 14 degrees of volar tilt, 24.7 degrees of radial inclination, and 1.3 mm of ulnar-positive variance. We confirmed 4 trigger digits as a complication. However, there were no numbness recurrence, CTS onset, or other complications. Concurrent ECTR in distal radius ORIF using a volar locking plate was efficacious and safe.