gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Trigger Digit Incidence after Carpal Tunnel Release: Z-Plasty Reconstruction Vs Traditional Carpal Tunnel Release

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  • presenting/speaker Ignacio Esteban-Feliu - Vall Hebrón Hospital, Hospital Quiron Dexeus - Icatme, Barcelona, Spain
  • Irene Gallardo-Calero - Vall Hebrón Hospital, Barcelona, Spain
  • Sergi Barrera-Ochoa - Sant Joan de Deu Hospital, Hospital Quiron Dexeus - Icatme, Becelona, Spain
  • Nuria Vidal-Tarrasón - Vall Hebrón Hospital, Barcelona, Spain
  • Alex Lluch-Bergadà - Vall Hebrón Hospital, Institut Kaplan, Barcelona, Spain

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1382

doi: 10.3205/19ifssh0286, urn:nbn:de:0183-19ifssh02860

Published: February 6, 2020

© 2020 Esteban-Feliu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The development of trigger digit after carpal tunnel syndrome release surgery has been widely reported. Anterior displacement of the flexor tendon has been reported after carpal tunnel release (CTR), causing it to lose its pulley function increasing flexor tendon friction at the proximal digital pulleys. Lluch described Z-plasty reconstruction of the flexor retinaculum to prevent such complication.

Methods: We conducted a retrospective review to determine whether patients who undergo Z-plasty reconstruction have a lower incidence of trigger digit postoperatively. One thousand fifty patients were included, 865 whom had undergone traditional carpal tunnel release and 185 Z-plasty reconstruction

Results and Conclusions: No differences were found in terms of incident trigger digit after surgery (9.3% of the patiens who underwent traditional release versus 11.9% in the Z-plasty group, p>0.05). Neither difference was found when comparing mean time to development of trigger digit. The thumb was the most frequently (41%) involved digit. In the absence of randomized long-term studies comparing traditional and Z- plasty CTR, given our results, we see no reason to favor Z-plasty reconstruction over standard carpal tunnel release as a means to prevent postoperative triggering of digits.