Relationship of Carpal Tunnel Release and New Onset Trigger Finger.

Abstract

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. 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. 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. 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. Prognostic IV.