The Presence of Limited Joint Mobility Is Significantly Associated with Multiple Digit Involvement by Stenosing Flexor Tenosynovitis in Diabetics

Abstract

Diabetes is associated with several disorders of the hand, including stenosing flexor tenosynovitis (SFTS). The feature of SFTS in diabetics is a higher prevalence of multiple digit involvement. We examined the magnitude of the tendency for involvement of more digits by SFTS in diabetic patients than in nondiabetic patients, and attempted to clarify the factors influencing multiple digit involvement by SFTS in diabetics. The study comprised 302 diabetic patients with SFTS and 235 nondiabetic patients with SFTS. The total number of digits exhibiting SFTS within the 1-year period following the initial visit to the Department of Orthopaedic Surgery was investigated in a prospective manner. We compared the difference in the frequency of multiple digit involvement by SFTS between diabetic and nondiabetic patients using the chi-squared test. Multiple regression analysis was performed to examine the contribution of independent variables [defined as 12 factors including age, sex, type of diabetes, estimated duration of diabetes, HbA(1c) values, carpal tunnel syndrome, Dupuytren contracture, limited joint mobility (LJM), de Quervain's disease, diabetic retinopathy, diabetic nephropathy, and dyslipidemia] to the total number of digits affected by SFTS in diabetic patients. Diabetic patients showed a significantly higher prevalence of multiple digit involvement than nondiabetic patients (p < 0.0001). Multiple regression analysis in diabetic patients revealed that the presence of LJM was positively associated with the prevalence of multiple digit involvement (r = 0.626, p < 0.0001). LJM in diabetics is closely associated with SFTS involving multiple digits.