Carpal Tunnel Syndrome as a Complication of Surgical Scaphoid Reconstruction in Nonunion and Secondary Fracture Dislocation

Abstract

The purpose of this study was to identify risk factors for postoperative carpal tunnel syndrome (CTS) in operative management for scaphoid nonunion and secondary fracture dislocation, treated surgically with takedown and bone grafting. We reviewed medical records of all our patients that underwent carpal tunnel release after scaphoid reconstruction surgery from August 2002 to December 2020. We identified a total of 7 out of 191 patients (3.7%). We investigated surgical parameters, pre- to postoperative changes, in three-dimensional measurements of the scaphoid and carpal tunnel morphometry. We found the preoperative intrascaphoid angle (ISA) and the postoperative change in ISA to correlate with an increased risk of postoperative CTS. Patients undergoing operative scaphoid reconstruction that require a high degree of geometric correction can be at risk to develop postoperative CTS, hence they should be subject to a lower threshold decision for prophylactic carpal tunnel release.

Level of Evidence Level III.

Keywords

scaphoid reconstruction - postoperative carpal tunnel syndrome - pseudarthrosis - complication carpal reconstruction - CARD analysis

Authors' Contributions

O.A., T.P., and A.S. conceived the study. S.B. and L.N. were involved in gaining ethical approval. S.B., L.R., O.A., and T.P. were further involved with patient recruitment and data analysis. S.B. and L.N. wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Ethical Approval

Ethical approval for this study was obtained from the Cantonal Ethics Commission of Zurich (2021–02485).

Patients' Consent

General written informed consent was obtained from all patients.

^* Sophie Brackertz and Octavian Andronic have contributed equally to this work and share first authorship.

Publication History

Received: 29 August 2023

Accepted: 09 November 2023

Article published online:
22 December 2023

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