FREQUENCY OF CARPAL TUNNEL SYNDROME WITH OR WITHOUT FLEXOR RETINACULUM RELEASE IN DISTAL RADIUS FRACTURES MANAGED BY OPEN REDUCTION AND INTERNAL FIXATION

Abstract

Background:
Distal radius fractures are frequently encountered injuries and are commonly managed with open reduction and internal fixation. Carpal tunnel syndrome is a recognized complication associated with these fractures due to median nerve compression from edema, hematoma, or altered carpal tunnel dynamics. The role of concomitant flexor retinaculum release during fracture fixation remains controversial.

Objective:
To determine the frequency of carpal tunnel syndrome in patients with distal radius fractures managed by open reduction and internal fixation, with or without flexor retinaculum release.

Methodology:
This descriptive cross-sectional study was conducted at the Department of Orthopedic Surgery, CMH Rawalpindi, from May 2024 to October 2024. A total of 100 patients aged 18–65 years with distal radius fractures managed surgically by open reduction and internal fixation were included using non-probability consecutive sampling. Patients with pre-existing carpal tunnel syndrome, previous wrist surgery, or associated nerve injuries were excluded. Data regarding demographic characteristics, surgical technique, and postoperative development of carpal tunnel syndrome were recorded. Diagnosis of carpal tunnel syndrome was based on clinical assessment, with nerve conduction studies performed where indicated. Data were analyzed using SPSS version 26.

Results:
The mean age of patients was 41.8 ± 12.6 years. Carpal tunnel syndrome was observed in 17% of patients overall. Among patients who underwent flexor retinaculum release, 7.9% developed carpal tunnel syndrome, compared to 22.6% in those without release.

Conclusion:
Carpal tunnel syndrome is a common complication following distal radius fixation. Selective flexor retinaculum release may reduce the frequency of postoperative median nerve compression in high-risk patients.