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The Incidence of Trigger Digit after Carpal Tunnel Release
Louis C. Grandizio, DO; John D. Beck, MD; Michael R. Rutter, BS; Jove Graham, PhD; Joel C. Klena, MD
Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA

Introduction: Diabetic patients are at increased risk for developing carpal tunnel syndrome (CTS) and there is a link between surgery for idiopathic CTS and development of trigger digit (TD). The purpose of this study is to determine if diabetic patients are at greater risk for developing post-operative TDs compared to a non-diabetic cohort.

Materials and Methods: A retrospective review of our electronic medical records identified all patients who had undergone carpal tunnel release (CTR) by a single hand fellowship-trained surgeon from September 2007 through May 2012. For patients with diabetes mellitus (DM), additional information regarding method of disease control and HbA1c level was recorded. We recorded HbA1c levels 3 months prior to and 3 months following CTR. The location and time to development of post-operative, new-onset TD was recorded for each patient. Statistical testing included chi-square or student-t testing and multivariate logistic regression analysis.

Results: Of the 1,020 patients who underwent CTR, 170 had a diagnosis of DM. Of the 850 non-diabetic patients 4% developed TD within 6 months of CTR and 6% within one year of CTR compared to 12% and 14% respectively for diabetic patients. A multivariate regression analysis revealed DM as a significant risk factor for developing TD following CTR at 6 months and 12 months. We found no significant association between HbA1c level at the time of CTR and the likelihood of developing TD.

Conclusion: The incidence of TD following CTR is higher in the diabetic population compared to a non-diabetic cohort. The presence of the DM rather than the severity was the most important factor for developing TD. Pre-operative counseling and post-operative vigilance in the diabetic population undergoing CTR may be warranted for early identification of TDs following surgery.

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