Does Simultaneous Surgical Treatment of Dupuytren's Contracture and Carpal Tunnel Syndrome Increase the Risk for Developing Complex Regional Pain Syndrome?
Scott Nathan Loewenstein, MD; Stephen Peter Duquette, MD; Adkinson M Joshua, MD
Indiana University, Indianapolis, IN
Introduction:
Previous observational studies have suggested that simultaneous surgical treatment of carpal tunnel syndrome (CTS) and Dupuytren's contracture increases the risk for developing complex regional pain syndrome (CRPS). A survey of hand surgeons revealed that many would not consider simultaneous surgical treatment of both conditions. Our goal was to evaluate the risk for CRPS after simultaneous surgical treatment of CTS and Dupuytren's contracture.
Methods:
All patients undergoing invasive treatment for CTS, Dupuytren's contracture, or both (total 66,145 patients) between 1987-2017 were identified using the Indiana Network for Patient Care (INPC). The INPC is a large, multi-institutional, statewide information exchange that collects medical information and billing data for over 17 million patients. Demographics, comorbidities, and 1-year post-operative incidence of CRPS were reviewed.
Results:
52,249, 1,616, and 139 patients underwent surgical treatment of CTS, Dupuytren's contracture, and simultaneous treatment of both, respectively, over the study period. There was no statistically significant difference in the 1-year post-operative incidence of CRPS in patients who had one condition treated vs. both simultaneously (0.57% vs. 0.72%, p=0.59).
Conclusions:
There was no statistically significant increase in the risk for CRPS in patients undergoing simultaneous surgical treatment of CTS and Dupuytren's contracture.
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