Clinical Epidemiology (Sep 2022)
Incidence of Carpal Tunnel Syndrome Requiring Surgery May Increase in Patients Treated with Trigger Finger Release: A Retrospective Cohort Study
Abstract
Hsin-Han Hsieh,1 Wen-Tien Wu,1,2 Jui-Tien Shih,3 Jen-Hung Wang,4 Kuang-Ting Yeh1,2 1School of Medicine, Tzu Chi University, Hualien, Taiwan; 2Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; 3Department of Orthopaedic Surgery, Taoyuan Armed Forces General Hospital, Taoyuan City, Taiwan; 4Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, TaiwanCorrespondence: Kuang-Ting Yeh, Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien, 970473, Taiwan, Email [email protected]: The correlation between carpal tunnel syndrome (CTS) surgery and trigger finger (TF) surgery is unclear; we conducted this nationwide population-based study to assess the development of severe CTS requiring surgery after TF surgery.Patients and Methods: This retrospective cohort study used the data of patients diagnosed as having TF between January 1, 2001, and December 31, 2017, and they were divided into two comparative groups. Patients who underwent surgical release within 1 year of diagnosis were included in the TF-OP group, and those who did not undergo TF release during the same period were included in the TF-NOP group. The primary outcome was the new incidence of CTS release (CTR), and data on the related risk factors were collected for analysis.Results: A total of 8232 patients each were enrolled into the TF-OP and TF-NOP groups and were 1:1 propensity score matched (mean patient age, 54.7 ± 10.1 years; mean follow-up duration, 6.58 years). The incidence rate of CTR was 1.1 per 1000 person-years in the TF-OP group and 0.7 per 1000 person-years in the TF-NOP group. The adjusted hazard ratio of TF surgery was 1.51. The factors significantly correlated with an increased incidence of CTR were age, female sex, diabetes mellitus, and chronic renal failure. In subgroup analysis, patients aged > 65 years and female patients in the TF-OP group were still at significantly higher risks of CTR than were their counterparts in the TF-NOP subgroups. The cumulative incidence of CTR after TF surgery linearly increased with time in both groups.Conclusion: Patients undergoing TF release may have a higher incidence of CTR 1 year later, especially women and patients aged > 65 years. Diabetes mellitus and chronic renal failure may be risk factors.Keywords: trigger finger release, nationwide cohort study, subgroup analysis, diabetes mellitus, chronic renal failure
