Investigation of carpal tunnel syndrome following surgical treatment of distal radius fractures through volar approach

The aim of the study was investigation of presence of carpal tunnel syndrome (CTS) following fixation of distal radius fractures through volar approach. 33 distal radius fracture cases treated surgically by fixation and plating by volar approach, between January 2008 and January 2012 at Bulent Ecevit University Department of Orthopaedics, were evaluated. Posoperatively functional, radiological and electrophysiological evaluations of both surgically treated side and uninvolved side were performed. Clinical evaluations were carried out utilizing Wiley and Gartland's evaluation system, whereas radiological evaluations were utilized using the evalution method described by Steward et al. Presence of carpal tunnel syndrome was evaluated by physical examination methods such as median nerve provocative tests, grasp and pinch stress, ultrasonographic measurements of median nerve and carpal tunnel volume at the level of os piriforme, as well as electromyographic evaluations. Mean age of the cases were 44,2 (21-68) for men versus 53,8 (36-68) for women. Results of functional evaluation of the cases according to Gartland and Werley's system were very good at 73%, good in 21%, fair at 6%. Radiological evaluation revealed very good at 67%, good at 33%. Grip strength was higher at control side compared to surgical side, and this difference was statistically significant. According to evaluation for presence of CTS, 3 cases (9%) were found to have severe CTS. At those severe CTS cases, no difference between surgical side and uninvolved side were encountered, regarding ultrasonographic measurements of median nerve dimensions and carpal tunnel cross sectional area. In this study, we observed similar post operative CTS prevelance with normal population. We also did not found any relation between presence of CTS and volar fixation and plating for distal radius fractures. We concluded that surgical treatment of distal radius fractures through volar approach is a safe method regarding risk of median nerve compressive neuropathy. Keywords: Distal radius fracture, volar plating, Carpal tunnel syndrome