The authors performed a prospective study of carpal canal pressures in 10 patients undergoing volar plating of distal radius fractures. The maximum recorded pressure was 65 mmHg in 1 case, whereas the peak pressures in the remaining cases were 40 mmHg or less. Final pressures were recorded 24 hours postoperatively and were 31 mmHg or less in all cases. There were no patients who complained of median nerve dysfunction during the 24-hour data collection period, or at 12 week follow-up assessment. Based on the pressure recordings, the authors recommend against routine prophylactic carpal tunnel decompression following volar plating of distal radius fractures.
Increased pressures within the carpal tunnel are known to occur with distal radius fractures and acute pressure increases can potentially lead to median nerve dysfunction. Prophylactic carpal tunnel release with distal radius fracture repair has been recommended by some surgeons but advised against by other surgeons. This study provides valuable information on carpal canal pressures after volar plating of distal radius fractures, but does not solve the controversy regarding concomitant carpal tunnel decompression.
Radius, Distal, Fracture, Volar, Plating, Carpal, Tunnel
Journal of Hand Surgery