Sixty patients with unilateral distal radius fractures from low energy trauma were managed by closed fracture reduction and long-arm cast immobilization. Clinical signs of carpal tunnel syndrome were reported at a mean of 10 months post injury in 12 patients or 20% (range, 6.5 weeks to 27 months). These 12 cases were confirmed by electrodiagnostic study. There were no instances of acute carpal tunnel syndrome, pre-existing carpal tunnel syndrome, or bilateral carpal tunnel syndrome. The authors detected a correlation between late onset carpal tunnel syndrome and a suboptimal clinical outcome. There were no associations between carpal tunnel syndrome and fracture type or resultant distal radius bone alignment.
The clinical outcome after a distal radius fracture is dependent upon several factors, including patient age and activity level, articular congruency, median nerve function, and the integrity of soft-tissue stabilizing structures. Radius fracture is a well-recognized cause of carpal tunnel syndrome. The findings from this study would appear to support a high index of suspicion and careful evaluation of median nerve function following closed management of distal radius fractures.
Journal of Hand Surgery