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Routine carpal tunnel release not needed when plating distal radius fractures
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 William D. Lanzinger |
A recently presented study does not support regular prophylactic carpal tunnel release during volar plate fixation of distal radius fractures to prevent median neuropathy, and adds that conservative treatment can provide symptom relief for patients who develop postoperative median neuropathy.
“When we indeed do volar plating and carpal tunnel release at the same time, [patients] had good results, and actually those patients who had previous symptoms of carpal tunnel syndrome do better than those who had acute onset after injury,” William D. Lanzinger, MD, said during his presentation here at the 2011 Annual Meeting of the American Society for Surgery of the Hand.
“There is an 8% incidence of mild median neuropathy, but the treatment was not surgical,” he added. “Therefore, we do not recommend routine prophylactic carpal tunnel release at the time of volar plating of distal radius fractures.”
Lanzinger and his team conducted a retrospective review of 199 cases of volar plate fixation for distal radius fractures performed by two surgeons during a 3-year period. Of these patients, 17 developed a median neuropathy at the time of injury and underwent a simultaneous carpal tunnel release.
Of the 182 patients who solely had volar plating, 15 patients (8%) developed a postoperative median neuropathy. All of these patients received nonsurgical treatment and their symptoms resolved, Lanzinger reported.
Reference:
- Lanzinger WD, Bindra RR, Cordell CL, et al. The value of carpal tunnel release in conjunction with volar plating of distal radius fractures. Paper #9. Presented at the 2011 Annual Meeting of the American Society for Surgery of the Hand. Sept. 8-10. Las Vegas.
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