Revision Carpal Tunnel Release: Risk Factors and Rate of Secondary Surgery.

Abstract:

BACKGROUND:The first aim of this study was to determine the rate of revision carpal tunnel release in five urban hospitals over a period of 14 years. The secondary aim was to assess what demographic, condition-related, and treatment-related factors are associated with revision carpal tunnel release. METHODS:Between 2002 and 2015, 7464 patients underwent carpal tunnel release. After manually reviewing the medical records, the authors identified 113 patients who underwent revision surgery. Multivariable logistic regression analysis was performed to study association with demographics (age, sex, and race), unilateral or bilateral treated wrist(s) (including carpal tunnel release performed simultaneously and separately), and type of surgery (open or endoscopic). To gain further insight into these factors, a matched case-control analysis in a 1:3 ratio was performed. RESULTS:One hundred thirteen of 7464 patients (1.5 percent) underwent revision carpal tunnel surgery. The median (interquartile range) time to revision surgery was 1.23 years (0.47 to 3.89 years). In multivariable logistic regression analysis, older age, male sex, bilateral carpal tunnel release, and endoscopic carpal tunnel release were independently associated with higher odds for revision surgery. Multivariable conditional logistic regression of the matched case-control cohort showed that smoking and rheumatoid arthritis were independently associated with revision carpal tunnel release. Splint treatment before the initial surgery was independently associated with single carpal tunnel release. CONCLUSION:Endoscopic release, male sex, smoking, rheumatoid arthritis, and undergoing staged or simultaneous bilateral carpal tunnel release are risk factors for revision surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, III.

journal_name

Plast Reconstr Surg

authors

Westenberg RF,Oflazoglu K,de Planque CA,Jupiter JB,Eberlin KR,Chen NC

doi

10.1097/PRS.0000000000006742

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1204-1214

issue

5

eissn

0032-1052

issn

1529-4242

pii

00006534-202005000-00019

journal_volume

145

pub_type

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