Association between stenosing tenosynovitis and carpal tunnel syndrome: retrospective case series study

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Mantas Fomkinas1, Aurimas Dobilinskas1, Ernest Zacharevskij1, Kęstutis Braziulis1, Rytis Rimdeika1

1Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Plastic and Reconstructive Surgery, Kaunas, Lithuania

Abstract

Background and aim. To evaluate the relationship of stenosing tenosynovitis (ST) and carpal tunnel syndrome (CTS), including development of these conditions after surgery for the other.

Materials and methods. A case series analysis reviewed subjects with ST and CTS treated surgically. All patients included were over the age of 18 and had annulotomy or retinaculotomy performed. Patients with recurrent disease were excluded. Data collection and analysis accounted for the type of procedure performed, time period of these conditions development. Data analysis was performed using IBM SPSS software. Results with values of p < 0,05 were considered statistically significant.

Results. There was a total of 1858 patients (mean age 60.05, SD 13.57) – 400 men (21.5%) and 1458 women (78.5%). 1406 patients were diagnosed with CTS, 345 – ST and 107 – both pathologies. It was found that the rate of development of CTS after annulotomy (4.1%) was statistically significantly higher (p < 0.05) than the rate of development of ST after retinaculotomy (1.6%) (p > 0.05). The CTS after annulotomy most commonly occurs after more than 12 months (p = 0.003), while ST after retinaculotomy – after 6 – 12 months (p > 0.05).

Conclusion. ST and CTS are often diagnosed concomitantly, although tend to develop after the surgical treatment for each other. The rate of development of CTS after annulotomy is significantly higher than the rate of development of ST after retinaculotomy. The CTS after annulotomy most commonly occurs after more than 12 months, while ST after retinaculotomy – after 6 – 12 months.

Keywords: carpal tunnel syndrome, stenosing tenosynovitis, trigger digit, carpal tunnel release, retinaculotomy, annulotomy.

Full article

https://doi.org/10.53453/ms.2023.3.2

Association between stenosing tenosynovitis and carpal tunnel
syndrome: retrospective case series study
Mantas Fomkinas
1
, Aurimas Dobilinskas
1
, Ernest Zacharevskij
1
, Kęstutis Braziulis
1
, Rytis Rimdeika
1
1
Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Plastic and
Reconstructive Surgery, Kaunas, Lithuania
Abstract
Background and aim

Materials and methods
 ! "
#$
$%&'"(
)**+
Results !+!,**+$ -+./0**1 +2 0+!
.!+2 0*,-0+/ *./%
0 2 3)3**+
 ,2343**+
 1353***-/,/ 1343**+
Conclusion              


1/,/ 1
Keywords:

Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
Medical Sciences 2023 Vol. 11 (3), p. 10-20, https://doi.org/10.53453/ms.2023.3.2
10
Ryšys tarp stenozuojančio tenosinovito ir riešo kanalo tunelinio
sindromo: retrospektyvinis atvejų grupės tyrimas
Mantas Fomkinas
1
, Aurimas Dobilinskas
1
, Ernest Zacharevskij
2
, Kęstutis Braziulis
1
, Rytis Rimdeika
1
1
Lietuvos sveikatos mokslų universiteto ligoninė Kauno klinikos, Plastinės ir rekonstrukcinės chirurgijos klinika,
Kaunas, Lietuva
Santrauka
Tikslas. 67  879 :;  < 7
(=<
Tyrimo metodai. 77>77?@
==7"@77@77A9871* 1/1* .@
(="?877BC !?7
@(=;7"777<7
 <7@  7   %<:   7
7??<7@?:@7
"9<77<77)**+
Rezultatai.A987 !+!C,**+D -+./0**?1 +2 0+!?
.!+2 0*,7(=-0+/7 *./
6<77<7)**+7(=C0 2
7 ,24**+(=C
 1@?5***-7C,/ 1@?4
**+
Išvados. (=C:7C<7(=
   7< C    7 (=  
C<@ 1@?7<
@,/ 1@?
Raktažodžiai:<7:7
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
11
1. Introduction
     
       
   E  " 
(  F G   

  

  F1G %   
   
    7 
      
E1**+
     
+H2F-G
 
      
:
     7 F0G 

1.+!2F+I.GJ
1/-7
    F+ !G   
    F,G    


 /      #
#
      #
 FHG  

     
F!I *G
%       
  7 >7 
       I
     #
F!G

%

    
$     7 
K7
     
 F I 0G7

1,2
   F + ,G : 
      
77
!/0
L      F 1 .G 
 7   0+  ,*   -
     F +G 


#%
 L      #
      
%
 #    
  F !G 
      
  #

M !H+/
M   F HG 

#  #     
      
    %  
7
:-/0F1*1 G
N
    
       
   F11G   
     
1.+!2F+I.G..
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
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1-2F G
%        
0*/,*
      F.G $ 

7

K#
#7
      
#7
     
     
   7   
 F G $    
    
7 
     
  #  #  
F1-10GO


I#    F. 1+G 
     
#
F1-.G
       
    

     

2. Materials and methods
   !+! 
     " 
(   E  >
PE=
        
   Q 
   1* 1 / 1* .  
      
      
   
       E7
$R
L


#
      

  I  R 
"R      

   
     
#"B !
Q"
  
#
#   
        
  :   $ 
:%&'""7
1+7
     L
 S1     
 
 K    
)**+
3. Results
  !+!   
,**+$ -+.0**
 1 +2  0+!  .!+2 
 0*,
  / -0+   
/ *.
K 
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
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


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$
$2
Figure 1. Study sample distribution by gender and pathology
- ..H-2
,!  .*2  + -!2  
 *!H .0.2  
1.. H*2
H1 ,-2      K
7
    
5**..
Table 1. Study sample distribution by pathology
In total ST CTS ST + CTS
N % N % N % N %
Males 0** 1 + ,! .* - . .H1 + -!
Females 0+! .!+ 1.. H* *!H .01 H1 ,-
All patients !+! *** -0+ !, 0*, .0. *. +!
ST – stenosing tenosynovitis, CTS – carpal tunnel syndrome, N - number of individuals, % - percentage of
individuals.
+.H*
$ -1-/,*+1$ -.!
/,*!0$  -


+.-! $ 0!H  +.0- $ -!. 
     
   ,1-, $ 01, 
+HH,$ -+H3)3**+
,10.
$ *1+,* $ 1.HK1
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
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  T
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' J
$
'
Figure 2.Study sample distribution by age, gender and pathology
3)3**+

   
 /  0 2   

 ,21
Table 2. The incidence of disease after surgical treatment
CTS ST χ2 df p
N % N %
.0* **
In total 0*, H!0 -0+ H+H
Another pathology occurrence
after surgical treatment
1- , 0 0
ST – stenosing tenosynovitis, CTS – carpal tunnel syndrome, N - number of individuals, % - percentage of
individuals, χ2 – chi square criterion, df – degrees of freedom, p – significance level.

 1353***-
    
,/ 1
343*3*+K-

0!!2       
0.2
       L
     .. 2
3)3**+U
3)3**+
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
15
Figure 3. Time periods between surgical treatment of hand pathologies – carpal tunnel syndrome (CTS) and
stenosing tenosynovitis (ST)
 


 
 

4 1

,I 1

), * ), ,I 1

4 1

*
*
1*
-*
0*
+*
,*
.*
,+
0,
H
65.7
,+
-.
$2
4. Discussion
N     
     
     7 
J
   
0 2
     
,2
 R  E  
1**+ +2!.+
    
      
    
%

     
+H1+2F-GU
1* *     
     
    ,-2 F.G >   1* .
#
     
%
   7   
 -.     
F1,G
=   1**+    
##
  
      
   O# 
       

 %    
7
     
   $   
     
    
     #  
   #   
     
#     
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
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L     #
      7  
 3F111.G
%      
    1  
35*3**-
  , / 1   
   >   1* .  
 H,+    7 
,
F1,GJ
  1* 1     
     
    
      !
    
     , 
    F G &  
      
    
    J  

   E  
      
&
       


     


%7
 
  #    


   =  
7
     


    
     
E     
   :
     

  ,     # 
   P7 
     
     




   1    
    
#       

5. Conclusions

     



1     
    
 1
    
    
,/ 1
6. Statements and declarations
Funding
6

Competing interests
       
:
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
17
I


Ethics approval
O      
&   > P 
E     
     
      

Consent to participate and publish

      J
#&
> P  E  
     
     
     :

     
#
Data availability
(

References
J >O K $ & '% 
(" O     
V
E   1* -W-! B0HI++ $N%B
BQQQ * * ,Q1* 1*!*0*
1 (  > $ J (
    
    V & "#
"6%1**HW0B -$N%BBQQQ
* !,Q .0HI.11 I0I -
- E = 67 E  =
6EXEI
   B 
      
E  1**+W *1I-B1*+I1*! $N%B
BQQQ * 01Q*1 !! *0*+**1H*+
0 XE%EU67
$ '( =    
$  " K#
   % % '
1* .W+, B 0-HI 001 $N%B
BQQQ *1 ,HQ+,.+!0
+ '>'>JK#

   V " ' (
1* 0WH-,B+10I+1. $N%B
BQQQ * *H.Q"E'************** *
, Y   ' & (
%#
      
 I     
 V P 1*1* W1--B0 HI01-
$N%BBQQQ * **.Q0*0..I* !I*1! I#
. U "E J $( ' NV
(7      
   E  1* *W +1B! I
!. $N%B
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! ="V($'"
O
VE1**+W !1B1+HI1,H$N%B
BQQQ * H.Q1**+*1** 
H %7':O'':7
:7 =    I
    K '
1* -W+-1B+I -
* V$V'O
    #
 6 1**+W1+1B H,I1*- $N%B
BQQQ * *++QI1**+I!. -1!
& V$ 
N 6 1**+W !+B+! I+!+ $N%B
BQQQ * *H.Q* **** .- 01+!*,!
+
Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
18
1 (:: ' J V'  B
VE
  1**,W-  B -+I 0, $N%B
BQQQ * * ,Q1**+ ** -
- 7'(===
'
     
    P
1* !W-.1B -0I -H $N%B
BQQQ * 0-,,Q .*-!
0  V % X 6 E 7 '
#

VE1* 1W-. *B1* 1I
1*1* $N%B
BQQQ * * ,Q1* 1*,*1.
+ ' V K#   
       V
N O ' 1***W01+B+1,I+0+ $N%B
BQQQ * *H.Q***0-.,0I1****+***I
*** 1
, 77KJ'&&7E
" P K KI   
    N  
1* 1W -1+B,!+I,H  $N%B
BQQQ * **.Q**0*1I* I 00*I*
. &  & $ " 
$VE1* +W0* B1-*0I1-*H
$N%BBQQQ * * ,Q1* +*0*0 
! K 6Y&7VV
V&'($(7
VEOY
1* 0W-H.B.*0I.*. $N%B
BQQQ * ..Q .+- H-0 10,H 1H
H 7 VO J J> 

    6 
H,*W0*B+- I+0* $N%B
BQQQ * * ,Q**-HI, *H ,-,*,*I 
1* '777 E N 'O  (
$$B
  ( '7 '
1**!W 1BH1IH, $N%B
BQQQ * **.Q 1 .!I**.IH* 1I 
1  Z>N"'
J='U$J
[##
V"(
  1* .W.* *B 0 I 0 H $N%B
BQQQ * * ,Q1* .*+*-.
11 =="\\:
'O  =6 U    #

#
VN(1**+W1-1B10-I10!
$N%BBQQQ * * ,Q1**0*,* 0
1- J ( U 6 K: 
V " 
      
' 6 1** W10 B 0,1I 0,. $N%B
BQQQ * **1Q ,H
10 UV'7$%&>
E((7
 V E  & 1**0W1H0B- +I-1*
$N%BBQQQ * * ,Q1**0*1**H
1+ ="7%%
    B  
[VEOY1**HW-0 B+!I
+H $N%B
BQQQ * ..Q .+- H-0*!*H,* +
1, >KX'LNV>>E
%
B  I
   ' &
1* .WH,1.B.-++ $N%B
BQQQ * *H.Q'$************.-++
1. > = & =J  J 
     # 
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Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
19
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Journal of Medical Sciences. 18 Mar, 2023 - Volume 11 | Issue 3. Electronic - ISSN: 2345-0592
20