Vol. 13 No. 2 (2021): Archives of Public Health
Clinical Science

The most common disorders of the hand associated with carpal tunnel syndrome in adults

Dushanka Grujoska-Veta
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Daniela Georgieva
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Nenad Atanasov
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Ilir Shabani
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Liljana Angeleska
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Antonio Georgiev
Private Health Institution Cardiology Prima; MIT University, Skopje, Republic of North Macedonia
Jasna Bogdanska
Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Institute of Medical and Experimental Biochemistry, Republic of North Macedonia

Published 2021-11-20


  • carpal tunnel syndrome,
  • trigger finger,
  • de Quervain’s disease

How to Cite

Grujoska-Veta D, Georgieva D, Atanasov N, Shabani I, Angeleska L, Georgiev A, Bogdanska J. The most common disorders of the hand associated with carpal tunnel syndrome in adults. Arch Pub Health [Internet]. 2021 Nov. 20 [cited 2024 Jun. 25];13(2):120-9. Available from: https://www.id-press.eu/aph/article/view/6014


Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies caused by chronic compression of the median nerve in the area of the carpal tunnel and its etiology is multifactorial. Trigger fingers and de Quervain’s disease are common disorders of the hand related to CTS in adults.Theaim of this study was to present the most common disorders of the hand such as stenosing tenosynovitis in adults with surgically treated CTS and to evaluate their demographic data.Material and methods: A total of 116 surgically treated patients with established diagnosis of CTS (clinically and by electrophysiological examination) were included in this prospective study, which was conducted at the University Clinic for Orthopedic Diseases in Skopje. Demographic data, findings of history of the disease and clinical examination were recorded and analyzed.Results: Participants with CTS included in the study were with a mean age of 55.41±10.7 years (age range 29-75). 75% of them were female. 63.8% of participants suffered from one or more comorbid chronic diseases. On admission to hospital, disorders such as trigger fingers and de Quervain’s disease were concomitantly diagnosed in 15.51% on ipsilateral hand with CTS. All disorders were surgically treated following open carpal tunnel release, as “one stage procedure”, under local anesthesia.Conclusion: Our findings have determined concomitant existence of CTS and stenosing tenosynovitis (trigger fingers and de Quervain’s disease) on ipsilateral hand, which suggests common etiological factors. Female gender and age range 40-60 years are major common factors related to these three disorders.


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  1. Phalen G. S. The carpal-tunnel syndrome: seventeen years' experience in diagnosis and treatment of six hundred and fifty-four hands. J Bone Joint Surg1966; 48A: 211-228. DOI: https://doi.org/10.2106/00004623-196648020-00001
  2. Mondelli M, Giannini F, Giacchi M. Carpal tunnel syndrome incidence in a general population. Neurology 2002;58(2):289-94. DOI: https://doi.org/10.1212/WNL.58.2.289
  3. Atroshi I, Gummesson C, Johnsson R, Ornstein E,Ranstam J, Rosén I.Prevalence of Carpal Tunnel Syndrome in a General Population. JAMA 1999;282:153-158. DOI: https://doi.org/10.1001/jama.282.2.153
  4. Dala-Ali BM, Nakhdjevani A, Lloyd M A, Schreuder FB. The Efficacy of Steroid Injection in the Treatment of Trigger Finger. Clinics in Orthopedic Surgery 2012;4:263-268 DOI: https://doi.org/10.4055/cios.2012.4.4.263
  5. Merry SP, O’Grady J S, Boswell C L. Trigger Finger? Just Shoot! Journal of Primary Care & Community Health, Volume 11: 1 –6, DOI: https://doi.org/10.1177/2150132720943345
  6. Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum. 2004;51(4):642–51. DOI: https://doi.org/10.1002/art.20535
  7. Wolf JM, Sturdivant R X, Owens B D. Incidence of de Quervain's tenosynovitis in a young, active population. J Hand Surg Am 2009 ;34(1):112-5. DOI: https://doi.org/10.1016/j.jhsa.2008.08.020
  8. Palmer KT, Harris EC, Coggon D. Carpal tunnel syndrome and its relation to occupation: a systematic literature review. Occup Med (Lond)2007;57(1):57-66. DOI: https://doi.org/10.1093/occmed/kql125
  9. Karpitskaya Y, Novak CB, Mackinnon SE. Prevalence of smoking, obesity, diabetes mellitus, and thyroid disease in patients with carpal tunnel syndrome. Ann Plast Surg. 2002;48(3):269-73. DOI: https://doi.org/10.1097/00000637-200203000-00007
  10. Rempel D,Dahlin L, Lundborg G.Pathophysiology of Nerve Compression Syndromes: Response of Peripheral Nerves to Loading. J Bone Joint Surg1999;81 А:1600–1610. DOI: https://doi.org/10.2106/00004623-199911000-00013
  11. Chang YC, Chiang JH, Lay IS, Lee YC. Increased risk of coronary artery disease in people witha previous diagnosis of Carpal Tunnel Syndrome: A nationwide retrospective population-based case-control study. Biomed Res Int 2019:3171925. DOI: https://doi.org/10.1155/2019/3171925
  12. Ettema A M, Amadio PC, et al. A histological and biochemical study of the subsynovial connective tissue in idiopathic carpal tunnel syndrome. J Bone Joint Surg 2004; 86A: 1458-1466. DOI: https://doi.org/10.2106/00004623-200407000-00014
  13. YunokiM, Imoto R, Kawai N, Matsumoto A, Hirashita K. Occurrence of Trigger Finger Following Carpal Tunnel Release. Asian J Neurosurg. 2019; 14(4): 1068–1073. DOI: https://doi.org/10.4103/ajns.AJNS_149_19
  14. Clarke MT, Lyall HA, Grant JW, Matthewson MH. The histopathology of de Quervain's disease. J Hand Surg [Br] 1998;23 (6): 732-4. DOI: https://doi.org/10.1016/S0266-7681(98)80085-5
  15. Yurdakul FG, Bodur H, Cakmak OO, Ates C, Sivas F, Eser F, Tasdelen OY. Оn the severity of carpal tunnel syndrome: diabetes or metabolic syndrome. J ClinNeurol 2015;11(3):234-240 DOI: https://doi.org/10.3988/jcn.2015.11.3.234
  16. Solomon DH, Katz JN, Bohn R, Mogun H. Nonoccupational risk factors for carpal tunnel syndrome. J Gen Intern Med 1999;14:310-314 DOI: https://doi.org/10.1046/j.1525-1497.1999.00340.x
  17. Grandizio LC, Beck JD, Rutter MR, Graham J, Klena JC. The incidence of trigger digit after carpal tunnel release in diabetic and nondiabetic patients. J Hand Surg Am 2014; 39: 280-285 DOI: https://doi.org/10.1016/j.jhsa.2013.10.023
  18. Goshtasby PH, Wheeler DR, Moy OJ. Risk factors for trigger finger occurrence after carpal tunnel release. Hand Surg 2010; 15: 81-87 DOI: https://doi.org/10.1142/S0218810410004606
  19. Staub F, Dombert T, Assmus H.Carpal tunnel syndrome in haemodialysis patients: analysis of clinical and electrophysiological findings in 268 patients (395 hands).Handchir Mikrochir Plast Chir 2005;37:150-7. DOI: https://doi.org/10.1055/s-2005-865691
  20. Tadjerbashi K, Akesson A. Atroshi I. Incidence of referred carpal tunnel syndrome and carpal tunnel release surgery in the general population: Increase over time and regional variations. J OrthopSurg 2019; 27(1):1–5. DOI: https://doi.org/10.1177/2309499019825572
  21. Bahar-Moni AS, Abdullah S, Fauzi H, Chee-Yuen SY, Abdul-Razak FZ, Sapuan J. Demographics of patients undergoing carpal tunnel release in an urban tertiary hospital in Malaysia. Malays Orthop J 2019;13(3):53-59. DOI: https://doi.org/10.5704/MOJ.1911.009
  22. English JH, Gwynne-Jones DP. Incidence of carpal tunnel syndrome requiring surgical decompression: a 10.5-year review of 2309 patients. J Hand Surg Am 2015; 40:2427–34. DOI: https://doi.org/10.1016/j.jhsa.2015.07.029
  23. Farioli A, Curti S, Bonfiglioli R, Baldasseroni A, Spatari G, Mattioli S, Violante FS.Observed differences between males and femalesin surgically treated carpal tunnel syndromeamong non-manual workers: A sensitivity analysisof findings from a large population study. Ann Work Expo Health 2018; 62(4):505–515. DOI: https://doi.org/10.1093/annweh/wxy015
  24. Nosewicz J, Cavallin C, Cheng CI, Ragina N, Weiss AW, Zacharek A. Factors associated with trigger digit following carpal tunnel release. World J Orthop 2019; 10(12): 454-462 DOI: https://doi.org/10.5312/wjo.v10.i12.454
  25. Kaplan Y, Kurt SG, Karaer H. Carpal tunnel syndrome inpostmenopausal women. J Neurol Sci 2008; 270:77–81. DOI: https://doi.org/10.1016/j.jns.2008.02.003
  26. Apostoli P, Sala E, Curti S,et al. Loads of housework?Biomechanical assessments of the upper limbs in womenperforming common household tasks. Int Arch OccupEnviron Health2012; 85:421–5. DOI: https://doi.org/10.1007/s00420-011-0690-z
  27. Rottgers SA, Lewis D &Wollstein RA. Concomitant presentation of carpal tunnel syndrome and trigger finger. J Brach PlexPeriph Nerve Inj 2009; 4: 13.
  28. Kumar P, Chakrabarti I. Idiopathic carpal tunnel syndrome and trigger finger: is there an association? J Hand SurgEur 2009;34(1):58-9. DOI: https://doi.org/10.1177/1753193408096015
  29. Lin FY, Manrique O J, Lin C L, Cheng H T. Incidence of trigger digits following carpal tunnel release A nationwide, population-based retrospective cohort study. Medicine 2017 96:27(e7355), DOI: https://doi.org/10.1097/MD.0000000000007355
  30. Shafaee-Khanghah Y, Akbari H, Bagheri N. Prevalence of carpal tunnel release as a risk factor of trigger finger. World J PlastSurg 2020;9(2):174-178. DOI: https://doi.org/10.29252/wjps.9.2.174
  31. Acar MA, Kütahya H, Güleç A, Elmadağ M, Karalezli N,Ogun T C. Triggering of the digits after carpal tunnel surgery. Ann PlastSurg 2015;75(4):393-7. DOI: https://doi.org/10.1097/SAP.0000000000000233
  32. Ashmead D 4th, Okada H, Macknin J, Naalt SV, Staff I, Wollstein R. Trigger fingers after open carpal release. Plast Surg (Oakv) 2020;28(4):192-195. DOI: https://doi.org/10.1177/2292550320928554
  33. Lin FY, Wu CI, Cheng HT. Coincidence or complication? A systematic review of trigger digit after carpal tunnel release. J Plast Surg Hand Surg 2018;52(2):67-73. DOI: https://doi.org/10.1080/2000656X.2017.1345751
  34. Lee SK, Bae KW, Choy WS. The relationship of trigger finger and flexor tendon volar migration after carpal tunnel release. J Hand SurgEur Vol 2014;39(7):694-8. DOI: https://doi.org/10.1177/1753193413479506
  35. Karalezli N, Kütahya H, Güleç A, Toker S, Karabörk H, Ogun TC. Transverse carpal ligament and forearm fascia release for the treatment of carpal tunnel syndrome change the entrance angle of flexor tendons to the A1 pulley: the relationship between carpal tunnel surgery and trigger finger occurrence. Scientific World Journal 2013; 2013:630617 DOI: https://doi.org/10.1155/2013/630617