D26. Routine Endoscopic Carpal Tunnel Release (ECTR) At the Time of ORIF of Distal Radius Fractures (DRF) reduces the Incidence of Complex Regional Pain Syndrome (CRPS)

PURPOSE: Complex regional pain syndrome (CRPS) is a devastating consequence of distal radius fracture (DRF) with a well-recognized incidence of 4-7%. Untreated peripheral nerve compression such as carpal tunnel syndrome (CTS) exacerbates and prolongs CRPS symptoms. In an effort to minimize CRPS, our practice routinely performes endoscopic carpal tunnel release on all DRF patients. In this study we evaluate the incidence of CRPS in a cohort of patients who underwent routine endoscopic carpal tunnel release (ECTR) at the time of DRF fixation and compare it to historical rates. METHODS: We performed a single-center retrospective chart review of all patients surgically treated for DRF in our ASC between 2020-2022. Less than 3months follow-up patients were excluded. Demographic characteristics, comorbidities, fracture characteristics, and, therapy notes were reviewed. Multivariable analyses were performed to identify factors associated with CRPS following surgery. RESULTS: We identified 685 patients (178M; 507F) with DRF treated electively with ECTR at the time of ORIF without obvious findings of acute CTS. Average age (61±19) days presentation from injury (4±4d), intra-vs-extra articular fracture pattern (76vs24%), postoperative immobilization period (16±7d). Of these patients, only.006% (4) were diagnosed with CRPS in their ipsilateral extremity within 3 months of sustaining the DRF. Multivariate analysis failed to identify any predictive variables in those patients that developed CRPS. CONCLUSION: This retrospective review shows that the incidence of CRPS in this treatment group is 1000 folds lower than that routinely reported for DRF. Our series suggests that patients may benefit from ECTR concurrent to DRF ORIF.