Causal association between carpal tunnel release surgery and trigger finger

WorkSafeBC Evidence-Based Practice Group, Martin CW
Record ID 32018005167
Authors' objectives: To determine whether there is any evidence to support the (causal) association between carpal tunnel release surgery (CTR) and the subsequent development of trigger finger (TF).
Authors' results and conclusions: 616 studies were identified from search no. 1 to search no. 6 in this systematic review. Thirty-seven of the 616 studies were retrieved in full for further appraisal. However, after examining the full text of these thirty-seven studies, only seventeen provided relevant data, and are summarized in Table 1 (can be found in our full text paper). Low to medium quality higher level of evidence as well as all low level, low quality evidence provided some evidence on the higher risk of developing TF post-CTR. The evidence coming from retrospective cohort and case-controls demonstrated increased risk up to 3.6 times higher of developing TF among CTS patients receiving CTR versus those who did not receive CTR. It should be noted that the biological plausibility of this potential association is still unclear. At present, there is some evidence of the increased risk of developing trigger finger (TF) post carpal tunnel release (CTR) among carpal tunnel syndrome patients (CTS). However, this evidence needs to be interpreted with caution due to bias and confounding that may affect the observed association. Further, to conclude that such an association was causal in nature, further data may be needed to provide such a conclusion, including on the consistency of such association, the biological plausibility as well as any consistent temporal association. Currently there is no data demonstrating an association (causal or otherwise) in the co-occurrence of CTS and TF with occupational factors.
Authors' methods: A systematic literature search was conducted on commercial medical literature databases on February 1, 2023. An additional search was also conducted on NIOSHTIC-2 database (, a free bibliographic database of literature in the field of occupational safety and health maintained by the US National Institute for Occupational Safety and Health (NIOSH). No limitations, such as the on the date or language of publication, were implemented in any of these searches. A manual search was also conducted on the references of the articles that were retrieved in full. After finding out the potential co-occurrence of carpal tunnel syndrome (CTS) and trigger finger and discussing this fact with the requestor of this systematic review, we expanded our search to investigate the potential (causal) association between the co-occurrence of carpal tunnel syndrome and trigger finger with work. The same commercial medical databases were searched on February 7, 2023. The search was also done on the NIOSHTIC-2 database.
Project Status: Completed
Year Published: 2023
English language abstract: An English language summary is available
Publication Type: Mini HTA
Country: Canada
MeSH Terms
  • Carpal Tunnel Syndrome
  • Trigger Finger Disorder
  • Postoperative Complications
  • carpal tunnel syndrome
  • trigger finger
  • surgery
Organisation Name: WorkSafeBC
Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698
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Copyright: WorkSafe BC
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.