Palmar Fibromatosis Nodules After Carpal Tunnel Release: A Prospective High-Resolution Ultrasound Study

Purpose or Learning Objective: Dupuytren's disease, also known as palmar fibromatosis, is characterized by thickening and fibrous nodules of the palmar fascia, potentially leading to functional impairment of the hand. Although its etiology remains unclear, we have observed that surgical procedures such as carpal tunnel syndrome release may trigger the development of fibrotic nodules in the palmar fascia. In this study we investigated whether patients who undergo carpal tunnel syndrome surgery are more likely to develop palmar fibromatosis nodules compared with those with nonoperated carpal tunnel syndrome and healthy individuals, using high-resolution ultrasound.

Methods or Background: In this prospective study, we examined 120 patients who had previously undergone carpal tunnel syndrome surgery, screening for palmar fibromatosis nodules with high-resolution ultrasound (6–18 MHz probe). We further evaluated two control groups: 50 healthy volunteers and 30 patients diagnosed with carpal tunnel syndrome who had not yet had surgery. The prevalence of palmar fibromatosis nodules across these groups was documented and compared.

Results or Findings: Of the 120 patients who had carpal tunnel syndrome surgery, 35% (n = 42) were found to have palmar fibromatosis nodules. In contrast, only one individual in the group of 50 healthy volunteers had nodules, a known familial case identified incidentally. None of the 30 patients with nonoperated carpal tunnel syndrome showed evidence of nodules. These findings suggest a highly significant increase in palmar fibromatosis among post–carpal tunnel syndrome surgery patients compared with both healthy controls and those with nonoperated carpal tunnel syndrome.

Conclusion: Our findings suggest that carpal tunnel syndrome release surgery may be associated with a higher incidence of Dupuytren's disease, raising important questions about the role of surgical intervention in the development of fibromatosis. More research is needed to explore whether certain surgical techniques or patient factors could influence the risk and to develop strategies that might help prevent these complications.

Publication History

Article published online:
02 June 2025