# Association Between Lower-Limb Fractures and Carpal Tunnel Syndrome: A Nationwide Population-Based Cohort Study

## TL;DR

People with lower-limb fractures have a slightly higher risk of developing carpal tunnel syndrome, especially younger males.

## Contribution

This study identifies a population-based association between lower-limb fractures and increased carpal tunnel syndrome risk.

## Key findings

- Lower-limb fractures are linked to a modestly higher risk of carpal tunnel syndrome.
- The risk is stronger in males and younger adults aged 20–65 years.
- Early monitoring may help prevent carpal tunnel syndrome in high-risk patients.

## Abstract

What are the main findings?

Lower-limb fractures increase the risk of developing carpal tunnel syndrome (CTS).

The risk is higher in males and younger adults (20–65 years).

What is the implication of the main finding?

CTS risk should be considered when prescribing assistive devices after fractures.

Early monitoring may help prevent CTS in high-risk patients.

Background: Lower-limb fractures often require prolonged use of assistive devices, which may increase mechanical stress on the upper extremities. However, the association between lower-limb fractures and subsequent carpal tunnel syndrome (CTS) remains unclear. Methods: This nationwide population-based cohort study used Taiwan’s National Health Insurance Research Database (2011–2019) to identify 10,140 patients with lower-limb fractures and 10,140 propensity score-matched controls. Cox regression analysis estimated CTS risk after adjusting for demographics and comorbidities. Results: Patients with lower-limb fractures demonstrated increased CTS risk compared to controls (adjusted hazard ratio [HR] = 1.12, 95% confidence interval [CI]: 1.003–1.26; p = 0.044), with stronger associations in males (HR = 1.28, 95% CI: 1.05–1.55) and younger adults aged 20–65 years (HR = 1.19, 95% CI: 1.03–1.38). Conclusions: Lower-limb fractures are associated with modestly increased CTS risk, particularly in males and younger patients. Though biologically plausible, this observational study cannot establish causality. Heightened clinical awareness may be warranted, though prospective validation is needed.