Carpal tunnel syndrome in women undergoing breast reduction

Abstract

Women with mammary hypertrophy who present for reduction mammaplasty have several well-described musculoskeletal complaints, but a high prevalence of carpal tunnel syndrome had not been reported in the past. One hundred fifty-one patients, who underwent reduction mammaplasty from 1994 to 1996 were iden-tified from a plastic surgery practice. To this group was added a convenience sample of 64 women volunteers with relatively smaller breasts (brassiere cup size B or smaller). The entire group was questioned about spe-cific symptoms and examined using standard provocative tests. Carpal tunnel syndrome was defined as the coexistence of symptoms and at least two physical examination findings. Its association with breast size, age, race, and body mass index was examined. Stepwise logistic regression was used to determine which physical characteristics were predictive of the condition. Carpal tunnel syndrome was found in 30 patients (19.9%) (95% confidence interval, 13.8-27.1) and in none of the women in the convenience sample. Breast size and, to a lesser degree, body mass index were found to be highly significant predictors of carpal tunnel syndrome. Af er controlling for breast size, race was also significant. Breast size displayed an independent risk ratio of 6.67 when comparing the upper quartile of size to the lower quartiles. There was a markedly higher prevalence of carpal tunnel syndrome in women who presented for reduction mammaplasty than in those with smaller breasts. Breast size was a significant predictor of carpal tunnel syndrome. © 2009 Springer-Verlag Berlin Heidelberg.