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Updated: Jan 21, 2026

Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Second to fourth digit ratio (2D:4D) in women with carpal tunnel syndrome
Anna Kasielska-Trojan1, Aneta Sitek2, Bogusław Antoszewski1
1Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Łódź, Poland.
Background:
Carpal tunnel syndrome (CTS), a median nerve compressive neuropathy at the wrist, is the most common entrapment nerve disorder. Sex is an important risk factor of CTS as this condition is to five times more common in women than in men (sex-hormone dependent). There are no studies concerning 2D:4D (biomarker of prenatal sex steroids exposure) in patients with CTS.
Aim:
Here we consider the relationship between 2D:4D and CTS in women.
Study Design And Methods:
The study involved 90 female participants (40 with a severe CTS (the mean age - 52.78 yrs., SD 11.44) and 50 control women (the mean age - 47.2 yrs., SD 8.23)). Anthropometric measurements were performed and the following indices were calculated: BMI, WHR and right and left 2D:4D.
Results:
A stepwise logistic regression model showed that higher WHR and lower right 2D:4D increase the risk of CTS in women (AUC = 0.8865).
Conclusions:
These associations may suggest a role for prenatal and post-natal sex-hormones in CTS development, i.e. in the context of oestrogen receptor activation (number and/or sensitivity) and the pattern of fat distribution. Further studies examining the role of hormonal influence in this disorder may help to plan prophylaxis of CTS (e.g. early HRT).
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