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Incidence and Patient-Level Risk Factors for Complex Regional Pain Syndrome Following Cubital Tunnel Surgery
Stephen J Perle1, Nicholas C Bank2, Sarah Conlon2
1The University of North Carolina School of Medicine, Chapel Hill, NC.
Journal of Hand Surgery Global Online
|May 1, 2026
Summary
Complex regional pain syndrome (CRPS) after cubital tunnel surgery is rare, affecting about 0.33% of patients. Female sex and conditions like fibromyalgia are risk factors for developing CRPS.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Neurology
Background:
- Complex regional pain syndrome (CRPS) is a severe complication after upper-extremity surgery.
- The incidence of CRPS following isolated cubital tunnel surgery (CuTS) is not well-defined.
Purpose of the Study:
- To determine the incidence of CRPS types I and II after isolated CuTS.
- To identify patient-specific risk factors associated with CRPS development post-CuTS.
Main Methods:
- Retrospective cohort study utilizing the TriNetX research database.
- Analysis of 9,719 patients undergoing isolated CuTS between 2000 and 2024.
- Calculation of 1-year cumulative incidences and multivariable Cox proportional hazards models.
Main Results:
- The 1-year incidence of CRPS type I was 0.20% and type II was 0.13%.
- Female sex, fibromyalgia, and polyneuropathy were linked to increased CRPS risk.
- Prior nerve injuries and specific surgeries were associated with CRPS subtypes.
Conclusions:
- CRPS following isolated CuTS is rare (approx. 0.33% incidence).
- Identifiable risk factors include female sex, polyneuropathy, fibromyalgia, and prior upper-extremity procedures.
- Findings aid in preoperative counseling and risk stratification for CuTS patients.
