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Upper Extremity Entrapment Neuropathies in Adults With Arthrogryposis Multiplex Congenita: A National Database Study
Adam Boukind1, Andrea Biaggi-Ondina1, Aidin R T Apte2
1Division of Plastic Surgery, Washington University in St. Louis, St. Louis, Missouri, USA.
Summary
Adults with arthrogryposis multiplex congenita (AMC) have higher rates of upper extremity nerve compression. This includes carpal tunnel and cubital tunnel syndromes, particularly in older adults, necessitating proactive monitoring.
Area of Science:
- Neurology
- Orthopedics
- Rehabilitation Medicine
Background:
- Adults with arthrogryposis multiplex congenita (AMC) face lifelong disability due to joint contractures.
- The risk of upper extremity compressive neuropathies in AMC patients is not well-understood.
Purpose of the Study:
- To evaluate the prevalence and risk of upper extremity entrapment neuropathies in adults with AMC compared to controls.
- To assess the age-specific progression of these neuropathies in the AMC population.
Main Methods:
- Utilized the TriNetX US Collaborative Network to identify 2772 adults with AMC and 100,903,909 controls.
- Compared prevalence ratios (PR) and 95% confidence intervals (CI) for upper extremity entrapment neuropathies.
- Conducted age-stratified analyses across three groups: 18-39, 40-59, and 60-69 years.
Main Results:
- Adults with AMC showed significantly elevated rates of carpal tunnel syndrome (PR 1.84), cubital tunnel syndrome (PR 3.76), and proximal neuropathies (PR 4.77-5.44).
- Electrodiagnostic testing was proportionally less elevated (PR 2.43), suggesting minimal detection bias.
- Age-stratified analyses revealed progressively increasing risk ratios, with the 60-69 age group experiencing the highest prevalence, especially for cubital tunnel syndrome (74.70-fold).
Conclusions:
- AMC confers an elevated and age-progressive risk for compressive neuropathies across the upper extremity.
- Proactive surveillance for nerve compression is warranted in AMC patients to prevent further functional impairment and chronic pain.
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