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oai:figshare.com:article/34054047 2026-10-02T04:42:01Z category_323 portal_316 item_type_3 month_year_10_2026

Table 3_Tophaceous gout-related carpal tunnel syndrome and flexor tendon involvement: a systematic review.xlsx Ali Can Günenç (25162149) Mehmet Şefik Oruç (25162152) Surgery carpal tunnel syndrome flexor tendon gout median nerve compression systematic review tenosynovitis tophaceous gout Background<p>Tophaceous gout is an uncommon but clinically important cause of secondary carpal tunnel syndrome (CTS), with lesions ranging from diffuse flexor tenosynovitis to intratendinous destruction and direct median nerve involvement.</p>Methods<p>PubMed/MEDLINE, Scopus, and Web of Science Core Collection were searched through 23 July 2026, supplemented by Google Scholar, publisher-page verification, and citation searching. Human primary reports explicitly attributing CTS or wrist-level median neuropathy to gout, tophus, or monosodium urate deposition were eligible. Two reviewers independently screened records. Fifty-seven reports (27 complete/detailed and 30 limited clinical sources) formed the primary synthesis and underwent design-appropriate Joanna Briggs Institute appraisal; 12 bibliographic or translation-limited reports were retained as historical ancillary evidence. Primary reports were additionally classified post hoc by causal certainty.</p>Results<p>Of 478 database records, 302 unique records were screened, and 69 canonical reports were included. The 57-report primary synthesis comprised 44 case reports or clinical-image reports, 12 case series, and one nonrandomized comparative study, representing at least 120 patients, 152 CTS wrists, and 146 gout-attributable wrists. Sex was reportable for 117 patients, of whom 111 (94.9%) were male. Causal certainty was Tier 1 (direct local confirmation) in 41 reports, Tier 2 (anatomically supported) in 5, and Tier 3 (explicit report-level attribution) in 11. Post hoc sensitivity analyses retaining Tier 1 + 2 (n = 46) and then Tier 1 only (n = 41) did not change the principal qualitative interpretations. Open decompression with lesion treatment was the most frequently reported operative pattern, but evidence remained insufficient to determine a preferred tendon procedure. JBI findings are reported by design; 481 item-level judgments are retained only as an audit total.</p>Conclusion<p>Gout should be considered in atypical, acute, severe, recurrent, bilateral, or mass-associated CTS. In surgically treated reports, decompression was commonly combined with individualized management of tophaceous and tendon disease. The evidence is predominantly case-based and hypothesis-generating and is insufficient to define a validated treatment pathway or preferred tendon procedure.</p> 2026-10-02T04:42:01Z Dataset Dataset 10.3389/fsurg.2026.1948883.s002 https://figshare.com/articles/dataset/Table_3_Tophaceous_gout-related_carpal_tunnel_syndrome_and_flexor_tendon_involvement_a_systematic_review_xlsx/34054047 CC BY 4.0