title: A square-shaped wrist as a predictor of carpal tunnel syndrome: A meta-analysis.
abstract: BACKGROUND
  This meta-analysis aims to assess an association between wrist ratio (wrist thickness/wrist width) and carpal tunnel syndrome (CTS).
  
  
  METHODS
  Sixteen studies qualified for a random-effects meta-analysis.
  
  
  RESULTS
  Mean wrist ratio was higher in individuals with CTS compared with those without CTS [pooled mean difference 0.036, 95% confidence interval (CI) 0.025-0.046]. Pooled odds ratio (OR) of CTS for mean wrist ratio was 4.56 (95% CI 2.97-6.99), and for wrist ratio ≥0.70 vs. <0.70 it was 2.73 (95% CI 1.49-5.01). In addition, the pooled OR for a 1-unit (0.01) increase in wrist ratio was 1.12 (CI 1.09-1.16). The association between wrist ratio and CTS did not differ between men and women. Moreover, there was no evidence of publication bias.
  
  
  CONCLUSIONS
  This meta-analysis suggests that a square-shaped wrist is a predictor for CTS in both men and women. Future studies should explore whether a square-shaped wrist can potentiate the adverse effects of obesity and occupational workloads on CTS.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.
authors.forename: Rahman
authors.initials: R
authors.lastname: Shiri
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000209:etiology; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D014955:Wrist Joint / Q000033:anatomy & histology* / Q000473:pathology
keywords: carpal tunnel syndrome; hand; median nerve; risk factor; wrist