Effects of slight flexion-extension and radial-ulnar deviation postures on carpal tunnel volume

Anderson, Drew A.; Agur, Anne; Oliver, Michele; Gordon, Karen D.

doi:10.1016/j.clinbiomech.2022.105575

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…Analysis was performed on a computed tomography dataset of ten cadaveric specimens, (5 male, 5 female, mean age = 80.7 ± 10.9 years) [ 8 ]. The specimens were procured from Science Care Inc. (Phoenix, AZ, USA) where consent was obtained from the donors.…”

Section: Methodsmentioning

confidence: 99%

“…Precise FE and RUD angles of each posture were measured using inertia-based coordinate systems of the third metacarpal and the distal portion of the radius captured in the scan [ 15 ]. Three-dimensional carpal tunnel surface meshes with proximal and distal boundaries were generated for each scan based on previously described methods using anatomical landmarks of the transverse carpal ligament (TCL) [ 8 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Specimen was included as a categorical factor to account for anatomical variability between specimens. Scan order was included as a factor for the volume, CSA, width, and depth measures since the scans were collected in the same order for each specimen, and scan order was found to be a significant factor in a previous analysis of CTV [ 8 ]. Quartile was assessed as a main effect along with the first (linear) and second order (quadratic) effects of FE and RUD angle (FE, RUD, FE 2 , and RUD 2 ).…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies reported CTV to decrease with 30° of wrist flexion and extension relative to neutral posture [ 5 – 7 ]. However, a recent analysis focused on slight deviations from neutral wrist posture found that CTV did not significantly change over ± 20° range of flexion-extension (FE) [ 8 ]. Interestingly, a significant CTV decrease was observed between –5° and 15° of radial-ulnar deviation (RUD) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, a recent analysis focused on slight deviations from neutral wrist posture found that CTV did not significantly change over ± 20° range of flexion-extension (FE) [ 8 ]. Interestingly, a significant CTV decrease was observed between –5° and 15° of radial-ulnar deviation (RUD) [ 8 ]. Radial-ulnar deviation has been less studied with respect to CTV changes, with the focus on flexion and extension potentially due to patient reported symptoms or an emphasis on wrist FE in ergonomic assessment.…”

Section: Introductionmentioning

confidence: 99%

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Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures

2022

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Non-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with ±20° flexion-extension (FE), however, CTV decreased with ulnar deviation over the range of -5° to 15° radial-ulnar deviation (RUD). These findings suggest CTV may be too coarse of a measure to reflect the effects of slight non-neutral postures, or that volume is conserved and redistributed due to changes in tunnel morphology with posture. The objective of this study was to assess volume distribution along the length of the carpal tunnel and to quantify regional morphology changes with deviated wrist postures in both FE and RUD. Analysis was performed on a dataset of computed tomography scans collected on ten cadaveric specimens (5 male, 5 female, mean age = 80.7 ± 10.9 years) over a range of FE and RUD postures. The carpal tunnel of each scan was divided into four quartiles of equal length along the tunnel to quantify volume distribution. Volume within the carpal tunnel was seen to redistribute with both FE and RUD. Decreased volume in the distal aspect of the tunnel with flexion and proximal aspect of the tunnel with ulnar deviation may contribute to localized compression of the medial nerve. Measures of mean cross-sectional area, width and depth by quartile provided an indication of the morphology changes associated volume redistribution. Morphology analysis also revealed twisting between the proximal and distal aspects of the tunnel which increased with flexion and ulnar deviation and may further contribute to strain on the median nerve.

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Section: Methodsmentioning

confidence: 99%