Establishment of carpal contents/canal ratio by means of magnetic resonance imaging

Cobb, Tyson K.; Dalley, Bernell K.; Posteraro, Robert H.; Lewis, Royce C.

doi:10.1016/0363-5023(92)90454-w

Cited by 39 publications

(19 citation statements)

References 8 publications

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“…The narrowest point of the carpal tunnel has previously been identified by MRI to be at the level of the hook of the hamate [3,5,7,9,14], but this has been questioned through more recent MRI studies [2]. We find that neither the width, nor depth, nor cross-sectional area changes significantly along the length of the carpal tunnel.…”

Section: Discussioncontrasting

confidence: 53%

“…The cross-sectional area was 134.9 ± 23.6 mm 2 . The volume of the defined carpal tunnel was 1,737±542 mm 3 . .687) included only palm width, as once the variance accounted for by this variable was removed, the remaining variance attributed to the other variables (wrist width, depth, circumference, and palm circumference) became non-significant.…”

Section: Resultsmentioning

confidence: 97%

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Morphological Analysis of the Carpal Tunnel

Pacek

Tang

Goitz

et al. 2009

Hand (New York, N,Y.)

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Although carpal tunnel release is one of the most commonly performed procedures in the USA, the morphology of the carpal tunnel as determined previously in the literature has been questioned. Previous methodology has been questioned for accuracy by recent studies. The purpose of this study was to perform a morphological analysis of the carpal tunnel and correlate carpal tunnel and hand dimensions. The carpal tunnels of ten cadaveric specimens were emptied of their contents and a silicone cast of the carpal tunnel was then created. This cast was then digitized, and the dimensions of the carpal tunnel were calculated. These dimensions were compared with the measured hand dimensions of the specimens. The width, depth, tilt angle, length, cross-sectional area, and volume of the carpal tunnel were 19.2 ± 1.7 mm, 8.3 ± 0.9 mm, 14.8 ± 7.8°, 12.7 ± 2.5 mm, 134.9 ± 23.6 mm 2 , and 1,737 ± 542 mm 3 , respectively. Width, depth, and cross-sectional area did not change significantly along the length of the carpal tunnel, but tilt angle did. The width of the palm strongly correlates with the width of the carpal tunnel. Other dimensional correlations did not reach statistical significance. The carpal tunnel is of uniform dimension along its length. The long axis of the carpal tunnel in cross-section rotates volarly from the radial side of the hand increasingly with distal progression along the carpal tunnel. Based on our analysis of ten cadaveric specimens, the width of the carpal tunnel may be estimated by the width of the palm using the equation: Width CT ¼ 1:285 þ 0:236 Â Width palm .

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Section: Discussioncontrasting

confidence: 53%

Section: Resultsmentioning

confidence: 97%

Morphological Analysis of the Carpal Tunnel

Pacek

Tang

Goitz

et al. 2009

Hand (New York, N,Y.)

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“…A study by Cobb et al (1994) indicates that lumbricals incursion into the carpal tunnel during flexion is a normal occurrence. Another study by Cobb et al (1992) found a great deal of variation in the mass of lumbricals. Their findings suggest that hypertrophied or longer lumbricals would pass further into the tunnel during lumbrical incursion.…”

Section: Discussionmentioning

confidence: 96%

Coexistence of multiple anomalies in the carpal tunnel

et al. 2005

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We determined the frequency of anomalous structures within the carpal tunnels of 89 cadaveric forearm-hand specimens. We also examined these same specimens for variations in the branching pattern of the median nerve, and analyzed the range in length and width of the lumbricals. Many of the hands contained extra tendinous slips from the long flexors within the tunnel, subligamentous thenar branches of the median nerve, or lumbricals with bipennate origins. Only one hand had an anomalous muscle belly within the tunnel, two had persistent median arteries, two had high division of the median nerve in the distal forearm, and eight had lumbricals with lengths or widths that were greater or less than 2 standard deviations (SD) from the mean. Twenty-nine percent of all hands examined had two to five anomalies/variations per tunnel, whereas another 27% had one anomaly or variation per tunnel. More right hands (17%) than left (11%) contained two to five anomalous/variant structures per carpal tunnel. More right hands (19%) than left (8%) contained only one variant/anomalous structure per carpal tunnel. Anticipation of the frequency and multiplicity of anomalous structures and variations within this region is of importance to clinicians, particularly surgeons.

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“…Cobb et al examined carpal tunnel contents to carpal tunnel volume ratios. They showed that there is a mass-volume inequity in the carpal canal of patients with carpal tunnel syndrome (Cobb et al, 1992(Cobb et al, , 1997. This inequity, which is caused by either a decrease in the volume of the carpal canal or an increase in the volume of its contents, is commonly corrected with surgery to release the flexor retinaculum.…”

Section: Discussionmentioning

confidence: 99%

Carpal Tunnel Volume Changes of the Wrist Under Distraction

Cho

Means

Shrout

et al. 2008

J Hand Surg Eur Vol

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This study attempts to determine changes in carpal canal volume with distraction across the wrist. Uniform longitudinal distraction was maintained with two external fixators on the radial and ulnar aspects of the forearm axis of five cadaver specimens. After CT scanning, volume determinations were made at 5 mm increments beginning at the lunocapitate joint to a point 1.5 cm distal to the middle finger carpometacarpal joint. There was a statistically significant decrease of the mean total carpal canal volume from 0 to 4.54 kg of distraction, with no statistically significant decrease from 0 to 2.27 kg or 2.27 to 4.54 kg. The largest decrease occurred at 15 and 20 mm distal to the proximal edge of the transverse carpal ligament corresponding to the level of the hamate hook. Reduction in mean carpal canal volume was 10.2% and 7.5% at these distances, respectively, from 0 to 4.54 kg of distraction. Progressive distraction across the wrist causes a decrease in total carpal canal volume.

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Establishment of carpal contents/canal ratio by means of magnetic resonance imaging

Cited by 39 publications

References 8 publications

Morphological Analysis of the Carpal Tunnel

Morphological Analysis of the Carpal Tunnel

Coexistence of multiple anomalies in the carpal tunnel

Carpal Tunnel Volume Changes of the Wrist Under Distraction

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