Morphological Analysis of the Transverse Carpal Ligament

Pacek, Corey A.; Chakan, Matthew; Goitz, Robert J.; Kaufmann, Robert A.; Li, Zong Ming

doi:10.1007/s11552-009-9219-2

Cited by 39 publications

(44 citation statements)

References 7 publications

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“…Moreover, it has been shown that the flexor retinaculum progressively thickens from proximal to distal, and it is the thickest distally and ulnarly, although there is also some thickening proximally and radially (Pacek et al, 2010;Goitz et al, 2014). These anatomical features suggest that the pressure within the tunnel should be higher in its distal portion.…”

Section: Discussionmentioning

confidence: 99%

The significance of ultrasonographic carpal tunnel outlet measurements in the diagnosis of carpal tunnel syndrome

Csillik

Bereczki

Bora³

et al. 2016

Clinical Neurophysiology

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). The sponsor had no direct involvement in the collection, analysis and interpretation of data and in the preparation of the manuscript. 2 HIGHLIGHTS Median nerve enlargement in CTS is significantly greater at the tunnel outlet than at the inlet  It is postulated that pressure progressively increases from proximal to distal within the tunnel  The addition of outlet measurements increases diagnostic sensitivity and accuracy of CTS 3 ABSTRACT Objective: A retrospective study to investigate the utility of ultrasonographic carpal tunnel outlet measurements in the diagnosis of carpal tunnel syndrome (CTS).Methods: 118 hands of 87 patients with electrophysiologically confirmed CTS and 44 control hands of 23 subjects were assessed. Cross-sectional areas (CSA) of the median nerve were measured at the tunnel inlet, outlet, and forearm. Longitudinal diameters (LAPD) were measured at the inlet, proximal tunnel, distal tunnel, and outlet.Results: CSA at the outlet (median: 18 mm 2 ) and its palm-to-forearm-ratio (median: 2.7) were significantly larger than CSA at the inlet (median: 15 mm 2 ) and its wrist-to-forearm-ratio (median: 2.2) (p <0.001). 27% of the hands showed enlargement only at the outlet versus 13% only at the inlet.LAPD jump was significantly greater, suggesting relief of higher pressure, at the outlet / distal tunnel versus inlet / proximal tunnel (p <0.001). Conclusion:Median nerve enlargement in CTS is greater at the tunnel outlet than at the inlet. We postulate that this is explained by the progressive increase of pressure within the tunnel from proximal to distal.Significance: The addition of outlet measurements to inlet measurements increased sensitivity and accuracy of the ultrasonographic diagnosis of CTS by 15% and 10%, respectively.

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Section: Discussionmentioning

confidence: 99%

The significance of ultrasonographic carpal tunnel outlet measurements in the diagnosis of carpal tunnel syndrome

Csillik

Bereczki

Bora³

et al. 2016

Clinical Neurophysiology

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“…Following informed consent, the patient underwent right carpal tunnel release. Intra-operatively, an hourglass-shaped compression at the proximal portion of the carpal tunnel was noted, as was a thickened transverse carpal ligament of 3-4 mm [15]. No gross abnormalities of the median nerve were noted.…”

Section: Journal Of Aesthetic and Reconstructive Surgery Issn 2472-1905mentioning

confidence: 95%

“…Bilateral carpal tunnel releases (CTR) were performed without complications. Intra-operatively, the transverse carpal ligament measured approximately 3.0 mm at its thickest point bilaterally [15]. No abnormalities of the median nerve were appreciated.…”

Section: Journal Of Aesthetic and Reconstructive Surgery Issn 2472-1905mentioning

confidence: 96%

Primary Familial Carpal Tunnel Syndrome with Long-term Followup: A Study of Two Families and Review of the Literature

Cantwell¹,

Batdorf²

2016

J Aesthet Reconstr Surg

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“…Based on the classification of Amadio, Beris et al found that of 110 patients who had undergone open surgical carpal tunnel release, 11 had variations of the median nerve at the wrist [9]. The transverse carpal ligament anatomy is also varied, although no correlation between wrist circumference and actual dimensions of the transverse ligament was demonstrated [10]. pa cjen tów nie ty po wy prze bieg ner wu po środ ko we go na po zio mie nad garst ka [9].…”

Section: Introductionmentioning

confidence: 99%

“…pa cjen tów nie ty po wy prze bieg ner wu po środ ko we go na po zio mie nad garst ka [9]. Zró żni co wa na jest rów -nież ana to micz na bu do wa wię za dła po przecz ne go nad garst ka, lecz nie wy ka za no ko re la cji po mię dzy ob wo dem nad garst ka a rze czy wi sty mi wy mia ra mi wię za dła po przecz ne go [10].…”

Section: Introductionunclassified

Effectiveness of Carpal Tunnel Syndrome Rehabilitation after Endoscopic Versus Open Surgical Release

Chmielewska

Skęczek-Urbaniak

Kubacki

et al. 2013

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Ze spół ka na łu nad garst ka (zkn) jest czę stą po sta cią neu ro pa tii uci sko wej koń czy ny gór nej. Re ha bi li ta cja po ope ra cji zkn po pra wia spraw ność rę ki. Ce lem pra cy by ła oce na wpły wu re ha bi li ta cji u pa cjen tów po ope ra cyj nym le cze niu ze spo łu ka na łu nad garst ka (zkn) i po rów na nie me to dy en do sko po wej z otwar tą.Ma te riał i me to dy. Ze wzglę du na tech ni kę prze pro wa dzo nej ope ra cji, 26 pa cjen tów po dzie lo no na dwie gru py: E (en do sko pia) i K (tech ni ka otwar ta). Oce nia no zmia ny pod wpły wem re ha bi li ta cji ta kich pa ra me trów jak: czu cie dwu punk to we opu szek pal ców ope ro wa nej rę ki, za kre sy ru chów sta wów rę ki, ob wo dy sta wów nad garst ko wo -promie nio we go i śród ręcz no -pa licz ko wych, na si le nie do le gli wo ści bó lo wych oraz na tę że nie do znań su biek tyw nych zwią za nych z zkn.Wy ni ki. Gru py ró żni ły się po mię dzy so bą pod wzglę dem na si le nia do znań su biek tyw nych -drę twie nie, cierpnię cie, śred nich war to ści ob wo dów oraz za kre su czu cia opusz ków pal ców I -IV. Śred nie w/w pa ra me trów w gru pie K by ły istot nie wy ższe niż w gru pie E. U pa cjen tów w gru pie E re ha bi li ta cja przy nio sła po pra wę wy ra żo ną zmniejsze niem do le gli wo ści bó lo wych i su biek tyw nych do znań, zwięk sze nie ru cho mo ści w sta wach rę ki i po wrót czu cia dwu punk to we go w pal cach I -IV. W gru pie K naj więk sze zmia ny do ty czy ły ru cho mo ści w sta wach rę ki. Na si le nie do le gli wo ści bó lo wych ule gło ob ni że niu, lecz nie istot nie sta ty stycz nie. Czu cie dwu punk to we wy raź nie się po pra wiło, lecz war to ści śred nie od le gło ści po mię dzy ra mio na mi cyr kla We be ra dla po szcze gól nych pal ców wska zy wa ły nadal na ob ni że nie zdol no ści dys kry mi na cji czu cia.Wnio ski. 1. Prze pro wa dzo na re ha bi li ta cja przy nio sła wy raź ną po pra wę funk cjo no wa nia rę ki u pa cjen tów w grupach ró żnią cych się tech ni kę ope ra cyj ną uwol nie nia ner wu po środ ko we go. 2. Efek tem re ha bi li ta cji by ła po pra wa gę -sto ści uner wie nia wy ra żo na zmia na mi czu cia dwu punk to we go opu szek pal ców ope ro wa nej rę ki w obu gru pach. 3. Więk szy po stęp le cze nia uzy ska no u pa cjen tów ope ro wa nych tech ni ką en do sko po wą. Material and methods. Twenty-six patients were divided into endoscopy (E) and open surgery (K) groups. The following parameters were assessed after rehabilitation: two-point discrimination by fingertips of the operated hand, ranges of motion of joints of the hand, circumferences of the radiocarpal and metacarpo pha langeal joints and the severity of pain and other symptoms.Results. The groups differed regarding the severity of symptoms (numbness), joint circumferences and tactile sensation in fingertips I-IV. The mean values of these parameters were significantly higher in group K compared to group E. In group E, rehabilitation decreased severity of pain and other symptoms and increased the ranges of motion. Rec...

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Morphological Analysis of the Transverse Carpal Ligament

Cited by 39 publications

References 7 publications

The significance of ultrasonographic carpal tunnel outlet measurements in the diagnosis of carpal tunnel syndrome

The significance of ultrasonographic carpal tunnel outlet measurements in the diagnosis of carpal tunnel syndrome

Primary Familial Carpal Tunnel Syndrome with Long-term Followup: A Study of Two Families and Review of the Literature

Effectiveness of Carpal Tunnel Syndrome Rehabilitation after Endoscopic Versus Open Surgical Release

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