Transverse Ultrasound Assessment of the Displacement of the Median Nerve in the Carpal Tunnel during Wrist and Finger Motion in Healthy Volunteers

Abstract

Purpose: The purpose of this study was to investigate the displacement of the median nerve in the carpal tunnel during finger motion at varied wrist positions using transverse ultrasound in healthy volunteers, in order to clarify the appropriate position of a wrist splint in treating carpal tunnel syndrome.

Median nerve movement in the carpal tunnel before and after carpal tunnel release using transverse ultrasound

“…3,6,7 In a previous study, we demonstrated the ultrasound technique to evaluate quantitatively the median nerve movement as a coordinate in the carpal tunnel during wrist and finger motion in healthy subjects and patients with CTS. 2,3 Subsequently, we found that at wrist palmar flexion position on the affected side, the median nerve moved statistically significantly the most ulnopalmarly among all wrist positions and became compressed the most strongly against the transverse carpal ligament by the flexor tendons in active finger flexion in patients with CTS. 3…”

“…The ultrasound image acquisition procedure has been described previously. 2,3 Briefly, each patient was seated with the elbow flexed, the forearm supinated, and the shoulder in neutral position. The forearm of the patient was fixed to a custom-made table with the wrist in the neutral position.…”

Transverse Movement of the Median Nerve in the Carpal Tunnel during Wrist and Finger Motion in Patients with Carpal Tunnel Syndrome

“…However, there has been little research detailing the transverse displacement of the median nerve within the carpal tunnel at various wrist positions during finger motion by ultrasound. We have recently described the ultrasound technique to evaluate quantitatively the median nerve movement as a coordinate within the carpal tunnel during wrist and finger motion in limited normal subjects (Nanno et al 2015). In the present study, using this technique, we evaluated the median nerve displacement within the carpal tunnel during wrist and finger motion in CTS patients.…”

“…Recently, several studies reported that the median nerve moves longitudinally and transversely in response to active tendon motion in the carpal tunnel during finger or wrist movement (Nakamichi and Tachibana 1992;Erel et al 2003;Yoshii et al 2009;van Doesburg et al 2010). Additionally, some authors have used transverse ultrasound to evaluate median nerve motion in the carpal tunnel (Yoshii et al 2009(Yoshii et al , 2013van Doesburg et al 2010van Doesburg et al , 2012Wang et al 2014a, b;Nanno et al 2015). With use of this modality, it has previously been determined that the median nerve becomes displaced palmarly and gets compressed against the TCL in active finger flexion in healthy subjects and in patients with CTS (Yoshii et al 2009(Yoshii et al , 2013van Doesburg et al 2012;Wang et al 2014a, b).…”

“…In recent years, several studies have demonstrated that wrist and finger motion could bring substantial movement of the median nerve and the flexor tendons at the wrist (Yoshii et al 2009(Yoshii et al , 2013van Doesburg et al 2010van Doesburg et al , 2012Wang et al 2014a, b;Nanno et al 2015). Additionally, the transverse displacements of the nerve and the tendons within the carpal tunnel have been evaluated during wrist or finger motion (Nakamichi and Tachibana 1992;Erel et al 2003).…”