Biomechanical changes after carpal tunnel release: A cadaveric model for comparing open, endoscopic, and step-cut lengthening techniques

Kiritsis, Paul G.; Kline, Samuel C.

doi:10.1016/s0363-5023(05)80003-6

Cited by 44 publications

(15 citation statements)

References 22 publications

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“…Neurological complications of carpal tunnel surgery are frequently related to direct injury of the palmar cutaneous Complications related to tendon translocation have been reported previously (2). Since transverse carpal ligament (TCL) serves as a pulley for the flexor tendons, bowstringing of the flexor tendons or displacement palmarward after division of TCL are well documented (12). This may cause entrapment of the median nerve between the cut edges of TCL and resulted in recurrence of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Ulnar nerve entrapment in guyon's canal due to recurrent carpal tunnel syndrome: case report

Özdemir

Calisaneller²,

Gülşen³

et al. 2010

Turkish Neurosurgery

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Guyon's canal syndrome is a compression neuropathy of the ulnar nerve entrapment at the wrist. Compression of the ulnar nerve at the wrist by a ganglion, lipomas, diseases of the ulnar artery, fractures of the hamate and trauma are common etiologcal factors. Unlike Guyon's canal syndrome, carpal tunnel syndrome (CTS) is the most common nerve entrapment of the upper extremity. Although, open (OCTR) or endoscopic carpal tunnel release (ECTR) is highly effective in relieving pain, failure with carpal tunnel release is seldom seen. In this paper, we presented a patient with ulnar nerve entrapment associated with recurrent CTS and discussed the possible pathomechanism with a review of current literature. KeywOrds: Guyon's canal, Recurrent carpal tunnel syndrome, Ulnar nerve, Median nerve ÖZGuyon kanalı sendromu ulnar, sinirin el bileğindeki basısına bağlı olarak gelişen bir tuzak nöropatisidir. Bası sebepleri arasında ganglion, lipom, ulnar arter hastalıkları, hamat kırıkları ve travma yaygın olarak bulunur. Karpal tünel sendromu ise üst ekstremitelerin en sık izlenen sinir tuzaklanmasıdır. Açık ya da endoskopik olarak yapılan karpal tünel serbestleştirilmesi ağrıyı azaltmada oldukça etkili olsa da, serbestleştirmede başarısız sonuçlar da nadir olarak izlenmektedir. Bu yazıda, rekürren karpal tünel sendromu ile birlikte gelişen bir ulnar sinir tuzaklanmasını sunduk ve olası patomekanizmayı literatür eşliğinde tartıştık.

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Section: Discussionmentioning

confidence: 99%

Ulnar nerve entrapment in guyon's canal due to recurrent carpal tunnel syndrome: case report

Özdemir

Calisaneller²,

Gülşen³

et al. 2010

Turkish Neurosurgery

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“…Biomechanically, the flexor tendons at the wrist are known to displace anteriorly after division of the transverse carpal ligament. [8][9][10] When this ''bowstringing" occurs, the angle of attack of the flexor tendon against the A1 pulley increases, which may cause a greater frictional and compressive force between the flexor tendons and the A1 pulley. 6,[11][12][13] This increased force at the tendon-pulley interface may lead to trigger digit, with deterioration of the boundary lubrication mechanism.…”

Section: Discussionmentioning

confidence: 99%

Carpal tunnel syndrome and development of trigger digit

Hayashi

Uchiyama

Toriumi

et al. 2005

Journal of Clinical Neuroscience

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“…The TCL has many biomechanical functions, including serving as an origin site for the thenar and hypothenar muscles [6, 8, 17, 39], stabilizing the carpal tunnel structure [4, 44, 48], acting as a pulley for the flexor tendons [14, 16], and contributing to carpal tunnel compliance [13, 19, 36]. Clinically, the TCL is closely associated with carpal tunnel syndrome (CTS) which is demonstrated by the ligament’s surgical transection as a common treatment to relieve median nerve compression within the carpal tunnel.…”

Section: Introductionmentioning

confidence: 99%

Thickness and Stiffness Adaptations of the Transverse Carpal Ligament Associated With Carpal Tunnel Syndrome

Marquardt

Gabra

Evans

et al. 2016

J. Musculoskelet. Res.

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The purpose of this study was to investigate the morphological and mechanical properties of the transverse carpal ligament (TCL) in patients with carpal tunnel syndrome (CTS). Thickness and stiffness of the TCL in eight female CTS patients and eight female control subjects were examined using ultrasound imaging modalities. CTS patients had a 30.9% thicker TCL than control subjects. There was no overall difference in TCL stiffness between the two groups, but the radial TCL region was significantly stiffer than the ulnar region within the CTS group and such a regional difference was not found for the controls. The increased thickness and localized stiffness of the TCL for CTS patients may contribute to CTS symptoms due to reduction in carpal tunnel space and compliance. Advancements in ultrasound technology provide a means of understanding CTS mechanisms and quantifying the morphological and mechanical properties of the TCL in vivo.

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Biomechanical changes after carpal tunnel release: A cadaveric model for comparing open, endoscopic, and step-cut lengthening techniques

Cited by 44 publications

References 22 publications

Ulnar nerve entrapment in guyon's canal due to recurrent carpal tunnel syndrome: case report

Ulnar nerve entrapment in guyon's canal due to recurrent carpal tunnel syndrome: case report

Carpal tunnel syndrome and development of trigger digit

Thickness and Stiffness Adaptations of the Transverse Carpal Ligament Associated With Carpal Tunnel Syndrome

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