Carpal canal pressure of the distracted wrist

Single-Incision Extensile Volar Approach to the Distal Radius and Concurrent Carpal Tunnel Release: Cadaveric Study

“…First, the carpal tunnel pressure measurements and the procedures were performed on cadaveric specimens. Although these specimens were fresh and the generation of increased carpal tunnel pressures via this cadaveric model has been well established, 19,20 it is unknown whether similar results would be obtained in the clinical setting owing to the inherent differences in behavior between living and nonliving tissue. Second, our study used a small sample size.…”

“…Both Baechler et al and Means et al demonstrated that increasing distraction forces across the carpus predictably increase carpal tunnel pressure in a linear fashion 19,20 to levels associated with carpal tunnel syndrome. 12 Five pairs of cadaveric forearms were harvested by disarticulation at the elbow.…”

Radiographic Parameters of Increased Carpal Tunnel Pressure With Progressive Wrist Distraction: A Cadaveric Study

“…The measurement method for carpal tunnel pressure has been reported previously. 10 A commercially available plastic finger trap was sutured into position on the middle finger of the hand. The carpal canal was entered sharply with a beveled hollow metal tube angled 45°and in line with the radial aspect of the ring finger at the level of the wrist flexion crease.…”

“…9 Increased carpal canal pressure and its association with adverse effects on nerve function is a concern with wrist distraction. 10 In a study with healthy volunteers Gelberman et al 11 found some loss of median nerve function at a carpal canal pressure of 40 mm Hg and complete blocking of sensory and motor function of the median nerve at a carpal canal pressure of 50 mm Hg. In a recent cadaveric study Baechler et al 10 found significant increases in carpal canal pressure with increasing distraction across the wrist joint.…”

Nonbridging External Fixation of Intra-Articular Distal Radius Fractures

“…Distraction, flexion, and locked ulnar deviation of the external fixator encourage pronation contractures. Distraction also increases the carpal canal pressure [10], which may predispose to acute carpal tunnel syndrome.…”