Explant Culture, Immunofluorescence and Electron-Microscopic Study of Flexor Retinaculum in Carpal Tunnel Syndrome

Allampallam, Krishnan; Chakraborty, J.; Bose, Kallol K.; Robinson, John J.

doi:10.1097/00043764-199603000-00011

Cited by 19 publications

(13 citation statements)

References 9 publications

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“…There are inconsistencies regarding whether or not thickening of the TCL occurs in CTS patients with some studies noting evident thickening [7, 11, 26] and others indicating no change in ligament thickness [35, 43]. Additionally, examinations of TCL samples from CTS patients have shown that some patients exhibit fibrosis [34] or cellular changes [1] within the ligament, but these findings have not been consistently confirmed [20, 31]. The current study is motivated, in large part, by such observations of TCL changes being anecdotal in nature and requiring invasive methodologies, with few studies quantitatively examining morphological and mechanical differences of the TCL among CTS patients and controls.…”

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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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.

View full text Add to dashboard Cite

show abstract

“…Imaging studies have shown that the TCLs were thickened in individuals with carpal tunnel syndrome [3]. In addition, TCLs associated with carpal tunnel syndrome have been shown to exhibit mucoid change, amyloid deposits, inflammation, fibrocartilagenous metaplasia, and faster growth of contractile cells [4,5], which may alter the mechanical properties of the ligament and create an adverse mechanical environment responsible for compression neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Carpal Tunnel Expansion by Palmarly Directed Forces to the Transverse Carpal Ligament

Tang

Chakan

et al. 2009

Journal of Biomechanical Engineering

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This study investigated the expansion of the carpal tunnel resulting from the application of palmarly directed forces to the transverse carpal ligament (TCL) from inside the carpal tunnel. Ten fresh-frozen cadaveric hands were dissected to evacuate the carpal tunnel and thus to expose the TCL. A custom lever device was built to apply forces, ranging from 10 to 200 N, to the TCL. Without force application, the carpal tunnel area was 148.4 ± 36.8 mm2. The force application caused the TCL to form arches with an increase in cross-sectional areas of 33.3 ± 5.6 mm2 at 10 N and 48.7 ± 11.4 mm2 at 200 N, representing respective increases of 22.4% and 32.8% relative to the initial carpal tunnel area. The TCL length remained constant under the applied forces. It was found that the TCL arch formation was due to the narrowing of the arch width, which resulted from the migration of the bony insertion sites of the TCL. A geometrical model of the carpal tunnel was then developed to elucidate the relationships among the arch width, TCL length, arch height, and arch area. The model illustrated the effectiveness of carpal tunnel expansion by TCL elongation or arch width narrowing.

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“…The transverse carpal ligament associated with carpal tunnel syndrome has been shown to have mucoid change, amyloid deposits, inflammation, fibrocartilagenous metaplasia, faster growth of contractile cells, and altered morphology. 1,15 Eighth, mechanical compression through physical contact between the transverse carpal ligament and the median nerve causes nerve damage. 2 To date, little is known about the mechanical properties of the carpal tunnel.…”

Section: Introductionmentioning

confidence: 99%

Gender Difference in Carpal Tunnel Compliance

2005

J. Musculoskelet. Res.

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The purposes of this study were to investigate the mechanical properties of the carpal tunnel and to examine carpal tunnel compliance as it related to gender difference. Twelve male and twelve female subjects without any neuromusculoskeletal disorders in the upper extremities participated in the study. Indentation testing was manually performed on the wrist volar to the transverse carpal ligament. Effective compliance was defined as the slope of the regression analyses of indentation force and displacement data. In the tested indentation force range (2.45-19.60 N), the displacement of females was 1.38 ± 0.25 mm, significantly smaller than that of the males, 1.82 ± 0.30 mm ( p < 0.001). Regression analyses in the force range showed that the effective compliance for females, 0.075 ± 0.012 mm/N, was 26.3% lower than that for males, 0.101 ± 0.018 mm/N (p < 0.005). It was concluded that females have less compliant carpal tunnel than males. The gender difference in carpal tunnel mechanics may predispose females to detrimental compression of the median nerve and carpal tunnel syndrome. 153 J. Musculoskelet. Res. 2005.09:153-159. Downloaded from www.worldscientific.com by NANYANG TECHNOLOGICAL UNIVERSITY on 08/24/15. For personal use only.

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Explant Culture, Immunofluorescence and Electron-Microscopic Study of Flexor Retinaculum in Carpal Tunnel Syndrome

Cited by 19 publications

References 9 publications

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

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

Carpal Tunnel Expansion by Palmarly Directed Forces to the Transverse Carpal Ligament

Gender Difference in Carpal Tunnel Compliance

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