Postoperative Changes of Carpal Canal Pressure in Carpal Tunnel Syndrome: A Prospective Study with Follow-Up of 1 Year

Abstract

Carpal canal pressures were measured in 103 patients with idiopathic carpal tunnel syndrome, before and after open release, with a postoperative follow-up of 1 year. Twenty-five normal subjects were used as controls. Pressures were measured with the wrists in three positions: neutral, full passive flexion and full passive extension. At each wrist position, the mean pre-operative pressures in the study group were significantly higher than in the control group. In both groups, the pressures were maximal with full passive extension and minimal in the neutral wrist position. Immediately after surgical release, there was a marked decrease of the carpal canal pressures. However, during the second postoperative month, there was a significant increase of the pressures at each wrist position, although these were still within the normal control range. This rise in pressures persisted to 12 months. These findings suggest that the carpal ligament reconstitutes by normal scar formation, but with lengthening such that the volume of the carpal canal is enlarged, so preventing a rise in pressure with return of the pre-operative problem.

Dynamics of Intracarpal Tunnel Pressure in Patients With Carpal Tunnel Syndrome

“…Although the mean intracarpal tunnel pressures for the active hand before ligament division were substantially greater than those reported previously, the mean pressures after ligament division for both the relaxed and active hands were comparable with those previously reported. 1,2,4,5,7,12,25 This significant reduction in intracarpal tunnel pressure supports the hypothesis that considerable contact pressures exist against the deep surface of the TCL before its release.…”

“…1,2,4,5,12,17 However, intracarpal tunnel pressures measured during active hand use were substantially greater than those previously reported. The maximum pressure recorded during MGF was 2500 mm Hg.…”

“…1,2,5,9,[11][12][13][14] One limitation of this study was that we did not measure wrist position. Although each patient was instructed to maintain a neutral wrist position during active hand use and practiced each activity preoperatively while maintaining a neutral wrist position, no measurement of wrist position was recorded.…”

Gliding characteristics of flexor tendon and tenosynovium in carpal tunnel syndrome: A pilot study

“…The underlying disease mechanism for CTS is increased carpal tunnel pressure (Gelberman et al, 1981(Gelberman et al, , 1983Szabo and Chidgey, 1989;Werner et al, 1997;Schuind, 2002;Diao et al, 2005;Sanz et al, 2005).…”

Distal radius kırıklarına genel bakış ve konservatif tedavisi

“…Yukarıda da bahsedildiği gibi, karpal tünel içindeki basınç artışından dolayı el bileğinin aşırı derece fleksiyon pozisyonlanmasından kaçınılmalıdır. [15,25,26] Hafif derecedeki KTS şikayetleri, genellikle medyan sinir etrafındaki şişliğe ve ezilmeye bağlıdır. El ve el bileğinde hatırı sayılır şişlik varsa, tam alçı yerine ateller veya her iki tarafından kesilerek iki ayrı kapak haline getirilmiş alçılar tercih edilir.…”