Release of the Transverse Carpal Ligament Alone Is Associated With Elevated Pressure Beneath the Distal Volar Forearm Fascia in a Cadaver Model of Carpal Tunnel Syndrome

Means, Kenneth R.; Parks, Brent G.; Lee, Steve K.; Segalman, Keith A.

doi:10.1016/j.jhsa.2007.08.020

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Pensy¹,

Brunton²,

Parks³

et al. 2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Methodsmentioning

confidence: 98%

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

Pensy¹,

Brunton²,

Parks³

et al. 2010

The Journal of Hand Surgery

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“…Once the skin is incised, the palmar fascia is released longitudinally, again along a line that courses just ulnar to the palmaris longus or just radial to the hamate hook. Some surgeons release the forearm fascia proximal to the level of the distal volar wrist crease, either with an extension of the skin incision proximally or with subcutaneous release 29 . If the surgeon extends the skin incision proximally, he or she should make a z-type extension or at least extend at an oblique angle at the level of the distal wrist crease to avoid a longitudinal scar, which could lead to a flexion contracture.…”

Section: Treatmentmentioning

confidence: 99%

Endoscopic Compared with Open Operative Treatment of Carpal Tunnel Syndrome

2016

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Carpal tunnel syndrome is the most common peripheral nerve compression syndrome. Treatment options include wrist-neutral bracing, corticosteroid injections, operative release of the transverse carpal ligament, and symptom-relief options. Endoscopic carpal tunnel release may give patients a faster recovery compared with traditional open release, but there are no ultimate differences in outcome among the various surgical options.

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“…In these studies the pressure in and around the fibular tunnel would be measured-using a pressure sensorin fresh cadavers, healthy volunteers, and patients suffering from fibular tunnel syndrome (Sato et al, 1999;Means et al, 2007). If our hypothesis is confirmed, management of CFN affection in and around the fibular tunnel must take into consideration the innate protective mechanisms of the nerve.…”

Section: Discussionmentioning

confidence: 99%

Protective mechanisms of the common fibular nerve in and around the fibular tunnel: A new concept

Gharbawy

Skandalakis

2009

Clinical Anatomy

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The most frequent site at which the common fibular nerve is affected by compression, trauma, traction, masses, and surgery is within and around the fibular tunnel. The aim of this study was to determine whether there were protective mechanisms at this site that guard against compression of the nerve. Twenty-six lower limbs of 13 preserved adult cadavers (11 males and two females) were used. Proximal to the entrance of the tunnel, three anatomical configurations seemed to afford the required protection for the nerve: reinforcement of the deep fascia; tethering of the common fibular nerve to both the tendon of the biceps femoris and the reinforced fascia; and the particular arrangement of the deep fascia, fibular head, and soleus and gastrocnemius muscles. At the entrance of the tunnel, contraction of the first segment of fibularis longus muscle could afford the required protection. In the tunnel, contraction of the second and third segments of fibularis longus muscle could guard against compression of the nerve. The tough fascia on the surface of fibularis longus muscle and the fascial band within it, which have long been accused of compression of the nerve, may actually be elements of the protective mechanisms. We conclude that there are innate, anatomical protective mechanisms which should be taken into consideration when decompressing the common fibular nerve. To preserve these mechanisms whenever possible, the technique should be planned and varied according to the underlying etiology.

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Release of the Transverse Carpal Ligament Alone Is Associated With Elevated Pressure Beneath the Distal Volar Forearm Fascia in a Cadaver Model of Carpal Tunnel Syndrome

Cited by 10 publications

References 17 publications

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

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

Endoscopic Compared with Open Operative Treatment of Carpal Tunnel Syndrome

Protective mechanisms of the common fibular nerve in and around the fibular tunnel: A new concept

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