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The effect of wrist position on the relative motion of tendon, nerve, and subsynovial connective tissue within the carpal tunnel in a human cadaver model
Author(s) -
Yoshii Yuichi,
Zhao Chunfeng,
Zhao Kristin D.,
Zobitz Mark E.,
An KaiNan,
Amadio Peter C.
Publication year - 2008
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20640
Subject(s) - wrist , tendon , anatomy , retinaculum , medicine , cadaver , carpal tunnel , carpal tunnel syndrome , median nerve , connective tissue , range of motion , surgery , pathology
The purpose of this study was to measure the effect of wrist position on the relative motion of the middle finger flexor digitorum superficialis (FDS) tendon, subsynovial connective tissue (SSCT), median nerve, and flexor retinaculum during simulated active finger motion. The relative motion of each tissue was measured by fluoroscopy in 10 human cadavers. Measurements were obtained for wrist positions of neutral (0 degree extension), 30 and 60 degrees of flexion, and 30 and 60 degrees of extension. The shear strain index (SSI) was defined as the difference in motion between two tissues (tendon, SSCT, or nerve) divided by tendon excursion, expressed as a percentage. The motion of the tendon, SSCT, and nerve in the 60 degree flexed position was significantly less than the motion in all other wrist positions ( p < 0.001). The SSI at 60 degrees of flexion for tendon–SSCT and tendon–nerve were significantly increased compared with all other positions ( p < 0.001). Because the SSCT and tendon are physically connected, a decrease in SSCT motion relative to the tendon would increase the shear strain on the SSCT with tendon motion. Thus, this result suggests that the SSCT may be predisposed to shear injury from activity done in 60 degrees of wrist flexion. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1153–1158, 2008