Open AccessEvaluation of Dynamic Carpal Arch Stability following Carpal Tunnel Release Using Four-Dimensional Computed Tomography
Author(s) -
Hiroo Kimura,
Kazuki Sato,
Noboru Matsumura,
Taku Suzuki,
Takuji Iwamoto,
Kuniaki Ohori,
Yoshitake Yamada,
Morio Matsumoto,
Masaya Nakamura,
Masahiro Jinzaki,
Takeo Nagura
Publication year - 2021
Publication title -
journal of hand and microsurgery
Language(s) - English
Resource type - Journals
eISSN - 0974-6897
pISSN - 0974-3227
DOI - 10.1055/s-0040-1718969
Subject(s) - wrist , medicine , carpal tunnel syndrome , carpal tunnel , arch , anatomy , carpal bones , orthodontics , surgery , civil engineering , engineering
This study aimed to assess the carpal arch dynamics during active finger and wrist motion following carpal tunnel release using four-dimensional computed tomography (4D-CT). Materials and Methods Four patients who diagnosed with bilateral carpal tunnel syndrome and underwent unilateral carpal tunnel release were prospectively included. 4D-CT of the bilateral wrists during active finger and wrist motion was performed for 10 seconds at five frames per second. The distances between the tip of tuberosity of the scaphoid and the volar ridge of the pisiform (S-P distance) and volar ridge of trapezium and the tip of hook of hamate (T-H distance) were measured at each position and the values of S-P and T-H distances were compared between the postoperative and contralateral wrists. Results During finger motion, the S-P and T-H distances were not different at any position between the postoperative side and contralateral side. Conversely, S-P and T-H distances gradually increased in the postoperative wrists. The differences between the sides of S-P distance were significant, with >0 degrees of wrist extension, and differences of T-H distance were significant with >15 degrees of wrist extension. Conclusion This study demonstrated the carpal arch dynamics using 4D-CT and revealed that the carpal arch was widened with the wrist in extension after carpal tunnel release. This study suggests that the transverse carpal ligament plays an important role in maintaining carpal arch stability.