Changes in carpal tunnel pressures following endoscopic carpal tunnel release: a cadaveric study

The Journal of Hand Surgery
E NakaoA K Palmer

Abstract

The purpose of this experiment was to determine the amount of tissue that must be sectioned to adequately decompress the median nerve during an endoscopic carpal tunnel release procedure. In 6 fresh cadaver forearms, 2 balloons were inserted into the carpal tunnel. The first balloon was filled with saline solution to cause an initial carpal intracanal pressure of 50 mmHg. Pressure measurements were recorded, using the second balloon, at various increments of the flexor retinaculum division at 3 wrist positions (neutral, 35 degrees ; flexion, 35 degrees extension). At all increments of sectioning, carpal tunnel pressures in the neutral wrist position were consistently lowest and the values in 35 degrees extension were greatest. At each wrist flexion/extension angle, the pressure statistically decreased during incremental division of the flexor retinaculum. Incomplete release of the transverse carpal ligament resulted in incomplete decompression in the canal. Sectioning the overlying aponeurosis caused a further significant decrease in intracanal pressure.

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Citations

Aug 23, 2005·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·J SanzF Sánchez Del Campo
Sep 3, 2008·The Journal of Hand Surgery·Serdar TüzünerF Erkal Bilen
Dec 4, 2004·The Journal of Hand Surgery·Charles CassidyLeonard K Ruby
Dec 22, 2009·The Journal of Hand Surgery·Ben C Goss, John M Agee
Oct 22, 2009·Journal of Korean Neurosurgical Society·Seong Yeol AhnHee-Jin Yang
Jan 25, 2002·American Journal of Physical Medicine & Rehabilitation·Elif AkalinSema Oncel
Nov 24, 2004·Clinical Orthopaedics and Related Research·Jae-Young LimNam-Jong Paik

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