Transverse Carpal Ligament: Its Effect on Flexor Tendon Excursion, Morphologic Changes of the Carpal Canal, and on Pinch and Grip Strengths after Open Carpal Tunnel Release
| Autor: | Michael Lee, David T. Netscher, Ali M. Mosharrafa, Anna Kay Steadman, Charles Polsen, John Thornby, Haesun Choi |
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| Rok vydání: | 1997 |
| Předmět: |
musculoskeletal diseases
business.industry Anatomy Pinch Strength musculoskeletal system medicine.disease Median nerve nervous system diseases Tendon body regions Palmar aponeurosis medicine.anatomical_structure Cadaver Hand strength Ligament medicine Surgery Carpal tunnel syndrome business human activities |
| Zdroj: | Plastic & Reconstructive Surgery. 100:636-642 |
| ISSN: | 0032-1052 |
| Popis: | A three-part study is described that examines postoperative weakness after open carpal tunnel release and investigates the role of the transverse carpal ligament in the digital flexor pulley system. The effect of this ligament on flexor tendon excursion is evaluated in a cadaver study. Magnetic resonance imaging analysis is used to determine whether division of the transverse carpal ligament promotes volar migration of the median nerve and flexor tendons. Finally, the effects of ligament division and various methods of transverse carpal ligament reconstruction on the return of grip and pinch strengths after open carpal tunnel release are evaluated. The authors were able to determine that transverse carpal ligament reconstruction, particularly the transposition flap repair technique, after open carpal tunnel release confers a mechanical advantage and that the transverse carpal ligament is an important pulley for flexor tendon excursion. Based on the magnetic resonance imaging studies, volar displacement of carpal contents is reduced in patients undergoing transverse carpal ligament reconstruction by means of a transposition flap compared with those undergoing no ligament reconstruction and those undergoing reconstruction using the palmar aponeurosis. Postoperative grip and pinch strength values for the transposition flap repair group surpassed those of the other two groups at 12 weeks. |
| Databáze: | OpenAIRE |
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