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The carpal tunnel is a complex structure that can be partitioned into two arches: ligament arch that is formed by transverse carpal ligament, and bone arch that is formed by carpal bones. The abnormalities associated with these arches leads to a reduction in carpal tunnel space available for median nerve, causing entrapment of the nerve which is commonly known as carpal tunnel syndrome. Hence, the examination of individual arches’ space could assist in prognosis of various wrist pathomorphological conditions. Also, the available space for the median nerve during carpal tunnel syndrome can be augmented noninvasively by application of external radioulnar wrist compressive forces. However, little is known about the underlying effects of wrist compressive forces on individual arches’ morphology.The overall goal of this dissertation was to investigate the three-dimensional morphology of ligament and bone arches in normative and manipulated carpal tunnel. Morphological analysis of the normative tunnel revealed that the bone arch occupies more tunnel space than the ligament arch at all regions, but the ligament arch was the key contributor to the unequal carpal tunnel space across regions. Also, the biomechanical manipulation of the wrist in radio-ulnar direction resulted in an increase in ligament arch space and decrease in bone arch space, leading to a decrease in carpal tunnel space across regions. The investigations of these basic science studies advance our knowledge of carpal tunnel morphometry and mechanics. The partitional tunnel morphometric knowledge is valuable in understanding the regional abnormalities in tunnel morphology associated with various wrist pathological conditions. Additionally, due to the delicate positioning of the median nerve beneath the ligament, augmentation of ligament arch space by the non-invasive biomechanical manipulation strategy could potentially decompress the median nerve and relieve symptoms associated with carpal tunnel syndrome. |
