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J Hand Microsurg 2021; 13(03): 138-142
DOI: 10.1055/s-0040-1718969
Original Article

Evaluation of Dynamic Carpal Arch Stability following Carpal Tunnel Release Using Four-Dimensional Computed Tomography

Hiroo Kimura 
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Kazuki Sato
2   Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
,
Noboru Matsumura
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Taku Suzuki
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Takuji Iwamoto
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Kuniaki Ohori
3   Department of Radiology, Keio University School of Medicine, Tokyo, Japan
,
Yoshitake Yamada
3   Department of Radiology, Keio University School of Medicine, Tokyo, Japan
,
Morio Matsumoto
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Masaya Nakamura
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Masahiro Jinzaki
3   Department of Radiology, Keio University School of Medicine, Tokyo, Japan
,
Takeo Nagura
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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Abstract

Introduction 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.

Keywords

carpal tunnel syndrome - carpal tunnel release - computed tomography - 4D-CT


Publication History

Article published online:
19 November 2020

© 2020. Society of Indian Hand & Microsurgeons. All rights reserved. Thieme Medical and Scientific Publishers Pvt. Ltd., A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

Thieme Medical and Scientific Publishers Pvt. Ltd.
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