Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.

Non-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with ±20° flexion-extension (FE), however, CTV decreased with ulnar deviatio...

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Main Authors: Drew A Anderson, Michele L Oliver, Karen D Gordon
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0277234
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author Drew A Anderson
Michele L Oliver
Karen D Gordon
author_facet Drew A Anderson
Michele L Oliver
Karen D Gordon
author_sort Drew A Anderson
collection DOAJ
description Non-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with ±20° flexion-extension (FE), however, CTV decreased with ulnar deviation over the range of -5° to 15° radial-ulnar deviation (RUD). These findings suggest CTV may be too coarse of a measure to reflect the effects of slight non-neutral postures, or that volume is conserved and redistributed due to changes in tunnel morphology with posture. The objective of this study was to assess volume distribution along the length of the carpal tunnel and to quantify regional morphology changes with deviated wrist postures in both FE and RUD. Analysis was performed on a dataset of computed tomography scans collected on ten cadaveric specimens (5 male, 5 female, mean age = 80.7 ± 10.9 years) over a range of FE and RUD postures. The carpal tunnel of each scan was divided into four quartiles of equal length along the tunnel to quantify volume distribution. Volume within the carpal tunnel was seen to redistribute with both FE and RUD. Decreased volume in the distal aspect of the tunnel with flexion and proximal aspect of the tunnel with ulnar deviation may contribute to localized compression of the medial nerve. Measures of mean cross-sectional area, width and depth by quartile provided an indication of the morphology changes associated volume redistribution. Morphology analysis also revealed twisting between the proximal and distal aspects of the tunnel which increased with flexion and ulnar deviation and may further contribute to strain on the median nerve.
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spelling doaj.art-905084b169bf43ba8e0846ae9c4ee2bf2023-01-07T05:30:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711e027723410.1371/journal.pone.0277234Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.Drew A AndersonMichele L OliverKaren D GordonNon-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with ±20° flexion-extension (FE), however, CTV decreased with ulnar deviation over the range of -5° to 15° radial-ulnar deviation (RUD). These findings suggest CTV may be too coarse of a measure to reflect the effects of slight non-neutral postures, or that volume is conserved and redistributed due to changes in tunnel morphology with posture. The objective of this study was to assess volume distribution along the length of the carpal tunnel and to quantify regional morphology changes with deviated wrist postures in both FE and RUD. Analysis was performed on a dataset of computed tomography scans collected on ten cadaveric specimens (5 male, 5 female, mean age = 80.7 ± 10.9 years) over a range of FE and RUD postures. The carpal tunnel of each scan was divided into four quartiles of equal length along the tunnel to quantify volume distribution. Volume within the carpal tunnel was seen to redistribute with both FE and RUD. Decreased volume in the distal aspect of the tunnel with flexion and proximal aspect of the tunnel with ulnar deviation may contribute to localized compression of the medial nerve. Measures of mean cross-sectional area, width and depth by quartile provided an indication of the morphology changes associated volume redistribution. Morphology analysis also revealed twisting between the proximal and distal aspects of the tunnel which increased with flexion and ulnar deviation and may further contribute to strain on the median nerve.https://doi.org/10.1371/journal.pone.0277234
spellingShingle Drew A Anderson
Michele L Oliver
Karen D Gordon
Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.
PLoS ONE
title Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.
title_full Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.
title_fullStr Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.
title_full_unstemmed Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.
title_short Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.
title_sort carpal tunnel volume distribution and morphology changes with flexion extension and radial ulnar deviation wrist postures
url https://doi.org/10.1371/journal.pone.0277234
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