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Pubmed for Handhelds

PUBMED FOR HANDHELDS

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  • Title: Three-Dimensional Carpal Kinematics after Carpal Tunnel Release.
    Author: Schiller JR, Brooks JJ, Mansuripur PK, Gil JA, Akelman E.
    Journal: J Wrist Surg; 2016 Aug; 5(3):222-6. PubMed ID: 27468373.
    Abstract:
    BACKGROUND: Carpal tunnel release (CTR) has been shown to change carpal arch morphology. However, the effect of CTR on the three-dimensional kinematics of the carpal bones has not been demonstrated. PURPOSE: This study examined whether release of the transverse carpal ligament (TCL) would alter the three-dimensional kinematics of the carpus, specifically the bony attachments of the TCL. METHODS: The in vitro kinematics of the carpus was studied in five fresh-frozen cadaveric wrists before and after CTR using three-dimensional computed tomography. The specimens were evaluated in three positions: neutral, 60 degrees of flexion, and 60 degrees of extension. RESULTS: The data indicate that carpal arch width increases significantly in all positions after CTR as measured between the trapezium and hamate. Second, the trapezium-hamate distance increases in both a translational and rotational component after CTR. Additionally, the pisiform rotates away from the triquetrum after CTR. CONCLUSIONS: Carpal kinematics is significantly altered with a CTR, especially on the ulnar side of the wrist. CLINICAL RELEVANCE: Although the kinematic changes are small, they may be clinically significant and potentially responsible for pillar pain or postoperative loss of grip strength.
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