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Carpal Tunnel Volume Changes of the Wrist Under DistractionFrom The Curtis National Hand Center, Baltimore, MD, USA Correspondence: Keith A. Segalman, MD, c/o Anne Mattson, The Curtis National Hand Center, 3333 North Calvert Street, #200, Union Memorial Hospital, Baltimore, MD 21218, USA. Tel.: +1 410 261 8413; fax: +1 410 554 4363. E-mail: anne.mattson{at}medstar.net. This study attempts to determine changes in carpal canal volume with distraction across the wrist. Uniform longitudinal distraction was maintained with two external fixators on the radial and ulnar aspects of the forearm axis of five cadaver specimens. After CT scanning, volume determinations were made at 5 mm increments beginning at the lunocapitate joint to a point 1.5 cm distal to the middle finger carpometacarpal joint. There was a statistically significant decrease of the mean total carpal canal volume from 0 to 4.54 kg of distraction, with no statistically significant decrease from 0 to 2.27 kg or 2.27 to 4.54 kg. The largest decrease occurred at 15 and 20 mm distal to the proximal edge of the transverse carpal ligament corresponding to the level of the hamate hook. Reduction in mean carpal canal volume was 10.2% and 7.5% at these distances, respectively, from 0 to 4.54 kg of distraction. Progressive distraction across the wrist causes a decrease in total carpal canal volume.
Key Words: carpal canal volume • wrist distraction • hand
Journal of Hand Surgery (European Volume), Vol. 33, No. 5,
648-652 (2008) |
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