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An ultrasonographic and anatomical study of carpal tunnel, with special emphasis on the safe zones in percutaneous release

From the Chern Tai-Chang's Orthopaedics Clinic, Ping-Tong, the Departments of Orthopaedics, and Emergency Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, the Department of Orthopaedics, Kuo's General Hospital, Tainan, and the Department of Orthopaedics, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan

^* To whom correspondence should be addressed.

	Abstract

We examined 40 wrists of 12 embalmed and eight fresh cadavers and defined the relative position of the flexor retinaculum to the neurovascular structure, ultrasonographic markers and safe zones by ultrasonography and anatomical dissection. Both longitudinal and transverse ultrasonographic sections clearly depicted the flexor retinaculum, neurovascular bundles, median nerve, flexor tendons and bony boundaries of the underlying joints. Topographic measurement showed [i] good correlation between the actual extent of the flexor retinaculum and the ultrasonographically determined distance between bony landmarks in all hands, and [ii] the widths and lengths of well-defined safe zones. A comparison study confirmed the accuracy of ultrasonography. We conclude that these ultrasonographic landmarks can locate the flexor retinaculum and facilitate safe and complete carpal tunnel release with open or minimally invasive techniques.

Key Words: carpal tunnel syndrome, ultrasonographic landmark, percutaneous release, ultrasonography

First published on January 7, 2009, doi:10.1177/1753193408097322

Journal of Hand Surgery (European Volume) 2009;34:66.

A more recent version of this article appeared on February 1, 2009


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