Li Zong-Ming, Gabra Joseph N, Marquardt Tamara L, Kim Dong Hee
Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA.
Clin Biomech (Bristol). 2013 Apr;28(4):402-7. doi: 10.1016/j.clinbiomech.2013.02.014. Epub 2013 Apr 9.
Carpal tunnel morphology plays an essential role in the etiology and treatment of carpal tunnel syndrome. The purpose of this study was to observe the morphological changes of the carpal tunnel as a result of carpal arch width narrowing. It was hypothesized that carpal arch width narrowing would result in increased height and area of the carpal arch.
The carpal arch width of eight cadaveric hands was narrowed by a custom apparatus and cross-sectional ultrasound images were acquired. The carpal arch height and area were quantified as the carpal arch width was narrowed. Correlation and regression analyses were performed for the carpal arch height and area with respect to the carpal arch width.
The carpal tunnel became more convex as the carpal arch width was narrowed. The initial carpal arch width, height, and area were 25.7 (SD1.9) mm, 4.1 (SD0.6) mm, and 68.5 (SD14.0) mm(2), respectively. The carpal arch height and area negatively correlated with the carpal arch width, with correlation coefficients of -0.974 (SD0.018) and -0.925 (SD0.034), respectively. Linear regression analyses showed a 1mm narrowing of the carpal arch width resulted in proportional increases of 0.40 (SD0.14) mm in the carpal arch height and 4.0 (SD2.2) mm(2) in the carpal arch area.
This study demonstrates that carpal arch width narrowing leads to increased carpal arch height and area, a potential mechanism to reduce the mechanical insult to the median nerve and relieve symptoms associated with carpal tunnel syndrome.
腕管形态在腕管综合征的病因及治疗中起着至关重要的作用。本研究的目的是观察腕横弓宽度变窄导致的腕管形态变化。研究假设为腕横弓宽度变窄会导致腕横弓高度增加和面积增大。
使用定制装置使8具尸体手的腕横弓宽度变窄，并采集横截面超声图像。在腕横弓宽度变窄的过程中，对腕横弓高度和面积进行量化。对腕横弓高度和面积与腕横弓宽度进行相关性和回归分析。
随着腕横弓宽度变窄，腕管变得更加凸出。初始腕横弓宽度、高度和面积分别为25.7（标准差1.9）mm、4.1（标准差0.6）mm和68.5（标准差14.0）mm²。腕横弓高度和面积与腕横弓宽度呈负相关，相关系数分别为-0.974（标准差0.018）和-0.925（标准差0.034）。线性回归分析显示，腕横弓宽度每变窄1mm，腕横弓高度成比例增加0.40（标准差0.14）mm，腕横弓面积增加4.0（标准差2.2）mm²。
本研究表明，腕横弓宽度变窄会导致腕横弓高度和面积增加，这是一种减少正中神经机械性损伤并缓解腕管综合征相关症状的潜在机制。
