Department of Orthopaedic Surgery, Endowed Department of Human Resources Development for Community Medicine, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
J Orthop Res. 2013 Dec;31(12):1876-80. doi: 10.1002/jor.22462. Epub 2013 Aug 22.
The objective of this study was to evaluate the correlations between deformation and displacement of median nerve and flexor tendons during finger motion in the carpal tunnel for both carpal tunnel syndrome (CTS) patients and healthy controls. Sixty-two wrists of 31 asymptomatic volunteers and fifty-one wrists of 28 idiopathic CTS patients were evaluated by ultrasound. The displacement of the median nerve and the middle finger flexor digitorum superficialis (FDS) tendon, as well as area, perimeter, aspect ratio of a minimum enclosing rectangle, and circularity of the median nerve were measured in finger extension and flexion positions. Deformation indices were defined as the ratios of indices in finger extension and flexion positions. The correlations between displacement and deformation indices were evaluated. There were significant correlations between nerve palmar-dorsal displacement and deformation indices (p < 0.05). The aspect ratio deformation index showed the strongest correlation to palmar-dorsal displacement of the nerve (-0.572, p < 0.01). This study showed that there is a relationship between median nerve deformation indices and nerve palmar-dorsal displacement in the carpal tunnel. Since the highest correlations were between palmar-dorsal nerve displacement direction and aspect ratio deformation index, these parameters may be helpful to understand the pathophysiology of CTS.
本研究旨在评估正中神经和屈肌腱在腕管内手指运动过程中的变形和位移与腕管综合征(CTS)患者和健康对照组之间的相关性。通过超声评估了 31 名无症状志愿者的 62 只手腕和 28 名特发性 CTS 患者的 51 只手腕。在手指伸展和弯曲位置测量了正中神经和中指屈指浅肌(FDS)肌腱的位移,以及正中神经的面积、周长、最小外接矩形的纵横比和圆形度。变形指数定义为手指伸展和弯曲位置指数的比值。评估了位移和变形指数之间的相关性。神经掌背位移与变形指数之间存在显著相关性(p < 0.05)。形态比变形指数与神经掌背位移的相关性最强(-0.572,p < 0.01)。本研究表明,腕管内正中神经的变形指数与神经掌背位移之间存在一定的关系。由于神经掌背位移方向与形态比变形指数之间的相关性最高,这些参数可能有助于理解 CTS 的病理生理学。