Alsafar Farah, Li Zong-Ming
Hand Research Laboratory, Department of Orthopaedic Surgery, University of Arizona College of Medicine, Tucson, Arizona.
J Wrist Surg. 2021 Oct 1;11(2):150-153. doi: 10.1055/s-0041-1735887. eCollection 2022 Apr.
The purpose of the study was to examine the coverage of thenar and hypothenar muscles on the transverse carpal ligament (TCL) in the radioulnar direction through in vivo ultrasound imaging of the carpal tunnel. We hypothesized that the TCL distance covered by the thenar muscle would be greater than that by the hypothenar muscle, and that total muscle coverage on the TCL would be greater than the TCL-alone region. Ultrasound videos of human wrist were collected on 20 healthy subjects. Automated algorithms were used to extract the distal cross-sectional image of the trapezium-hamate level. Manual tracing of the anatomical features was conducted. Thenar muscles covered a significantly larger distance (11.9 ± 1.8 mm) as compared with hypothenar muscles (1.7 ± 0.8 mm) ( < 0.001). The TCL covered by thenar and hypothenar muscles was greater than the TCL-alone length ( < 0.001). The thenar and hypothenar muscle coverage on the TCL, as normalized to the total TCL length, was 61.0 ± 7.5%. More than 50% of the TCL at the distal carpal tunnel is covered by thenar and hypothenar muscles. Knowledge of muscular attachments to the TCL improves our understanding of carpal tunnel syndrome etiology and can guide carpal tunnel release surgery.
本研究的目的是通过腕管的体内超声成像，在桡尺方向上检查大鱼际肌和小鱼际肌在腕横韧带上的覆盖情况。我们假设大鱼际肌覆盖的腕横韧带距离将大于小鱼际肌覆盖的距离，并且腕横韧带上的肌肉总覆盖面积将大于仅腕横韧带区域。
收集了20名健康受试者的人手腕超声视频。使用自动算法提取大多角骨-钩骨水平的远端横截面图像。对解剖特征进行了手动追踪。
与小鱼际肌（1.7±0.8毫米）相比，大鱼际肌覆盖的距离明显更大（11.9±1.8毫米）（<0.001）。大鱼际肌和小鱼际肌覆盖的腕横韧带大于仅腕横韧带的长度（<0.001）。大鱼际肌和小鱼际肌在腕横韧带上的覆盖面积，以腕横韧带总长度归一化后为61.0±7.5%。
腕管远端超过50%的腕横韧带被大鱼际肌和小鱼际肌覆盖。了解肌肉与腕横韧带的附着情况有助于我们理解腕管综合征的病因，并可指导腕管松解手术。
