Clínica Ortopédica Dr. Dinis Carmo Lda, Porto, Portugal.
Centro Auditivo Widex, Porto, Portugal.
Hand (N Y). 2024 Sep;19(6):924-930. doi: 10.1177/15589447231160209. Epub 2023 Mar 22.
Abundant literature exists on the morphology of the carpal tunnel. Despite this, the shape of the carpal tunnel has been reported erratically, and most studies did not attempt to correlate findings with measurements taken from cadavers. The objective of this study was to perform a morphological analysis, determine the shape and mean dimensions of the carpal tunnel, determine the level of the narrowest area of the tunnel, and establish a set of values capable of serving as a reference for carpal tunnel release.
The carpal tunnels of 20 fresh cadaveric hands were dissected, and acrylic casts were created and measured using industrial computed tomography.
Of the 20 casts, 19 were shaped like elliptic cylinders, with little variation in their measurements along the length. The location of the narrowest section of the carpal tunnel is very different among casts, and the length of the roof of the carpal tunnel ranged from 21.26 to 29.86 mm.
The most common shape of the carpal tunnel is an elliptic cylinder. Because of the unpredictability of the location of the narrowest area of the carpal tunnel, carpal tunnel release must continue through all extension of its roof. We advise that the release should rarely be extended distally more than 30 mm from the distal palmar wrist crease, which corresponds, in most cases, to the middle of the pisiform.
关于腕管的形态学有大量文献。尽管如此，腕管的形状仍被报道存在差异，并且大多数研究并未尝试将发现结果与从尸体上测量的结果相关联。本研究的目的是进行形态学分析，确定腕管的形状和平均尺寸，确定隧道最狭窄区域的水平，并建立一组能够作为腕管松解参考的值。
对 20 只新鲜尸体手的腕管进行解剖，并用工业计算机断层扫描创建并测量丙烯酸铸型。
在 20 个铸型中，有 19 个呈椭圆形圆柱状，其长度上的测量值变化很小。腕管最狭窄部分的位置在铸型之间差异很大，腕管顶的长度范围为 21.26 至 29.86 毫米。
腕管最常见的形状为椭圆形圆柱。由于腕管最狭窄区域的位置不可预测，因此必须通过其顶的所有延伸来进行腕管松解。我们建议，松解不应从远侧掌腕皱褶远端超过 30 毫米处向远侧延伸，在大多数情况下，该位置对应于钩骨的中间。
