Gaziantep Abdulkadir Yuksel State Hospital, Gaziantep, Turkey.
Perilikaya, Havaalanıyolu Cd. No:302, 27100, Şahinbey/Gaziantep, Turkey.
Orthopadie (Heidelb). 2024 Oct;53(10):765-772. doi: 10.1007/s00132-024-04542-2. Epub 2024 Aug 22.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy syndrome of the upper extremities. The carpal tunnel is an osteofibrous canal that is medially bordered by hamulus ossis hamati and pisiform bone, and laterally by scaphoid and trapezoid bones. In this retrospective case-control study, we investigated the relationship between radiologically measured morphometric indices and CTS in female patients.
Clinical, radiological, and demographic data were collected for 55 hands of 40 female patients diagnosed with CTS and 58 hands of control subjects. Radiological measurements included various morphometric parameters derived from wrist and hand X-rays. Statistical analysis was conducted to assess associations between morphometric indices and CTS.
Significant associations were observed between CTS and several morphometric indices, including carpal height, capitate length, palm length, and others. Notably, these values were lower in CTS patients, suggesting a potential link between reduced carpal tunnel volume and increased pressure due to synovial hypertrophy. Additionally, a newly introduced index, Scaphoid Pisiform Width Index (SPWI), showed promise in assessing the proximal part of the carpal tunnel.
It was found that the values for Capitate length, Carpal height, Palm length, SPWI, and Palmar ratio were lower in the patient group. These results suggested that decreasing volume of the carpal tunnel allows for an easier increase in carpal tunnel pressure due to increased synovial hypertrophy and the carpal bone configuration affects the proximal part of the carpal tunnel, and influences the compression of the median nerve, in female patients.
腕管综合征(CTS)是上肢最常见的神经卡压综合征。腕管是一个由豌豆骨和钩骨内侧缘、舟骨和大多角骨外侧缘形成的纤维骨性管道。在这项回顾性病例对照研究中,我们研究了女性患者中影像学测量的形态计量学指标与 CTS 之间的关系。
收集了 40 名女性 CTS 患者的 55 只手和 58 只对照组的临床、影像学和人口统计学数据。影像学测量包括腕关节和手部 X 线片上的各种形态计量参数。进行了统计学分析,以评估形态计量学指标与 CTS 之间的关联。
CTS 与几种形态计量学指标之间存在显著关联,包括腕骨高度、头状骨长度、手掌长度等。值得注意的是,CTS 患者的这些值较低,表明腕管体积减小和由于滑膜增生导致压力增加之间可能存在联系。此外,新引入的 Scaphoid Pisiform Width Index(SPWI)指数在手背近端的腕管评估中具有潜力。
发现患者组的头状骨长度、腕骨高度、手掌长度、SPWI 和掌指比均较低。这些结果表明,腕管体积的减少使得由于滑膜增生引起的腕管压力更容易增加,腕骨的形态影响腕管的近端部分,并影响正中神经的压迫,在女性患者中更为明显。