Kunou M
Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1994 Oct;68(10):878-84.
An anatomical study of the carpal tunnel was performed to characterize the transverse carpal ligament, enabling improved endoscopic carpal tunnel release. One hundred wrist joints obtained from 50 cadavers were studied. The width of the transverse carpal ligament (TCL) was found to be narrower in females than in males, and there was no significant difference in the width of the ligament between the right and the left wrist joints. The length of the TCL was not significantly different between males and females or between the right and left wrist joints. On the sagittal plane, the TCL was spindle-shaped and its thickest part was in the distal third. The thickness of the TCL had a significant negative correlation with age. The width of the TCL had a significant positive correlation with both its length (p < 0.01) and the thickness of its distal part (p < 0.01). Neither the distance between the distal edge of the TCL and the superficial palmar arch nor the distance between the radial edge of the pisiform bone and the ulnar artery at the distal edge of the TCL were significantly correlated with sex, laterality, or age. These results indicated that the width and thickness of the TCL and the ulnar artery can be predicted by calculating the length of the TCL percutaneously, thus enabling a safe and reliable endoscopic carpal tunnel release to be performed clinically without any complication.
进行了一项腕管的解剖学研究,以描述腕横韧带的特征,从而改进内镜下腕管松解术。研究了从50具尸体上获取的100个腕关节。发现女性腕横韧带(TCL)的宽度比男性窄,并且左右腕关节之间韧带的宽度没有显著差异。TCL的长度在男性和女性之间或左右腕关节之间没有显著差异。在矢状面上,TCL呈纺锤形,其最厚部分位于远端三分之一处。TCL的厚度与年龄呈显著负相关。TCL的宽度与其长度(p < 0.01)和远端部分的厚度(p < 0.01)均呈显著正相关。TCL远端边缘与掌浅弓之间的距离以及豌豆骨桡侧边缘与TCL远端边缘处尺动脉之间的距离均与性别、左右侧或年龄无显著相关性。这些结果表明,通过经皮计算TCL的长度可以预测TCL和尺动脉的宽度和厚度,从而能够在临床上安全可靠地进行内镜下腕管松解术而无任何并发症。