Bay B K, Sharkey N A, Szabo R M
Orthopaedic Research Laboratories, University of California Davis School of Medicine, Sacramento 95817, USA.
J Hand Surg Am. 1997 Jul;22(4):621-7. doi: 10.1016/S0363-5023(97)80118-9.
Median nerve displacement and strain in the carpal tunnel region were measured as functions of wrist position and carpal tunnel pressure in 5 cadaver forearms during simulated active finger flexion. The positions of spherical stainless-steel markers embedded within the median nerve and flexor digitorum superficialis of the long finger were measured in 3 dimensions by a radiographic direct linear transformation technique. Each limb was tested in 3 wrist positions (60 degrees extension, neutral, and 60 degrees flexion) and 4 carpal tunnel pressures (0, 30, 60, and 90 mmHg). Carpal tunnel pressure was controlled with a balloon angiocatheter inserted deep to the flexor digitorum profundus. The ratio of median nerve to flexor tendon excursion was linear and was affected by wrist position but not carpal tunnel pressure. Patterns of strain in the median nerve proximal to the flexor retinaculum were different from those of strain within the carpal tunnel. Nerve strains were affected by wrist position, but carpal tunnel pressure had no effect. The hydrostatic pressure effect associated with carpal tunnel syndrome does not appear to influence median nerve kinetics or kinematics for the wrist positions studied.
在5具尸体前臂模拟主动手指屈曲过程中，测量腕管区域正中神经的位移和应变，作为腕部位置和腕管压力的函数。采用放射照相直接线性变换技术在三维空间中测量嵌入正中神经和示指浅屈肌内的球形不锈钢标记物的位置。每个肢体在3种腕部位置（伸展60度、中立位和屈曲60度）和4种腕管压力（0、30、60和90 mmHg）下进行测试。通过插入指深屈肌深部的球囊血管导管控制腕管压力。正中神经与屈肌腱偏移的比率呈线性，受腕部位置影响，但不受腕管压力影响。屈肌支持带近端正中神经的应变模式与腕管内的应变模式不同。神经应变受腕部位置影响，但腕管压力无影响。在所研究的腕部位置中，与腕管综合征相关的静水压力效应似乎不影响正中神经的动力学或运动学。
