Abstract
PurposeThe purpose of this study was to compare the properties of the median nerve and the flexor retinaculum within the carpal tunnel with Magnetic Resonance Imaging (MRI) under two conditions: (a) fingers extended, and (b) fingers in an isometric squeeze grip.MethodsThirty-Four volunteers participated in this experimental study. The flexor retinaculum and median nerve characteristics were measured during both conditions using MRI.ResultsThe isometric squeeze grip condition resulted in significant palmar bowing of the flexor retinaculum (t = 7.67, p<.001), a significant flattening-ratio of the median nerve (t = 4.308, p<.001), and no significant decrease in the cross-sectional area of the median nerve (t = 2.508, p = 0.017).ConclusionThe isometric squeeze grip condition resulted in anatomical deformations within the carpal tunnel, possibly explained by the lumbrical muscles incursion into the carpal tunnel during finger flexion.
Highlights
Carpal Tunnel Syndrome (CTS) is common neuropathy disorder encountered by healthcare specialists and is caused by prolonged abnormal force exerted on the median nerve within the Carpal Tunnel (CT) [1,2]
This shows that the palmar bowing of the flexor retinaculum was significantly greater during the isometric squeeze grip condition t(33) = 7.67, p
6.58 7.63 18.91 5.36 2.87 significantly flatter median nerve ratio and a significant palmar bowing of the flexor retinaculum
Summary
Carpal Tunnel Syndrome (CTS) is common neuropathy disorder encountered by healthcare specialists and is caused by prolonged abnormal force exerted on the median nerve within the Carpal Tunnel (CT) [1,2]. The most common conservative treatment of CTS involves splinting the wrist in neutral position while leaving the digits free The rationale for this splint is that it maintains the CT in its widest position which allows the median nerve to heal. This intervention is used extensively by hand therapists and is considered adequate to improve the symptoms of CTS, the evidence supporting significant benefits from traditional splints is limited [1,7,8,9] and surgical intervention is reported to be as a superior treatment option for CTS than splinting (see O’Connor et al [8] & Verdugo et al [9] for reviews)
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