Abstract
The purpose of this study was to investigate the sex-based differences in the carpal arch morphology. Carpal arch morphology was quantified using palmar bowing and area of the arch formed by the transverse carpal ligament. The carpal arch was imaged at the distal and proximal tunnel levels using ultrasonography in 20 healthy young adults (10 women and 10 men). It was found that females had a smaller carpal arch height compared to men at both distal and proximal levels (p<0.05) and smaller carpal arch width only at the proximal level (p<0.05) but not distally. Palmar bowing index, the carpal arch height to width ratio, was significantly smaller in females at the distal level (p<0.05) but not at the proximal level. Carpal arch cross-sectional area normalized to the wrist cross-sectional area was found to be significantly smaller in females at both tunnel levels compared to men (p<0.05). This study demonstrates that females have a smaller carpal arch compared to men with a reduced palmar bowing distally and a smaller arch area at both tunnel levels. The findings help explain the higher incidence of carpal tunnel syndrome in women as a smaller carpal arch makes the median nerve more vulnerable to compression neuropathy.
Highlights
The carpal tunnel is formed by the transverse carpal ligament (TCL) at its volar boundary and the carpal bones at its medial, lateral, and dorsal boundaries
Prolonged compression of the median nerve could lead to compression neuropathy known as carpal tunnel syndrome (CTS)
The algorithm eliminated operator dependency to find the arch cross sections that contained the anatomical configuration for manual tracing of the TCL volar boundary
Summary
The carpal tunnel is formed by the transverse carpal ligament (TCL) at its volar boundary and the carpal bones at its medial, lateral, and dorsal boundaries. The tunnel serves as a passageway for the median nerve and digit flexor tendons. The delicate positioning of the median nerve within the tunnel makes it susceptible to compression from area reduction or shape alteration of the TCL-formed carpal arch. Prolonged compression of the median nerve could lead to compression neuropathy known as carpal tunnel syndrome (CTS). One possible cause proposed for the higher incidence is that women have a smaller wrist size than men [2]. The smaller wrist size in women correlates with a relatively smaller carpal tunnel cross-sectional area in women compared to men [3, 4].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
