title: Scaphoid kinematic behavior after division of the transverse carpal ligament.
abstract: OBJECTIVE
  The effect that carpal tunnel release (CTR) has on scaphoid motion has not been reported. Accordingly the purpose of this study was to determine the flexion/extension behavior of the scaphoid during global wrist radial/ulnar deviation before and after division of the transverse carpal ligament (TCL).
  
  
  METHODS
  In this study we examined the in vitro kinematics of the scaphoid during wrist deviation in 6 cadaver forearms both before and after the division of the TCL using a computerized camera monitoring system. The specimens were evaluated in 13 different positions, from 20 degrees of radial deviation to 40 degrees of ulnar deviation at increments of 5 degrees.
  
  
  RESULTS
  The data indicate that the difference in scaphoid position after TCL division is statistically significant when the wrist is in ulnar deviation of 15 degrees or greater. In addition a significant difference in scaphoid extension between pre- and post-TCL division conditions was found at 5 degrees of radial deviation as well as at 5 degrees or more of ulnar deviation and increased with increasing ulnar deviation.
  
  
  CONCLUSIONS
  Scaphoid kinematics are altered considerably in radial-ulnar deviation after division of the TCL. This alteration may have long-term consequences and contribute to commonly seen post-CTR symptoms.
authors.affiliation: Hand and Microvascular Surgery Laboratory, San Francisco General Hospital, San Francisco, CA 94110, USA.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishiko
authors.forename: Christian M
authors.initials: CM
authors.lastname: Puttlitz
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Lotz
authors.forename: Edward
authors.initials: E
authors.lastname: Diao
mesh_terms: D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002102:Cadaver; D002348:Carpal Bones / Q000503:physiopathology / Q000601:surgery*; D002349:Carpal Tunnel Syndrome / Q000601:surgery; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D021361:Scaphoid Bone / Q000503:physiopathology*; D014457:Ulna / Q000502:physiology