Postoperative morphologic analysis of carpal tunnel syndrome using high-resolution ultrasonography.
The authors evaluated the morphologic changes that follow division of the transverse carpal ligament in patients with carpal tunnel syndrome (CTS) using high-resolution ultrasonography. Ten patients, for a total of 20 hands, underwent high-resolution ultrasonographic studies before the operation and 8 months after the operation. They were all diagnosed with bilateral idiopathic CTS. The authors evaluated the configuration of the median nerve and carpal tunnel at 3 different levels of the wrist: the distal radiocarpal joint level, the pisiform level, and the hook of hamate level. The median nerve gained in thickness to a remarkable extent at 2 distal levels after the operation. The change in morphology of the carpal tunnel at these 2 distal levels was obvious, but the cross-sectional area of the carpal tunnel was increased significantly only at the hook of hamate level. The transverse diameters of the carpal tunnel were not significantly changed. As mentioned, the authors found that the median nerve gained significantly in volume at the distal part of the carpal tunnel postoperatively, and the volumetric increase in the carpal tunnel appears to have resulted from an anterior displacement of newly formed transverse carpal ligament, rather than from a widening of the bony carpal arch.
Lee
Chi Ho
CH
Department of Plastic and Reconstructive Surgery, Korea University, Ansan Hospital, Ansan, Korea.
Kim
Taek Kun
TK
Yoon
Eul Sik
ES
Dhong
Eun Sang
ES
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging; D008475:Median Nerve / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D014463:Ultrasonography; D014955:Wrist Joint / Q000000981:diagnostic imaging