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Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Possible role of carpal hyperextension in superficial digital flexor tendinopathy
D Whitlock1, T C Garcia, S A Vallance
1JD Wheat Veterinary Orthopedic Research Laboratory and Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA, USA.
Reasons For Performing Study:
The specific biomechanical circumstances that induce excessive superficial digital flexor tendon (SDFT) strain in horses are unknown.
Hypothesis:
Carpal joint hyperextension during axial limb loading during the middle of stance disproportionately enhances SDFT strains compared to suspensory ligament (SL) strains.
Methods:
Superficial digital flexor tendon and SL strains were measured in 7 cadaver limbs during in vitro loading that maintained carpal extension or allowed carpal hyperextension by constraining, or allowing rotation of, the radius during loading conditions that simulated the middle of stance at the walk. The effect of carpal hyperextension on SDFT and SL strains and joint angles was assessed using repeated measures ANOVA.
Results:
Limb loading generally resulted in higher SL strains than SDFT strains for both carpal extension and hyperextension loading conditions. Compared to carpal extension, carpal hyperextension resulted in increased strains in both the SDFT and the SL; however, a greater increase in strain was seen in the SDFT. On average, carpal hyperextension caused approximately 3° greater carpal extension, 1° greater metacarpophalangeal joint hyperextension, 1° greater proximal interphalangeal joint flexion and <1° greater distal interphalangeal joint flexion than did carpal extension.
Conclusions And Clinical Relevance:
Carpal joint hyperextension is likely to induce disproportionately higher strain in the SDFT than in the SL. Factors that affect carpal stability are likely to affect the risk for superficial digital flexor tendinopathy.
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