Changes in carpal tunnel compliance with incremental flexor retinaculum release

Area of Science:

• Orthopedics
• Biomechanics
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is often treated with flexor retinaculum transection.
• The biomechanical effects of this surgical release on carpal tunnel structural compliance are not fully understood.

Purpose of the Study:

• To investigate the impact of flexor retinaculum release on carpal tunnel structural compliance.
• To quantify changes in carpal tunnel dimensions following incremental surgical releases.

Main Methods:

• Cadaveric hands were used to study the effects of sequential flexor retinaculum releases.
• Transverse carpal ligament (TCL) and associated fascial structures were incrementally transected.
• Carpal tunnel compliance was measured by applying outward forces and assessing changes in carpal arch width.

Main Results:

• Intact flexor retinaculum showed significantly lower distal carpal tunnel compliance compared to proximal.
• Complete TCL release was necessary to significantly increase distal compliance.
• Complete flexor retinaculum release yielded substantial increases in both proximal (52%) and distal (332%) carpal tunnel compliance.

Conclusions:

• Complete flexor retinaculum release significantly enhances carpal tunnel compliance throughout the tunnel.
• The observed increase in structural compliance provides a biomechanical basis for the efficacy of carpal tunnel release surgery in CTS treatment.