Related Experiment Video
Updated: Mar 17, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Three-Dimensional Carpal Kinematics after Carpal Tunnel Release
Jonathan R Schiller1, Jeffrey J Brooks2, P Kaveh Mansuripur1
1Department of Orthopaedics, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Background:
Carpal tunnel release (CTR) has been shown to change carpal arch morphology. However, the effect of CTR on the three-dimensional kinematics of the carpal bones has not been demonstrated.
Purpose:
This study examined whether release of the transverse carpal ligament (TCL) would alter the three-dimensional kinematics of the carpus, specifically the bony attachments of the TCL.
Methods:
The in vitro kinematics of the carpus was studied in five fresh-frozen cadaveric wrists before and after CTR using three-dimensional computed tomography. The specimens were evaluated in three positions: neutral, 60 degrees of flexion, and 60 degrees of extension.
Results:
The data indicate that carpal arch width increases significantly in all positions after CTR as measured between the trapezium and hamate. Second, the trapezium-hamate distance increases in both a translational and rotational component after CTR. Additionally, the pisiform rotates away from the triquetrum after CTR.
Conclusions:
Carpal kinematics is significantly altered with a CTR, especially on the ulnar side of the wrist.
Clinical Relevance:
Although the kinematic changes are small, they may be clinically significant and potentially responsible for pillar pain or postoperative loss of grip strength.
