Palmar Creases and Their Implication on Carpal Tunnel Surgery

Area of Science:

• Anatomy
• Surgical Anatomy
• Hand Surgery

Background:

• Accurate knowledge of wrist and hand anatomy is crucial for preventing complications during carpal tunnel release surgery.
• Variations in anatomy necessitate defining a safe zone for the initial incision to minimize risks.

Purpose of the Study:

• To document variations in the surface anatomy of the hand.
• To identify a safe zone for carpal tunnel release incisions.
• To determine the relationship between palmar creases and this safe zone.

Main Methods:

• Utilized Kaplan's cardinal line and other superficial markers to estimate the safe zone.
• Measured the safe zone as the distance between the hook of the hamate and the motor branch of the median nerve (MBMN).
• Recorded the presence of longitudinal palmar creases within the identified safe zone.

Main Results:

• The average safe zone width was approximately 10.5 mm.
• 86.33% of the examined safe zones contained a longitudinal palmar crease.
• Significant variations in safe zone width were observed across different races and sexes, with males generally having wider zones than females.

Conclusions:

• The study identified a safe zone for carpal tunnel incision, averaging 10.5 mm from the hook of the hamate.
• The high prevalence of palmar creases within the safe zone suggests their utility in concealing surgical incisions.
• While anatomical variations exist, utilizing palmar creases may help minimize the risk of motor branch of the median nerve injury during carpal tunnel surgery.