Non-Surgical Carpal Arch Space Augmentation for Median Nerve Decompression

Area of Science:

• Orthopedics
• Biomedical Engineering
• Anatomy

Background:

• The carpal tunnel's confined space predisposes the median nerve to compression, causing carpal tunnel syndrome.
• Carpal tunnel release surgery, while effective, disrupts wrist biomechanics and can lead to complications like reduced grip strength and pillar pain.

Purpose of the Study:

• To review novel nonsurgical approaches for carpal arch space augmentation (CASA).
• To decompress the median nerve without transecting the transverse carpal ligament, thereby avoiding surgical complications.

Main Methods:

• Review of developed nonsurgical CASA techniques: radio ulnar wrist compression, muscle-ligament interaction, palmar pulling, and transverse carpal ligament collagenolysis.
• Summary of research encompassing theoretical considerations, in vitro and in situ experiments, computational modeling, and human subject studies.

Main Results:

• Exploration of multiple nonsurgical strategies to increase carpal tunnel volume.
• Investigation into the efficacy and safety of these CASA methods through diverse research methodologies.

Conclusions:

• Nonsurgical CASA offers a promising alternative to surgical carpal tunnel release.
• These methods aim to preserve wrist function while effectively decompressing the median nerve.