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Anatomy of the flexor retinaculum
T K Cobb1, B K Dalley, R H Posteraro
1Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock.
The Journal of Hand Surgery
|January 1, 1993
Summary
This study precisely defined carpal tunnel anatomy in cadavers, revealing its boundaries and dimensions. Findings support more extensive surgical release beyond just the transverse carpal ligament for carpal tunnel syndrome.
Area of Science:
- Anatomy
- Orthopedics
- Surgical Anatomy
Background:
- Carpal tunnel syndrome is a common condition.
- Accurate anatomic definition of the carpal tunnel is crucial for surgical interventions.
- Current surgical approaches may not fully address the entire flexor retinaculum.
Purpose of the Study:
- To accurately define the anatomic limits and dimensions of the carpal tunnel.
- To provide an anatomic basis for optimizing surgical release procedures for carpal tunnel syndrome.
Main Methods:
- Gross dissection of 10 cadaver upper extremities.
- Histologic examination of 3 cadaver upper extremities.
- Radiographic analysis of 13 cadaver upper extremities.
Main Results:
- The flexor retinaculum extends from the distal radius to the base of the third metacarpal.
- Mean proximal limit of the central flexor retinaculum is 11 mm distal to the capitate-lunate joint.
- Mean distal limit of the distal flexor retinaculum is 10 mm distal to the third carpometacarpal joint.
- Carpal tunnel width at the hamate hook (20 mm) is narrower than proximal (24 mm) and distal (25 mm) extents.
- The palmar boundary includes proximal fascia, transverse carpal ligament, and distal aponeurosis.
Conclusions:
- The palmar boundary of the carpal tunnel is composed of three continuous segments.
- This redefined anatomy provides a rationale for more comprehensive surgical release in carpal tunnel syndrome treatment.