Median nerve movement in the carpal tunnel before and after carpal tunnel release using transverse ultrasound
Median nerve movement in the carpal tunnel before and after carpal tunnel release using transverse ultrasound
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DOI：
10.1177/2309499017730422
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发表时间：
2017-09-18
影响因子：
1.6
通讯作者：
Takai, Shinro
中科院分区：
文献类型：
--
作者：
Nanno, Mitsuhiko;Kodera, Norie;Takai, Shinro
目的：我们的目的是比较腕管综合征（CTS）患者使用横向超声进行腕管松解术（CTR）前后腕管和手指运动时正中神经在腕管内的运动，并评估CTR治疗CTS的生物力学疗效。方法：对24例CTS患者进行横向超声检查。在CTR前后，分别在不同的腕关节位置与手指伸展和屈曲时，对正中神经在腕管内的位置进行定量检查。结果如下：我们发现，正中神经移动统计学显着手掌CTR后比以前在所有的手腕位置在手指运动。屈指时，正中神经向掌侧的平均位移以掌屈位最大。此外，正中神经的位移量在手指运动在所有的手腕位置后，CTR比以前在统计学上显着减少。结论：目前的研究表明，在腕管正中神经的运动模式，在腕关节和手指的运动进行比较之前和之后，使用横向超声CTS患者CTR。结果表明，正中神经在CTR后大大远离肌腱，避免了肌腱的压缩或剪切应力。这些超声信息可以提供对CTS的病理机制的进一步理解，并提供CTS的更准确的诊断和更好的CTR治疗。
Purpose: We aimed to compare the movement of the median nerve within the carpal tunnel during wrist and finger motions between before and after carpal tunnel release (CTR) using transverse ultrasound in carpal tunnel syndrome (CTS) patients and to evaluate the biomechanical efficacy of CTR for CTS. Methods: Twenty-four patients with CTS were examined by transverse ultrasound. The location of the median nerve within the carpal tunnel was examined quantitatively as a coordinate at varied wrist positions with finger extension and flexion, respectively, before and after CTR. Results: We found that the median nerve moved statistically significantly more palmarly after CTR than before at all wrist positions during finger motion. The average median nerve displacement toward the palmar side at the palmar flexion position in finger flexion was the greatest among all positions. Additionally, the displacement amounts of the median nerve during finger motion at all wrist positions were statistically significantly smaller after CTR than before. Conclusions: The current study demonstrated the movement patterns of the median nerve in the carpal tunnel during wrist and finger motions compared before and after CTR using transverse ultrasound in CTS patients. The findings suggested that as the median nerve shifted greatly palmarly away from the tendons after CTR, the nerve avoids compression or shearing stress from the tendons. This ultrasound information could offer further understanding of the pathomechanics of CTS and provide a more accurate diagnosis of CTS and better treatment by CTR.