scholarly journals Movement of the Distal Carpal Row During Narrowing and Widening of the Carpal Arch Width

2012 ◽  
Vol 134 (10) ◽  
Author(s):  
Joseph N. Gabra ◽  
Mathieu Domalain ◽  
Zong-Ming Li
Keyword(s):  
Carpal Tunnel ◽  
Rotation Axis ◽  
Carpal Tunnel Release ◽  
Three Dimensional ◽  
Joint Rotation ◽  
Ulnar Deviation ◽  
Motion Patterns ◽  
Arch Width ◽  
Complex Joint ◽  
Insight Into

Change in carpal arch width (CAW) is associated with wrist movement, carpal tunnel release, or therapeutic tunnel manipulation. This study investigated the angular rotations of the distal carpal joints as the CAW was adjusted. The CAW was narrowed and widened by 2 and 4 mm in seven cadaveric specimens while the bone positions were tracked by a marker-based motion capture system. The joints mainly pronated during CAW narrowing and supinated during widening. Ranges of motion about the pronation axis for the hamate-capitate (H-C), capitate-trapezoid (C-Td), and trapezoid-trapezium (Td-Tm) joints were 8.1 ± 2.3 deg, 5.3 ± 1.3 deg, and 5.5 ± 3.5 deg, respectively. Differences between the angular rotations of the joints were found at ΔCAW = −4 mm about the pronation and ulnar-deviation axes. For the pronation axis, angular rotations of the H-C joint were larger than that of the C-Td and Td-Tm joints. Statistical interactions among the factors of joint, rotation axis, and ΔCAW indicated complex joint motion patterns. The complex three-dimensional motion of the bones can be attributed to several anatomical constraints such as bone arrangement, ligament attachments, and articular congruence. The results of this study provide insight into the mechanisms of carpal tunnel adaptations in response to biomechanical alterations of the structural components.

scholarly journals Three-Dimensional Carpal Kinematics after Carpal Tunnel Release

2016 ◽  
Vol 05 (03) ◽  
pp. 222-226 ◽  
Author(s):  
Jonathan Schiller ◽  
Jeffrey Brooks ◽  
P. Mansuripur ◽  
Edward Akelman ◽  
Joseph Gil
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Three Dimensional ◽  
Carpal Kinematics

Open Carpal Tunnel Release: Comparison of a Long Versus Short Incision

1998 ◽  
Vol 6 (2) ◽  
pp. 89-92
Author(s):  
Vicki L Kruger ◽  
Morris TM Rebot
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Workers Compensation ◽  
Repetitive Motion ◽  
Motion Patterns ◽  
Endoscopic Release ◽  
History Of ◽  
Incision Technique ◽  
Open Carpal Tunnel Release ◽  
Postoperative Complaints

VL Kruger, MTM Rebot. Open carpal tunnel release: Comparison of a long versus short incision. Can J Plast Surg 1998;6(2):89-92. A total of 225 adults with carpal tunnel release of 313 wrists were studied to compare the outcome of a long (at least 3.5 cm) with that of a short (2.0 cm or less) incision technique. The two groups were compared for postoperative complaints, length of time until full function was regained, rate of referral to rehabilitation and the effect of Workers’ Compensation status. The surgical technique and rehabilitation protocol are described. The number and severity of postoperative complaints were significantly reduced in the short incision group. In the non-Workers’ Compensation group, 96% of short incision patients resumed full function within 28 days. This finding compares favourably with published results for endoscopic release, and is superior to results obtained with the long incision. Workers’ Compensation patients required longer to recuperate, with 78% regaining full function within 28 days. of those with Workers’ Compensation, 47% of the long incision group and 27% of the short incision group required out-patient therapy. for the non-Workers’ Compensation group, this percentage decreased to 21% of those with the long incision and 3% with the short incision. A history of vocational or avocational repetitive motion patterns was the most common indicator for therapy and accounted for 67% of rehabilitation referrals.

Significance of Incomplete Release of The Distal Portion of The Flexor Retinaculum

1994 ◽  
Vol 19 (3) ◽  
pp. 283-285 ◽  
Author(s):  
T.K. COBB ◽  
W.P. COONEY
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Distal Portion ◽  
Arch Width ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
The Mean ◽  
Distal Aspect ◽  
Partial Release

Endoscopic carpal tunnel release has been shown in recent studies to result in a significant number of incomplete releases of the distal aspect of the flexor retinaculum. The significance of this complication is unknown. To address this question, we measured the amount of carpal arch widening after incomplete and complete release. The mean amount of change in carpal arch width in five cadaveric hands after partial release (all but the distal 4 mm) was 0.74 mm, which was statistically significant. The mean additional change after release of the remaining 4 mm of the flexor retinaculum was 0.12 mm, which was not significant. Incomplete release of the distal 4 mm of the distal aspect of the flexor retinaculum allows carpal arch widening that is no different from that of complete sectioning of the flexor retinaculum in the cadaver limb.

Three-dimensional analysis of thumb motion recovery after carpal tunnel release

2021 ◽  
pp. 175319342110147
Author(s):  
Akira Kodama ◽  
Hiroshi Kurumadani ◽  
Teruyasu Tanaka ◽  
Rikuo Shinomiya ◽  
Toru Sunagawa ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Path Length ◽  
Carpal Tunnel Release ◽  
Three Dimensional ◽  
Motor Dysfunction ◽  
Joint Movement ◽  
Flexion Extension ◽  
Tunnel Syndrome ◽  
Thumb Motion

This study quantified recovery of thumb motion in patients with carpal tunnel syndrome after carpal tunnel release using three-dimensional motion analysis with a retroreflective surface-based marker method. Eighteen hands from 14 patients who underwent carpal tunnel release for idiopathic carpal tunnel syndrome were included. The angular movements of the three joints of the thumb, the path length of the thumb tip and the area enclosed by the perimeter path of the thumb tip were measured during circumduction. The range of joint movement, including abduction/adduction of the trapeziometacarpal joint, and flexion/extension of the interphalangeal and metacarpophalangeal joints and the path length of the thumb tips, improved significantly 1 year after surgery. The quantification of thumb kinematics helps to better understand motor dysfunction in carpal tunnel syndrome, assess the severity of the condition and decide on treatment. Level of evidence: IV

scholarly journals Knee Joint Rotation Axis Is More Laterally Rotated and Valgus Than We Previously Thought

2021 ◽  
Author(s):  
Liwen Zheng ◽  
Deye Song ◽  
Yongheng Luo ◽  
Wanchun Wang ◽  
Xinzhan Mao ◽  
...  
Keyword(s):  
Knee Joint ◽  
Rotation Axis ◽  
Knee Prosthesis ◽  
Research Result ◽  
Three Dimensional ◽  
Contributing Factors ◽  
Chi Square ◽  
Transepicondylar Axis ◽  
Joint Rotation ◽  
Joint Axis

Abstract Background: Currently, the patient satisfaction rate after receiving TKA is around 80% to 90% and there is still room for further improvement. With the aim to provide reference for improving TKA surgery, stereophotogrammetry was used in this study to evaluate knee joint kinematics.Methods: Multiple MRI images of knee joints flexed at 0, 10, 20... to 100 degrees were scanned in bilateral knees of 45 asymptomatic adult volunteers. After three-dimensional alignment of the femur, the displacement and rotation angles of the tibia flexed at different angles were measured. Contributing factors were tested using One-way ANOVA and chi-square test in SPSS 24.Results: 1)No contributing factors was found to influence rotation axis; 2) Within the range of motion at 0-100° of flexion, the rotation axis exhibited no significant displacement relative to the femur. 3) On the horizontal plane, the lateral rotation angle of knee joint axis was 4.91°±1.84°(3°~7°) relative to transepicondylar axis (TEA) and 7.84°±2.09° relative to posterior condylar axis (PCA); on the coronal plane, the valgus angle of knee joint axis was 3.38°±0.82°(2.5°~5°) relative to tibial plateau, and 6.53°±0.91°(5°~8°) relative to the perpendicular line of the lower limb force line. Conclusion: No contributing factors were found, but the rotation axis of the knee joint is more laterally rotated and valgus than previously thought. These findings may explain the research result of some current literatures, and may provide theoretical rationale for further improvement of knee prosthesis design.

Risk of Neurovascular Injury with Limited-Open Carpal Tunnel Release: Defining the “Safe-Zone”

2001 ◽  
Vol 26 (5) ◽  
pp. 484-487 ◽  
Author(s):  
T. L. ATIK ◽  
B. SMITH ◽  
M. E. BARATZ
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Ring Finger ◽  
Safe Zone ◽  
Ulnar Deviation ◽  
Radial Deviation ◽  
Neurovascular Structure ◽  
Middle Ring ◽  
Open Carpal Tunnel Release ◽  
Neurovascular Structures

Limited-open carpal tunnel release was performed in ten cadaver arms using the “Safeguard” system. The “Safeguard” guide was intentionally placed off of the longitudinal middle/ring finger axis, either in 15° of radial deviation or 15° of ulnar deviation. Despite the errant placement, carpal tunnel release was performed without damage to any neurovascular structure. The proximity of neurovascular structures to the middle/ring finger axis was measured in all ten cadaver specimens. From this, a “safe-zone” was defined for endoscopic or limited-open carpal tunnel release. The “safe-zone” expands when surgery is performed from distal to proximal. The area of the “safe-zone” is greatest when a protective guide is placed between the bursal sac of the carpal canal and the flexor retinaculum.

Structure and function of neural networks in the retina

1988 ◽  
Vol 46 ◽  
pp. 26-27
Author(s):  
Peter Sterling
Keyword(s):  
Ganglion Cells ◽  
Three Dimensional ◽  
Structure And Function ◽  
Synaptic Connections ◽  
Visual Axis ◽  
One Dimensional ◽  
Cat Retina ◽  
Ultrathin Sections ◽  
And Function ◽  
Insight Into

The synaptic connections in cat retina that link photoreceptors to ganglion cells have been analyzed quantitatively. Our approach has been to prepare serial, ultrathin sections and photograph en montage at low magnification (˜2000X) in the electron microscope. Six series, 100-300 sections long, have been prepared over the last decade. They derive from different cats but always from the same region of retina, about one degree from the center of the visual axis. The material has been analyzed by reconstructing adjacent neurons in each array and then identifying systematically the synaptic connections between arrays. Most reconstructions were done manually by tracing the outlines of processes in successive sections onto acetate sheets aligned on a cartoonist's jig. The tracings were then digitized, stacked by computer, and printed with the hidden lines removed. The results have provided rather than the usual one-dimensional account of pathways, a three-dimensional account of circuits. From this has emerged insight into the functional architecture.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

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