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The Effect of Wrist Surgery on Carpal Canal Pressure For CTS Subjects

Normal carpal canal pressure was restored to those diagnosed with carpal tunnel syndrome (CTS) and treated through transverse carpal ligament release surgery in a prospective study by Sanz et al. involving 103 subjects.

Study volunteers had pre-operative diagnosis of CTS determined through symptoms, physical signs, and electrodiagnostic studies. Other subject inclusion criteria were unilateral involvement, idiopathic origin, female gender, within 20 to 50 years of age, not heavy manual workers, and no local/systemic disease. Pre-operative carpal canal pressure was taken in the surgery room with the wrist in postural positions of neutral, full passive extension, and full passive flexion. Post-operative canal pressure with the wrist in the same postural positions was taken at five minutes, two months, six months, and twelve months after the surgical procedure. The carpal canal pressure of 25 controls was measured in the same manner as those in the study group.

Pre-operative canal pressures were significantly higher in the study group in all wrist positions compared to controls. Immediately after surgery, there was a marked lowering of canal pressure followed by a slight rise of pressure at the two month post surgery measurement which was sustained at the six and twelve month post surgery measurements. The two, six, and twelve month post-surgical canal pressure measurements were statistically similar to the canal pressure of the controls.

In both groups, full passive extension created the highest canal pressure while the lowest was found with the wrist in a neutral postural position.

Article Title: Postoperative Changes of Carpal Canal Pressure in Carpal Tunnel Syndrome: A Prospective Study with Follow-Up of 1 Year

Publication: Journal of Hand Surgery (British and European Volume) 30B: 611-614, 2005

Authors: WJ Sanz, A Lizaur and F S Del Campo

This article originally appeared in The Ergonomics Report™ on 2006-05-18.