In the group of patients with diabetes, the average cross-sectional area of the median nerve was measured as 10.2[+ or -]2.9 [mm.sup.2] in the proximal region, 7.5[+ or -]1.9 [mm.sup.2] beneath, and 7.7[+ or -]1.8 [mm.sup.2] in the distal region of the transverse carpal ligament
. In the control group, the average cross-sectional area of the median nerve was 10.2[+ or -]2.5 [mm.sup.2] in the proximal region, 6.9[+ or -]1.3 [mm.sup.2] beneath, and 6.6[+ or -]1.4 [mm.sup.2] in the distal region of the transverse carpal ligament
(20,21) Surgical release involves cutting the transverse carpal ligament
over the carpal tunnel to decompress the median nerve.
Insufficient loosening of the transverse carpal ligament
, the compression of the scar tissue on median nerve can be imaged with MRI .
Manipulative treatment of carpal tunnel syndrome: Biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament
: Part 2, effect of sex differences and manipulative "priming." The Journal of the American Osteopathic Association, 105(3), 1-9.
Tachibana, "Histology of the transverse carpal ligament
and flexor tenosynovium in idiopathic carpal tunnel syndrome," Journal of Hand Surgery, vol.
Patients in group A underwent coronal Z-type lengthening of transverse carpal ligament
, and patients in group B had conventional open approach surgery.
* Most patients will require surgical decompression of the transverse carpal ligament
The back wall of the carpal tunnel is bound by the carpal bones and a band of strong tissue called transverse carpal ligament
. Passing through the carpal tunnel are several structures - the various tendons which help in the movement of fingers, the (median) nerve which supplies half the palm and thumb and index finger, and branches of arteries that supply these structures.
The carpal tunnel is a space located posteriorly between the carpal bones of the wrist (moving from fight to left: trapezium, trapezoid, capitate, and hamate), forming the hard "carpal floor," and anteriorly, where the transverse carpal ligament
forms a fibrous sheath or the "carpal roof" (see Fig 1).
The flexor retinaculum or transverse carpal ligament
forms the roof of the canal through which the median nerve and the long flexor tendons pass.
Carlson performed right carpal tunnel surgery, releasing the median nerve which was plastered to the underside of the transverse carpal ligament
. Nurse Denyer returned to work on December 4, 2000, and began to experience pain and swelling.
Garcia's invention, the transverse carpal ligament
stretch pad, therapeutically stretches and strengthens stressed muscles, alleviating the symptoms.