Article

During ultrasound-guided carpal tunnel release, osseous landmarks may
supplement direct visualization of the distal transverse carpal ligament (dTCL)
to ensure a complete release. The purpose of this study was to determine the
relationship between the apex of the hook of the hamate (aHH) and the dTCL within
the transverse safe zone (TSZ) of the carpal tunnel. DESIGN: Twenty unembalmed
cadaveric specimens were dissected to determine the aHH-dTCL distance and the
aHH-SPA distance (the distance between the aHH and the superficial palmar arch)
at the ulnar and radial limits of the TSZ (the distance between the hook of the
hamate or ulnar artery to the median nerve). RESULTS: The aHH-dTCL distance
averaged 11-12 mm across the TSZ (maximum, 18.2 mm), whereas the aHH-SPA distance
was significantly greater on the radial side of the TSZ compared with the ulnar
side (22.6 +/- 3.6 mm vs. 14.0 +/- 4.0 mm). CONCLUSIONS: The dTCL lies
approximately 11-12 mm distal to the aHH across the TSZ, with an upper limit of
18.2 mm. Along with direct sonographic visualization of the dTCL, the aHH can be
used with other osseous landmarks to estimate the position of the dTCL during
ultrasound-guided carpal tunnel release.

Langue : ANGLAIS