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. 2015 Feb;4(1):31-4.
doi: 10.1055/s-0034-1398486.

What does the transverse carpal ligament contribute to carpal stability?

Matthias Vanhees  1 , Frederik Verstreken  2 , Roger van Riet  3
Affiliations

What does the transverse carpal ligament contribute to carpal stability?

Matthias Vanhees et al. J Wrist Surg. 2015 Feb.

Abstract

Background The transverse carpal ligament is well known for its involvement in carpal tunnel syndrome, and sectioning of this ligament remains the definite treatment for this pathology. Some authors believe that the transverse carpal ligament is an important stabilizer of the carpal arch, whereas others do not consider it to be significant. Several studies have been performed, both in vivo and in in vitro. Sectioning of the transverse carpal ligament does not seem to have any effect on the width of the carpal arch in the unloaded condition. However, patients will load the arch during their activities of daily living. Materials and Methods A cadaveric study was done with distraction of the carpal bones before and after sectioning the transverse carpal ligament. Results With the transverse carpal ligament intact, the carpal arch is mobile, with distraction leading up to 50% widening of the arch. Sectioning of the transverse carpal ligament resulted in a significant widening of the carpal arch by a further 30%. Conclusions Loading of the carpal arch after sectioning of the transeverse carapal ligament leads to a significant increase in intracarpal mobility. This will inevitably influence carpal kinematics in the patient and might be responsible for some complications after simple carpal tunnel releases, such as pillar pain, palmar tenderness, and loss of grip strength.

Keywords: carpal stability; carpal tunnel release; carpal tunnel syndrome; flexor retinaculum; transverse carpal ligament.

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Conflict of interest statement

Conflict of Interest None

Figures

Fig. 1
Fig. 1
Correct positioning of the screws was evaluated on postexperimental fluoroscopic images. The K-wires have already been removed. (Reproduced with permission from Tengrootenhuysen M, van Riet R, Pimontel P, Bortier H, Van Glabbeek F. The role of the transverse carpal ligament in carpal stability: an in vitro study. Acta Orthop Belg 2009;75(4):467–47.)
See this image and copyright information in PMC

References

    1. Cobb T K, Dalley B K, Posteraro R H, Lewis R C. Anatomy of the flexor retinaculum. J Hand Surg Am. 1993;18(1):91–99. - PubMed
    1. Stecco C, Macchi V, Lancerotto L, Tiengo C, Porzionato A, De Caro R. Comparison of transverse carpal ligament and flexor retinaculum terminology for the wrist. J Hand Surg Am. 2010;35(5):746–753. - PubMed
    1. Doyle J R. Palmar and digital flexor tendon pulleys. Clin Orthop Relat Res. 2001;(383):84–96. - PubMed
    1. Kline S C, Moore J R. The transverse carpal ligament. An important component of the digital flexor pulley system. J Bone Joint Surg Am. 1992;74(10):1478–1485. - PubMed
    1. Tengrootenhuysen M, van Riet R, Pimontel P, Bortier H, Van Glabbeek F. The role of the transverse carpal ligament in carpal stability: an in vitro study. Acta Orthop Belg. 2009;75(4):467–471. - PubMed