The Journal of Bone and Joint Surgery, Vol 71, Issue 5 679-683, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Measurement of pressure in the carpal canal before and after endoscopic management of carpal tunnel syndrome
I Okutsu, S Ninomiya, I Hamanaka, N Kuroshima and H Inanami
Department of Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo.
In forty-six patients who had carpal tunnel syndrome, a technique of
continuous infusion, given under local anesthesia and without a pneumatic
tourniquet, was used to measure pressures in the carpal canal before and
after endoscopic release of the transverse carpal ligament (retinaculum
flexorum manus). Pressures were similarly measured in sixteen subjects in a
control group. The mean preoperative pressures were significantly higher in
the patients who had carpal tunnel syndrome than in the patients in the
control group when the pressures were measured under four conditions: with
the wrist in the resting position, with active grip, and with maximum
passive extension and flexion of the wrist. The mean pressures improved
significantly postoperatively and were in the range of values that were
found under each condition for the control group. Measurement of pressure
in the carpal canal before and after operation may be useful in diagnosing
carpal tunnel syndrome and in determining the effectiveness of endoscopic
management.