Flexor tendon and synovial gliding during simultaneous and single digit flexion in idiopathic carpal tunnel syndrome

被引:41
作者
Ettema, Anke M. [1 ]
An, Kai-Nan [1 ]
Zhao, Chunfeng [1 ]
O'Byrne, Megan M. [2 ]
Amadio, Peter C. [1 ]
机构
[1] Mayo Clin, Coll Med, Div Orthopaed Res, Biomech Lab, Rochester, MN 55905 USA
[2] Mayo Clin, Coll Med, Dept Hlth Sci Res, Div Biostat, Rochester, MN 55905 USA
关键词
carpal tunnel syndrome; flexor tendon; subsynovial connective tissue; tendon motion; fibrosis;
D O I
10.1016/j.jbiomech.2007.09.017
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
The characteristic pathological finding in carpal tunnel syndrome (CTS) is non-inflammatory fibrosis of the subsynovial connective tissue (SSCT), which lies between the flexor tendons and the visceral synovium (VS). How this fibrosis might affect tendon function is unknown. To better understand the normal function of the SSCT, the relative motion of the middle finger flexor digitorum superficial is (FDS III) tendon and VS was observed during finger flexion in patients with CTS and cadavers with a history of CTS and compared to normal cadavers. A digital camcorder was used to monitor the gliding motion of the FDS III tendon and SSCT in eight patients with idiopathic CTS undergoing carpal tunnel release surgery (CTR), in eight cadavers with an antemortem history of CTS and compared these with eight cadaver controls. There were no significant differences noted in the total movement of the SSCT relative to the FIDS III. However, the pattern of SSCT movement relative to the FIDS III in the CTS patients and cadavers with an antemortem history of CTS differed from the controls in one of two patterns, reflecting either increased SSCT adherence to FDS III or increased SSCT dissociation from FIDS III. In CTS, the gliding characteristics of the SSCT are qualitatively altered. These changes may be the result of increased fibrosis within the SSCT, which in some cases has ruptured, resulting in SSCT-tendon dissociation. Similar changes are also identified postmortem in the CTS patient. (c) 2007 Elsevier Ltd. All rights reserved.
引用
收藏
页码:292 / 298
页数:7
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