Gliding characteristics of flexor tendon and tenosynovium in carpal tunnel syndrome: A pilot study

被引:52
作者
Ettema, Anke M.
Zhao, Chunfeng
Amadio, Peter C.
O'Byrne, Megan M.
An, Kai-Nan
机构
[1] Mayo Clin Coll Med, Div Orthoped Res, Biomech Lab, Rochester, MN USA
[2] Mayo Clin Coll Med, Div Biostat, Dept Hlth Sci Res, Rochester, MN USA
关键词
tendon gliding; tenosynovium; carpal tunnel syndrome; flexor tendon; MEDIAN NERVE; CANAL PRESSURES; GENERAL-POPULATION; PREVALENCE; FINGER; TISSUE; WRIST;
D O I
10.1002/ca.20379
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
The characteristic pathological finding in carpal tunnel syndrome (CTS) is noninflammatory fibrosis of the synovium. How this fibrosis might affect tendon function, if at all, is unknown. The subsynovial connective tissue (SSCT) lies between the flexor tendons and the visceral synovium (VS) of the ulnar tenosynovial bursa. Fibrosis of the SSCT may well affect its gliding characteristics. To investigate this possibility, the relative motion of the flexor tendon and VS was observed during finger flexion in patients undergoing carpal tunnel surgery, and for comparison in hands without CTS, in an in vitro cadaver model. We used a camera to document the gliding motion of the middle finger flexor digitorum superficialis (FDS III) tendon and SSCT in three patients with CTS during carpal tunnel release and compared this with simulated active flexion in three cadavers with no antemortem history of CTS. The data were digitized with the use of Analyze Software (Biomedical Imaging Resource, Mayo Clinic, Rochester, MN). In the CTS patients, the SSCT moved en bloc with the tendon, whereas, in the controls the SSCT moved smoothly and separately from the tendon. The ratio of VS to tendon motion was higher for the patients than in the cadaver controls. These findings suggest that in patients with CTS the synovial fibrosis has altered the gliding characteristics of the SSCT. The alterations in the gliding characteristics of the SSCT may affect the ability of the tendons in the carpal tunnel to glide independently from each other, or from the nearby median nerve. These abnormal tendon mechanics may play a role in the etiology of CTS.
引用
收藏
页码:292 / 299
页数:8
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