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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Quantitative relationship between palmar contact forces and carpal tunnel pressure

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  • presenting/speaker Kazutoshi Kubo - Showa University Hospital, Shinagawa-ku Hatanodai, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1545

doi: 10.3205/19ifssh0102, urn:nbn:de:0183-19ifssh01025

Published: February 6, 2020

© 2020 Kubo.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Carpal tunnel syndrome is the most common entrapment neuropathy occurring in upper limbs. The etiology, however, has not been fully understood yet. The increase of carpal tunnel pressure is considered as the common pathophysiological pathway. It has been identified that forces applied to the palm would affect the carpal tunnel pressure. However, the quantitative relationship between the palmar contact force and carpal tunnel pressure is not well known. The purpose of this study was to quantitatively evaluate the relationship of palmar contact forces and carpal tunnel pressure.

Methods: Eight human cadaver hands were used. The carpal tunnel pressure was measured with a diagnostic catheter-based pressure transducer inserted into carpal tunnel. A custom made device was used to apply forces to the palm until the desired carpal tunnel pressure was attained. Palmar contact forces corresponding to the determined carpal tunnel pressure level were recorded respectively. The testing was repeated with different ranges of tension applied to the flexor digitorum superficialis tendon of the third finger. The tensions were constant at 50 gram for the other flexor tendons and median nerve.

Statistically, two-way ANOVA of repeated measures were used to compare the palmar contact forces between tendon tensions as well as carpal tunnel pressures. Pair-wise comparison was conducted through post-hoc Bonferroni test. In addition, in order to build the quantitative relationship between palmar contact force and carpal tunnel pressure, linear fitting was implemented to find out the equation and coefficient of determination was also calculated to determine how fitted they were.

Results and Conclusions: The results showed that carpal tunnel pressure increased linearly with the force applied to the palm. However, no significant increase in applied forces was found when tendon tension increased. When carpal tunnel pressure was 30 mmHg, mean values of the contact force to the palm was 293 (SD: 15.2) gram-force including all tensions. These results would help to understand the effect of daily activities with hands on carpal tunnel pressure. Further evaluation in vivo study is aimed to realize in more detail the relationship between palmar contact forces and carpal tunnel pressure in the future.