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An anatomical study for safer carpal tunnel decompression

Mamatha Hosapatna, Anne D Souza, Sachendra Mittal, Antony Sylvan D Souza, Vrinda Hari Ankolekar.

Abstract
Objective: To calculate the dimensions of flexor retinaculum and to measure its distance from important anatomical landmarks.
Methods: The present study was carried out using 10 formalin-fixed cadavers (7 male and 3 female). Both hands were dissected using a midline incision to expose the flexor retinaculum (FR), superficial palmar arch (SPA), palmar cutaneous branch of the median nerve (PCMN) and the recurrent branch of the median nerve (RMN). Width of the FR was noted and the distances were measured using these landmarks.
Results: The width of the FR ranged from 13 mm to 26 mm and the average was 20.084.05 mm on the right side and 22.52.12 mm on the left side. An unpaired t test was applied to compare the means between the right and left sides. The distance of origin of PCMN from FR was more on the left side and the difference was statistically significant.
Conclusion: Careful attention to anatomical landmarks can minimize inadvertent damage to the palmar and thenar branches of the median nerve, as well as the superficial palmar arch, in carpal tunnel decompression.

Key words: Carpal tunnel, flexor retinaculum, median nerve, superficial palmar arch


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