Eur J Anat, 19 (1): 49-56 (2015)

Elliptical morphology of the carpal tunnel cross section

Joseph N. Gabra^1,2, Dong Hee Kim¹ and Zong-Ming Li^1,2

¹Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, Ohio, USA and ²Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, Ohio, USA

ABSTRACT Although the carpal tunnel is known for its anatomical constituents, its morphology is not well recognized. The aim of this study was to investigate the morphometric properties of the carpal tunnel and its surrounding structures. Magnetic resonance and cross-sectional images of the distal carpal tunnel were collected from eight cadaveric hands. Morphological analyses were performed for the cross sections of the carpal tunnel, interior carpus boundary, and exterior carpus boundary. The specimens had a carpal arch width and height of 23.9 ± 2.9 mm and 2.2 ± 0.9 mm, respectively. The carpal tunnel, interior carpus boundary, and exterior carpus boundary had perimeters of 54.8 ± 4.5 mm, 68.5 ± 7.0 mm, and 130.6 ± 11.8 mm, respectively, and areas of 183.5 ± 30.1 mm2, 240.7 ± 40.2 mm2, and 1002.3 ± 183.7 mm2, respectively. The cross sections were characterized by elliptical fitting with aspect ratios of 1.96 ± 0.15, 1.96 ± 0.19, and 1.76 ± 0.19 for the carpal tunnel, interior carpus boundary, and exterior carpus boundary, respectively. The major axis of the boundaries increased in pronation angle, relative to the hamate-trapezium axis, for the exterior carpus (6.0 ± 3.0º), interior carpus (8.2 ± 3.2º), and carpal tunnel (15.9 ± 2.2º). This study advances our understanding of the structural anatomy of the carpal tunnel, and the morphological information is valuable in the identification of structural abnormality, assistance of surgical planning, and evaluation of treatment of effects.

Keywords: Carpal tunnel, Carpus, Morphology