Role of fasciae around the median nerve in pathogenesis of carpal tunnel syndrome: microscopic and ultrasound study.
carpal tunnel syndrome
double crush syndrome
fasciae
median nerve
paraneural sheath
ultrasound
Journal
Journal of anatomy
ISSN: 1469-7580
Titre abrégé: J Anat
Pays: England
ID NLM: 0137162
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
accepted:
30
10
2019
pubmed:
5
12
2019
medline:
24
3
2021
entrez:
5
12
2019
Statut:
ppublish
Résumé
This study investigated the connections between the median nerve paraneural sheath and myofascial structures near it, from both macroscopic and microscopic points of view. Four samples of median nerve and surrounding tissues were excised from nine non-embalmed upper limbs for microscopic analysis. Ultrasound images were analysed in 21 healthy subjects and 16 carpal tunnel syndrome patients to evaluate median nerve transversal displacement during finger motion at carpal tunnel and forearm levels. An anatomical continuity between epimysium and paraneural sheath and a reduction of paraneural fat tissue from proximal to distal was found in all samples. Median nerve displacements at both levels were significantly reduced in carpal tunnel syndrome subjects (P < 0.001). It was observed that the median nerve is not an isolated structure but is entirely connected to myofascial structures. Therefore, unbalanced tension of epimysial fasciae can affect the paraneural sheath, limiting nerve displacement, and consequently this must be included in carpal tunnel syndrome pathogenesis.
Identifiants
pubmed: 31797384
doi: 10.1111/joa.13124
pmc: PMC7083567
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
660-667Informations de copyright
© 2019 Anatomical Society.
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