Position of the wrist associated with the lowest carpal-tunnel pressure: implications for splint design

J Bone Joint Surg Am. 1995 Nov;77(11):1695-9. doi: 10.2106/00004623-199511000-00008.


Increased carpal-tunnel pressure has been implicated in the pathophysiology of carpal tunnel syndrome, but it is not known whether splints that immobilize the wrist in a functional position of extension minimize carpal tunnel pressure. To determine the position of the wrist that results in the lowest carpal-tunnel pressure, twenty control subjects and four patients who had carpal tunnel syndrome were evaluated with use of a new, dynamic method that continuously measures carpal tunnel pressure throughout the range of motion of the wrist. The pressure was measured by means of a pressure transducer connected to a flexible catheter that had been inserted into the carpal canal. The position of the wrist was measured simultaneously with use of a two-axis electrogoniometer. Aided by a computer monitor that displayed a moving line of real-time carpal-tunnel pressure, each subject was instructed to move the wrist throughout the range of motion and to adjust it to the position that corresponded to the lowest carpal-tunnel pressure. For the control subjects, the lowest carpal-tunnel pressure averaged 8 +/- 4 millimeters of mercury (1.07 +/- 0.53 kilopascals), and the average position of the wrist associated with the lowest pressure was 2 +/- 9 degrees of extension and 2 +/- 6 degrees of ulnar deviation.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Carpal Tunnel Syndrome / physiopathology*
  • Carpal Tunnel Syndrome / therapy*
  • Case-Control Studies
  • Female
  • Humans
  • Immobilization / adverse effects
  • Male
  • Median Nerve / physiopathology
  • Middle Aged
  • Posture
  • Range of Motion, Articular
  • Splints / adverse effects
  • Transducers, Pressure
  • Ulnar Nerve / physiopathology
  • Wrist / physiopathology*