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Anatomical Study of the Median Nerve in the Carpal Tunnel and Etiologies of the Carpal-Tunnel Syndrome
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From the Hospital for Joint Diseases, New York
1963 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1963 Jul 01;45(5):953-966
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1. An anatomical study of the carpal tunnel and its contents is presented

2. The median nerve and the flexor tendons are crowded within an osseous trough, rigid on three sides, roofed by a thick transverse carpal ligament.

3. Compression of the median nerve within the carpal tunnel (carpal-tunnel syndrome) may be caused by: increase in the volume of the contents, whether due to injury or disease; decrease in the volume of the tunnel due to deformation of the bone trough (osteo-arthritis or fracture); thickening of the transverse carpal ligament17,26; and anomalous structures within the tunnel.

4. Extreme positions of volar flexion or dorsiflexion of the wrist reduce the volume of the carpal tunnel. These positions may initiate symptoms of median-nerve compression following an inflammatory process in the tunnel or an injury to the wrist.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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