J Wrist Surg 2014; 03(04): 233-234
DOI: 10.1055/s-0034-1394150
Special Focus Section: Transverse Carpal Ligament
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Transverse Carpal Ligament: Anatomy and Clinical Implications

Robert J. Goitz
1   University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
,
John R. Fowler
1   University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
,
Zong-Ming LI
2   Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

Publication Date:
24 October 2014 (online)

Abstract

The anatomical characteristics of the transverse carpal ligament (TCL) have recently been further clarified. Its bony insertion sites proximally to the scaphoid and pisiform are more round, whereas the distal insertion sites to the trapezium and hamate are more oblong, with reproducible areas of insertion. The thickness of the TCL varies along the path of the median nerve, with the thickest portions distal ulnarly and proximal radially. The predominant fiber orientation is transverse. This more detailed understanding of the anatomy of the TCL may enable more novel treatments of carpal tunnel syndrome.

 
  • References

  • 1 Pacek CA, Chakan M, Goitz RJ, Kaufmann RA, Li ZM. Morphological analysis of the transverse carpal ligament. Hand (NY) 2010; 5 (2) 135-140
  • 2 Cobb TK, Dalley BK, Posteraro RH, Lewis RC. Anatomy of the flexor retinaculum. J Hand Surg Am 1993; 18 (1) 91-99
  • 3 Tanabe T, Okutsu I. An anatomical study of the palmar ligamentous structures of the carpal canal. J Hand Surg [Br] 1997; 22 (6) 754-757
  • 4 Manley M, Boardman M, Goitz RJ. The carpal insertions of the transverse carpal ligament. J Hand Surg 2013; 38: 729-732
  • 5 Tanzer RC. The carpal-tunnel syndrome; a clinical and anatomical study. J Bone Joint Surg Am 1959; 41-A (4) 626-634
  • 6 Prantil RK, Xiu K, Kim KE , et al. Fiber orientation of the transverse carpal ligament. Clin Anat 2012; 25 (4) 478-482
  • 7 Isogai S, Murakami G, Wada T, Akita K, Yamashita T, Ishii S. Laminar configuration of the transverse carpal ligament. J Orthop Sci 2002; 7 (1) 79-83
  • 8 Cassidy C, Glennon PE, Stein AB, Ruby LK. Basal joint arthroplasty and carpal tunnel release through a single incision: an in vitro study. J Hand Surg Am 2004; 29 (6) 1085-1088
  • 9 Brett AW, Oliver ML, Agur AM, Edwards AM, Gordon KD. Quantification of the transverse carpal ligament elastic properties by sex and region. Clin Biomech (Bristol, Avon) 2014; 29 (6) 601-606
  • 10 Shen ZL, Li ZM. Ultrasound assessment of transverse carpal ligament thickness: a validity and reliability study. Ultrasound Med Biol 2012; 38 (6) 982-988