Gliding characteristics between flexor tendons and surrounding tissues in the carpal tunnel: A biomechanical cadaver study

The purpose of this study was to investigate the gliding characteristics of flexor tendons within the carpal tunnel with varied wrist positions and tendon motion styles, which may help us to understand the relationship between carpal tunnel syndrome (CTS) and repetitive hand motion. Eight fresh human cadaveric wrists and hands were used. The peak (PGR) and mean (MGR) gliding resistance of the middle finger flexor digitorum superficialis tendon were measured with the wrist in 0, 30, and 60° of flexion and extension. While moving all three fingers together, the PGR at 60° flexion was significantly higher than that at 0, 30, or 60° extension. While moving the middle finger alone, the PGR at 60 and 30° flexion was significantly higher than the PGR at 60° extension. The PGR moving the middle finger FDS alone was significantly greater than that for all three digits moving together in 0, 30, and 60° flexion. Differential finger motion with wrist flexion elevated the tendon gliding resistance in the carpal tunnel, which may be relevant in considering the possible role of wrist position and activity in the etiology of CTS.