{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T14:39:06Z","timestamp":1772548746101,"version":"3.50.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000038","name":"NSERC","doi-asserted-by":"crossref","award":["PGS-D"],"award-info":[{"award-number":["PGS-D"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"crossref"}]},{"name":"DJO Global"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Non-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with \u00b120\u00b0 flexion-extension (FE), however, CTV decreased with ulnar deviation over the range of -5\u00b0 to 15\u00b0 radial-ulnar deviation (RUD). These findings suggest CTV may be too coarse of a measure to reflect the effects of slight non-neutral postures, or that volume is conserved and redistributed due to changes in tunnel morphology with posture. The objective of this study was to assess volume distribution along the length of the carpal tunnel and to quantify regional morphology changes with deviated wrist postures in both FE and RUD. Analysis was performed on a dataset of computed tomography scans collected on ten cadaveric specimens (5 male, 5 female, mean age = 80.7 \u00b1 10.9 years) over a range of FE and RUD postures. The carpal tunnel of each scan was divided into four quartiles of equal length along the tunnel to quantify volume distribution. Volume within the carpal tunnel was seen to redistribute with both FE and RUD. Decreased volume in the distal aspect of the tunnel with flexion and proximal aspect of the tunnel with ulnar deviation may contribute to localized compression of the medial nerve. Measures of mean cross-sectional area, width and depth by quartile provided an indication of the morphology changes associated volume redistribution. Morphology analysis also revealed twisting between the proximal and distal aspects of the tunnel which increased with flexion and ulnar deviation and may further contribute to strain on the median nerve.<\/jats:p>","DOI":"10.1371\/journal.pone.0277234","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T18:40:59Z","timestamp":1669833659000},"page":"e0277234","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5535-0209","authenticated-orcid":true,"given":"Drew A.","family":"Anderson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele L.","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen D.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"issue":"2","key":"pone.0277234.ref001","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1197\/j.jht.2005.02.001","article-title":"Pathomechanics of peripheral nerve loading: Evidence in carpal tunnel syndrome.","volume":"18","author":"PJ Keir","year":"2005","journal-title":"J Hand Ther"},{"issue":"1","key":"pone.0277234.ref002","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1518\/001872007779598127","article-title":"Guidelines for wrist posture based on carpal tunnel pressure thresholds","volume":"49","author":"PJ Keir","year":"2007","journal-title":"Hum 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Biomech."},{"issue":"9","key":"pone.0277234.ref009","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.clinbiomech.2008.05.009","article-title":"Wrist and carpal tunnel size and shape measurements: effects of posture","volume":"23","author":"JPM Mogk","year":"2008","journal-title":"Clin Biomech (Bristol, Avon)."},{"key":"pone.0277234.ref010","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s11552-009-9220-9","article-title":"Morphological Analysis of the Carpal Tunnel","volume":"5","author":"CA Pacek","year":"2010","journal-title":"Hand"},{"issue":"1","key":"pone.0277234.ref011","first-page":"49","article-title":"Elliptical morphology of the carpal tunnel cross section","volume":"19","author":"JN Gabra","year":"2015","journal-title":"Eur J Anat"},{"key":"pone.0277234.ref012","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.clinbiomech.2019.10.024","article-title":"Clinical Biomechanics Morphological and positional changes of the carpal arch and median nerve associated with wrist deviations.","volume":"71","author":"K Lakshminarayanan","year":"2020","journal-title":"Clin Biomech"},{"issue":"5","key":"pone.0277234.ref013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0217425","article-title":"Sex-related differences in carpal arch morphology","volume":"14","author":"K Lakshminarayanan","year":"2019","journal-title":"PLoS One"},{"key":"pone.0277234.ref014","unstructured":"Anderson DA, In vitro Investigation of Carpal Tunnel Volume and Morphology Changes with Non-Neutral Wrist Postures. Ph.D. Thesis, University of Guelph. 2022. Available from: https:\/\/hdl.handle.net\/10214\/27247."},{"issue":"11","key":"pone.0277234.ref015","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1016\/j.jbiomech.2006.10.041","article-title":"A digital database of wrist bone anatomy and carpal kinematics","volume":"40","author":"DC Moore","year":"2007","journal-title":"J Biomech"},{"issue":"2","key":"pone.0277234.ref016","first-page":"1","article-title":"Inter- and intra-rater reliability of carpal tunnel volume measurement","volume":"10","author":"DA Anderson","year":"2021","journal-title":"Comput Methods Biomech Biomed Eng Imaging Vis"},{"key":"pone.0277234.ref017","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.clinbiomech.2004.10.002","article-title":"Coupling between wrist flexion\u2013extension and radial\u2013ulnar deviation","volume":"20","author":"Z-M Li","year":"2005","journal-title":"Clin Biomech"},{"issue":"7","key":"pone.0277234.ref018","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S0268-0033(02)00038-4","article-title":"Three-dimensional carpal kinematics in vivo","volume":"17","author":"TM Moojen","year":"2002","journal-title":"Clin Biomech"},{"issue":"04","key":"pone.0277234.ref019","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1055\/s-0034-1394133","article-title":"Carpal Tunnel Syndrome Pathophysiology: Role of Subsynovial Connective Tissue","volume":"03","author":"J-D Werthel","year":"2014","journal-title":"J Wrist Surg."},{"key":"pone.0277234.ref020","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.jelekin.2017.10.007","article-title":"The biomechanics of subsynovial connective tissue in health and its role in carpal tunnel syndrome","volume":"38","author":"Amadio PC Festen-Schrier VJMM","year":"2018","journal-title":"J Electromyogr Kinesiol"},{"key":"pone.0277234.ref021","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/jor.20321","article-title":"Gliding Characteristics between Flexor Tendons and Surrounding Tissues in the Carpal Tunnel: A Biomechanical Cadaver Study","volume":"25","author":"C Zhao","year":"2007","journal-title":"J Orthop Res"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T18:41:28Z","timestamp":1669833688000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277234"}},"subtitle":[],"editor":[{"given":"Priti","family":"Chaudhary","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":21,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0277234","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,30]]}}}