During open carpal tunnel release in patients with severe idiopathic carpal tunnel syndrome, an area of constriction in the substance of the median nerve is frequently noted. In a prospective study of 30 patients, the central point of the constricted part of the nerve was determined intraoperatively and found to be, on average, 2.5 (range 2.2â€“2.8) cm from the distal wrist crease. This point always corresponded to the location of the hook of the hamate bone. These intraoperative findings were compared with the â€œnarrowestâ€ point of the carpal canal as determined by anatomical and radiological studies in the literature.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, Volume 31, Issue 6,