Carpal Tunnel Syndrome and Trigger Finger in Childhood

Abstract

THE CARPAL tunnel syndrome, or compression neuropathy of the median nerve beneath the volar transverse carpal ligament (flexor retinaculum) at the wrist, is a well-defined clinical entity. The carpal tunnel (Figure) is formed by the concave arch of the carpal bones covered by the radiocarpal, intercarpal, and metacarpal ligaments. It is roofed by the transverse carpal ligament, running across the anterior aspect of the wrist. The carpal tunnel contains the flexor digitorum sublimis and flexor digitorum profundus invested by the ulnar bursa. It also contains the flexor pollicis longus sheathed by the radial bursa, median nerve, and median artery. The median nerve passes directly beneath the transverse carpal ligament and lies superficial to the nine flexor tendons of the digits within the close confines of the carpal canal, supplying distally the thenar muscles (abductor pollicis brevis, opponens pollicis, and superficial head of flexor pollicis brevis), the first and second lumbricales,