HISTOLOGY OF THE TRANSVERSE CARPAL LIGAMENT AND FLEXOR TENOSYNOVIUM IN IDIOPATHIC CARPAL-TUNNEL SYNDROME

Histology of the transverse carpal ligament and flexor tenosynovium wa s investigated in 166 wrists from 130 patients with idiopathic carpal tunnel syndrome. Nine wrists from 9 controls were used for comparison. In the patients, 73.5% of the ligament and 56.0% of the tenosynovium showed normal histology. In the remaining specimens, the ligament show ed mucoid change (17.5%), amyloid deposits (7.8%), inflammation (3.0%) , and chondrometaplasia (2.4%), and the tenosynovium showed fibrosis ( 25.3%), edema (7.2%), inflammation (10.2%), amyloid deposits (8.4%), a nd vascular hypertrophy (4.8%). The majority of these changes were mil d in degree and the pathophysiology did not appear to be meaningful. W e conclude that in idiopathic carpal tunnel syndrome, the ligament and tenosynovium often show normal histology and there are no typical or consistent changes with which idiopathic carpal tunnel syndrome can be associated. (J Hand Surg 1998;23A:1015-1024. Copyright (C) 1998 by th e American Society for Surgery of the Hand.).