Gelberman et al. directly measured intracarpal canal pressures using wick catheters in 15 CTS patients and 12 controls. The study asked whether objectively elevated pressures explain CTS pathophysiology and whether surgical release normalizes them. Measurements were taken at neutral, flexion, and extension — and immediately after carpal tunnel release.
The physiology behind your CTS counseling lives in this paper. Neutral wrist keeps pressure at ~32 mmHg (already elevated); flexing or extending to 90° spikes it to 94–110 mmHg. This is the quantitative basis for neutral-position night splinting and for advising patients to avoid sustained non-neutral wrist postures.
When a post-Colles fracture patient develops acute median nerve symptoms, these numbers support early canal pressure measurement to distinguish nerve contusion from acute CTS requiring urgent release — a distinction the authors explicitly raise.
The lack of correlation between pressure and symptom severity is a practical nuance: do not use a "borderline" pressure measurement to reassure a symptomatic patient. Clinical diagnosis drives management.
This paper established the quantitative framework for understanding CTS as a compartment-pressure problem, directly informing how subsequent literature treats both chronic and acute presentations.
Gelberman et al. directly measured intracarpal canal pressures using wick catheters in 15 CTS patients and 12 controls. The study asked whether objectively elevated pressures explain CTS pathophysiology and whether surgical release normalizes them. Measurements were taken at neutral, flexion, and extension — and immediately after carpal tunnel release.
The physiology behind your CTS counseling lives in this paper. Neutral wrist keeps pressure at ~32 mmHg (already elevated); flexing or extending to 90° spikes it to 94–110 mmHg. This is the quantitative basis for neutral-position night splinting and for advising patients to avoid sustained non-neutral wrist postures.
When a post-Colles fracture patient develops acute median nerve symptoms, these numbers support early canal pressure measurement to distinguish nerve contusion from acute CTS requiring urgent release — a distinction the authors explicitly raise.
The lack of correlation between pressure and symptom severity is a practical nuance: do not use a "borderline" pressure measurement to reassure a symptomatic patient. Clinical diagnosis drives management.
This paper established the quantitative framework for understanding CTS as a compartment-pressure problem, directly informing how subsequent literature treats both chronic and acute presentations.