Inflammation and fibrosis of transverse carpal ligament and flexor tenosynovium in severe idiopathic carpal tunnel syndrome

We approached a histopathologic study of idiopathic carpal tunnel syndrome (CTS) to identify its probable causative factors. The purpose of this study was to assess the prevalence of inflammation and fibrosis in the transverse carpal ligament (TCL) and flexor tenosynovium (FT) in severe idiopathic carpal tunnel syndrome. Thirty nine patients with severe idiopathic CTS undergoing open carpal tunnel release between 2008 and 2010 were selected. The TCL and FT biopsy specimens were analyzed to assess the prevalence of inflammation and fibrosis. The mean age of cases was 49 years (16 to 81). Ten (25.64%) were male and 29 (74.36%) female. Fibrous thickening was observed in 11 hands (28%); TCL fibrous thickening in 9 (21.95%), FT fibrous thickening in 1 (2.43%) and in one hand (2.43%) fibrous thickening was present in both of TCL and FT. Inflammatory changes were observed in four (10%) specimens; one (2.43%) in TCL, two (4.87%) in FT and one (2.43%) in both TCL and FT. Histopathologic study of TCL and FT in idiopathic CTS showed inflammation and fibrosis in some cases.