The carpal canal or tunnel conducts the long flexor tendons and the median nerve from the anterior compartment of the forearm into the central compartment of the palm. It is bounded by the volar transverse carpal ligament (flexor retinaculum) anteriorly and an arch formed by the carpal bone on the other three sides. On the radial side the ligament is attached to the tubercle of the navicular and the ridge on the greater multangular and, on the ulnar side, to the pisiform and the hook of the hamate. The ligament is continuous along its proximal margin with the deep fascia of the forearm, and it merges distally with the palmar fascia.This tunnel is, therefore, bounded by inelastic ligamentous tissue and bone. The close mechanical tolerance in this tunnel gives rise to increased pressure upon its contents when enlargement of any of the enclosed tissue by edema of trauma
BURNHAM PJ. Acute Carpal Tunnel Syndrome: Median Artery Thrombosis as Cause. Arch Surg. 1963;87(4):645–646. doi:10.1001/archsurg.1963.01310160107020
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