The carpal tunnel entrance is the proximal opening of the carpal tunnel at the wrist crease, where the median nerve and flexor tendons transition from the forearm into the rigid fibro-osseous tunnel. This transition zone is the level of electrodiagnostic carpal tunnel assessment.
| Location | Proximal wrist at the level of the distal wrist crease, between the pisiform and the scaphoid tubercle |
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The inlet where the median nerve and flexor tendons pass from the forearm into the rigid tunnel. Median nerve size is usually measured here on ultrasound when carpal tunnel syndrome is suspected.
The carpal tunnel entrance is the level where nerve conduction studies measure distal motor latency (distance from wrist crease to thenar eminence). Wrist splinting in neutral position keeps the tunnel at its maximum volume at this entrance level. Carpal tunnel syndrome compresses the nerve most severely at the entrance where the rigid flexor retinaculum begins.
Median nerve compression at the carpal tunnel entrance from retinaculum rigidity and increased tunnel pressure, measured by nerve conduction studies and treated by proximal-to-distal retinaculum release.
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