Carpal tunnel syndrome (CTS) is a pathology affecting hand function caused by median nerve overload. Numbness in the fingers, a loss of sensory and motor function in the hand, and pain are all symptoms of carpal tunnel syndrome. The lack of numerical data about the median nerve mechanical strain inside the carpal tunnel is the main disadvantage of current clinical approaches employed in carpal syndrome diagnostics. Moreover, application of each diagnostic method alone often leads to misdiagnosis. We proposed a combined approach including hand motion capture, finite element modelling (FEM), and electromechanical simulations to evaluate median nerve compression and find a correlation with hand mobility. The hand motion capture provided the boundary conditions for FEM. After that, FEM simulations of finger flexion and hand flexion / extension were performed. Further, FEM results were put in the electrical model of nerve conduction based on the Hodgkin-Huxley model and extended cable equation. It was exhibited median nerve conduction reduced significantly throughout the flexion and extension of the hand that compared to finger flexion. During finger flexion and hand flexion and extension, the load distribution over each of nine finger flexor tendons was evaluated. The tendons of the index finger were found to have the highest Mises stress values. It was found how tendon and connective tissue contact types affected carpal tunnel pressure. The difference between the contact types was 31.7% for hand extension and 59.9% for hand flexion. The developed approach has the potential to become an alternative diagnostic method for CTS at early stages. Additionally, it can be employed as non-invasive procedure for evaluation of carpal nerve stress.
Carpal tunnel syndrome (CTS) is the most common pathology among disorders of the peripheral nervous system related to median nerve compression. To our knowledge, there are limited data on the effect of tendon movement on median nerve compression. This study focuses on the understanding of the carpal syndrome by simulating the impact of tendons movement caused by fingers flexion by Finite Element Analysis. Therefore, such modeling is the step toward the development of a personalized technique for value determining median nerve compression. Open-source MRI of the human right hand was used to build patient-specific phalanges of the fingers. Carpal tunnel soft tissues were considered as hyper-elastic materials, while bone structures were considered as elastic ones. The final finite-element model had 40 solid bodies which contacted the joint. Results were obtained for four cases of wrist movements: finger flexion, hand flexion/extension, and wrist extension with subsequent by finger flexion. Compression of the median nerve ranged from 129 Pa to 227 Pa. The results show that compression of the median nerve occurs faster during wrist flexion than during wrist extension or finger flexion. A decrease in compression during finger flexion was noticed with wrist extension followed by finger flexion.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.