Volar/dorsal compressive mechanical behavior of the transverse carpal ligament

Main, Erin K.; Goetz, Jessica E.; Baer, Thomas; Klocke, Noelle; Brown, Thomas

doi:10.1016/j.jbiomech.2012.01.048

Cited by 13 publications

(10 citation statements)

References 20 publications

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“…This has all along been challenging to researchers investigating the biomechanical properties and role of the TCL from a computational (Guo et al, 2009;Li et al, 2009;Main et al, 2012) and experimental (Garcia-Elias et al, 1989;Tengrootenhuysen et al, 2009;Xiu et al, 2010) perspective. This paper describes the first approach taken towards determining tensile properties of the TCL using a commercial Maillon Rapide Delta.…”

Section: Discussionmentioning

confidence: 99%

“…These variations were small considering that specimen variability is an inherent factor considered and incorporated into cadaver related research designs. TCL tensile testing has predominantly been performed in the radial/ulnar direction with very little testing done until recently in the volar/dorsal direction (Main et al, 2012). Previous studies have investigated TCL tensile testing using manipulation and load bearing techniques (Sucher and Hinrichs, 1998;Xiu et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

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Tensile properties of the transverse carpal ligament and carpal tunnel complex

Ugbolue

Gislason

Carter

et al. 2015

Clinical Biomechanics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tensile properties of the transverse carpal ligament and carpal tunnel complex

Ugbolue

Gislason

Carter

et al. 2015

Clinical Biomechanics

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“…Previously, the mechanical properties of the TCL have only been studied in vitro using cadaveric specimens [8,12,13]. In this study, the in vivo stiffness of the TCL was investigated by measuring the SWV using ARFI imaging.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the largest elastic modulus of the TCL was found in the proximal radial region, with a mean of 2.8 MPa. Main et al [13] investigated the compressive mechanical properties of the TCL in the volar/dorsal direction and reported that they were location-dependent, i.e. the stiffness values at the compression sites with muscle attachments were greater than those at the compression sites without muscle attachments.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Study of Transverse Carpal Ligament Stiffness Using Acoustic Radiation Force Impulse (ARFI) Imaging

Shen

Vince

2013

PLoS ONE

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The transverse carpal ligament (TCL) forms the volar boundary of the carpal tunnel and may provide mechanical constraint to the median nerve, leading to carpal tunnel syndrome. Therefore, the mechanical properties of the TCL are essential to better understand the etiology of carpal tunnel syndrome. The purpose of this study was to investigate the in vivo TCL stiffness using acoustic radiation force impulse (ARFI) imaging. The shear wave velocity (SWV) of the TCL was measured using Virtual Touch IQTM software in 15 healthy, male subjects. The skin and the thenar muscles were also examined as reference tissues. In addition, the effects of measurement location and ultrasound transducer compression on the SWV were studied. The SWV of the TCL was dependent on the tissue location, with greater SWV values within the muscle-attached region than those outside of the muscle-attached region. The SWV of the TCL was significantly smaller without compression (5.21 ± 1.08 m/s) than with compression (6.62 ± 1.18 m/s). The SWV measurements of the skin and the thenar muscles were also affected by transducer compression, but to different extents than the SWV of the TCL. Therefore to standardize the ARFI imaging procedure, it is recommended that a layer of ultrasound gel be maintained to minimize the effects of tissue compression. This study demonstrated the feasibility of ARFI imaging for assessing the stiffness characteristics of the TCL in vivo, which has the potential to identify pathomechanical changes of the tissue.

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“…In particular, the repetitive flexion (Ibrahim et al, 2012;Seffinger and Hruby, 2007) or curling of the thumb, index finger (IF) and middle finger (MF) have been associated with CTS development. It has been suggested that the proximity of these associated tendons to the median nerve, and their 'pushing compressively' (Main et al, 2012) against the TCL during finger motion may result in higher nerve-tendon mechanical interaction, compared to other finger flexor tendons (Liong et al, 2014). However, the effects of the different nerve-tendon interactions in each finger motion and their resultant stress on the median nerve have not been previously examined.…”

Section: Introductionmentioning

confidence: 99%

Finite element simulation of intra-carpal tunnel pressure: the effects of individual finger flexion and histological changes

Liong

Lahiri

Lee

et al. 2015

IJECB

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Carpal tunnel syndrome (CTS) is a common neuropathy, yet its etiology is unknown. While repetitive finger flexion and interstitial subsynovial connective tissue (SSCT) thickening are commonly associated with idiopathic CTS development, the stress that the nerve experiences remain unexamined. In this study, a patient-specific computational model of the carpal tunnel was developed. Tendon displacements corresponding to thumb, index finger (IF) and middle finger (MF) flexion were prescribed. To replicate a CTS candidate, the most common physiological finding -fibrosis of the SSCT -was modelled. Heightened nerve coefficients were also prescribed to simulate nerve stiffening. This revealed that volarly-moving tendons, as in IF and thumb flexion, elicit greater nerve stresses than those dorsally-moving tendons, as in MF flexion. The stress encountered in CTS candidates significantly exceeded those in normal candidates, demonstrating that tendon path, and the in-vivo conditions of an individual's SSCT and median nerve stiffness predominantly affect nerve stress. (2015) 'Finite element simulation of intra-carpal tunnel pressure: the effects of individual finger flexion and histological changes', Int.

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Volar/dorsal compressive mechanical behavior of the transverse carpal ligament

Cited by 13 publications

References 20 publications

Tensile properties of the transverse carpal ligament and carpal tunnel complex

Tensile properties of the transverse carpal ligament and carpal tunnel complex

In Vivo Study of Transverse Carpal Ligament Stiffness Using Acoustic Radiation Force Impulse (ARFI) Imaging

Finite element simulation of intra-carpal tunnel pressure: the effects of individual finger flexion and histological changes

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