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. 2010 Oct;25(8):776-80.
doi: 10.1016/j.clinbiomech.2010.05.011. Epub 2010 Jun 26.

Biomechanics of the transverse carpal arch under carpal bone loading

Kai-Hua Xiu  1 , Joo-Han Kim, Zong-Ming Li
Affiliations

Biomechanics of the transverse carpal arch under carpal bone loading

Kai-Hua Xiu et al. Clin Biomech (Bristol). 2010 Oct.

Abstract

Background: Carpal tunnel release and conservative interventions are widely used in clinical therapies of carpal tunnel syndrome. The efficacy of these treatment and interventions mainly lies in the exploitation of the mechanical properties of carpal tunnel. This study investigated the structural mechanics of the transverse carpal arch using cadaveric hands.

Methods: Paired force was applied to the insertion sites of the transverse carpal ligament at both the distal (hamate-trapezium) and proximal (pisiform-scaphoid) levels of the carpal tunnel. The two pairs of forces were simultaneously applied in an inward or outward direction when the transverse carpal ligament was intact and transected. Transverse carpal arch and carpal tunnel compliance in response to the forces were analyzed. Three-way repeated measures ANOVA were used to examine the effect of the transverse carpal ligament status (intact/transected), the level of the carpal tunnel (distal/proximal) and the force application direction (inward/outward) on the biomechanics of the transverse carpal arch.

Findings: Transverse carpal ligament plays a stabilizing role in resisting outward deformation of the carpal tunnel. The carpal tunnel at the proximal level is more flexible than the carpal tunnel at the distal level. The carpal tunnel is more compliant under the inward force application than under the outward force application.

Interpretation: The understanding of carpal tunnel mechanics potentially helps to improve the existing strategies and to develop alternatives for the treatment of carpal tunnel syndrome.

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Figures

Figure 1
Figure 1
Two pairs of forces simultaneously applied to the carpal bones at the proximal and distal levels. Note that shown in the figure is the outward force application, and the inward force application was achieved by swapping the connection wires.
Figure 2
Figure 2
Arch widths of the carpal tunnel under 10 N force application at distal (a) and proximal (b) level.
Figure 2
Figure 2
Arch widths of the carpal tunnel under 10 N force application at distal (a) and proximal (b) level.
Figure 3
Figure 3
Force and arch width changes with and without TCL at the distal (a) and proximal (b) levels. Positive values correspond to increased distances under outward forces, and negative values represent distance decreases under inward forces.
Figure 3
Figure 3
Force and arch width changes with and without TCL at the distal (a) and proximal (b) levels. Positive values correspond to increased distances under outward forces, and negative values represent distance decreases under inward forces.
Figure 4
Figure 4
Compliance at the distal and proximal level of the carpal tunnel in the inward and outward directions.
See this image and copyright information in PMC

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