? Carpal tunnel syndrome (CTS) is the most prominent hand disorder and has an immense negative impact on national health care cost, worker productivity, and activities of daily living. Despite its increasing prevalence and public health burden, our understanding of CTS is rather limited and our treatment to CTS awaits improvement. ? The objective of this project is to elucidate the mechanical properties of the transverse carpal ligament (TCL), to comprehend the implication of TCL mechanics to CTS, and to use our findings to guide the development of alternative CTS treatments. We will achieve the objective using complementary experimental and theoretical approaches. Experimentally, we will investigate the material properties of the TCL and the structural properties of the carpal tunnel using cadaveric specimens. The experimental data will allow for the creation and validation of a finite element model of the carpal tunnel. The validated model will provide a valuable tool for the prediction of carpal tunnel mechanics and pathomechanics under numerous anatomical configurations and biomechanical boundary conditions. Our central hypothesis is that the mechanics of the TCL can be exploited for the development of a minimally invasive surgical treatment of CTS. Specifically, we will test the hypotheses that the carpal tunnel can be substantially expanded by stretching the TCL without compromising the structural integrity of the carpal tunnel, and that permanent residual expansion of the carpal tunnel can be obtained after an extended period of loading on the TCL.
The specific aims of this project are (1) to characterize the material properties of the TCL by tensile testing, (2) to examine the expansion and creep behaviors of the carpal tunnel by stretching the TCL from within the carpal tunnel, and (3) to establish a computational model for the determination of carpal tunnel morphometry under various anatomical configurations and loading conditions. ? Our study represents a novel bioengineering approach to an enhanced management of CTS. The results of our investigation will aid the discovery of alternative pathogeneses of CTS, and the development of alternative treatments of CTS. Our long-term goal is to scientifically understand the mechanics and pathomechanics of the carpal tunnel entity and its relevance to CTS, and help provide strategies for the prevention, assessment, and treatment of CTS. ? ? ?
