Finite element analysis for transverse carpal ligament tensile strain and carpal arch area.
Finite element analysis for transverse carpal ligament tensile strain and carpal arch area.
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腕横韧带拉应变和腕弓面积的有限元分析。
DOI：
10.1016/j.jbiomech.2018.04.005
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发表时间：
2018
影响因子：
2.4
通讯作者：
Li,Zong-Ming
中科院分区：
文献类型：
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作者：
Yao,Yifei;Erdemir,Ahmet;Li,Zong-Ming
正中神经周围的腕管软组织（如脂肪、肌肉和腕横韧带（TCL））的力学可能使正中神经易受压迫性神经病变的影响。本研究的目的是通过有限元分析（FEA）来了解腕管软组织力学特性和管内压力对TCL拉伸应变和腕弓面积（CAA）的作用。手动分割鱼际肌肉，皮肤，脂肪，TCL，钩骨，并在横向平面上的远端腕管骨从B型超声图像的尸体手。进行敏感性分析以检查TCL拉伸应变和CAA对TCL弹性模量（掌背侧0.125-10 MPa;横向1.375-110 MPa）、皮肤脂肪和鱼际肌肉初始剪切模量（皮肤脂肪1.6-160 kPa;肌肉0.425-42.5 kPa）和隧道内压力（60-480 mmHg）的依赖性。用同一尸体手的实验数据验证了不同隧道内压力下TCL拉伸应变的预测。结果表明，皮肤、脂肪和肌肉对TCL拉伸应变和CAA变化影响不大。而随着TCL弹性模量的降低和隧道内压力的增大，TCL的拉伸应变和CAA均增大。TCL拉伸应变和CAA随压力的增加而线性增加，随TCL弹性模量的减小而指数增加。通过降低弹性模量来软化TCL可能是腕管扩张的替代临床方法，以适应升高的隧道内压力并减轻正中神经压迫性神经病变。
Mechanics of carpal tunnel soft tissue, such as fat, muscle and transverse carpal ligament (TCL), around the median nerve may render the median nerve vulnerable to compression neuropathy. The purpose of this study was to understand the roles of carpal tunnel soft tissue mechanical properties and intratunnel pressure on the TCL tensile strain and carpal arch area (CAA) using finite element analysis (FEA). Manual segmentation of the thenar muscles, skin, fat, TCL, hamate bone, and trapezium bone in the transverse plane at distal carpal tunnel were obtained from B-mode ultrasound images of one cadaveric hand. Sensitivity analyses were conducted to examine the dependence of TCL tensile strain and CAA on TCL elastic modulus (0.125–10 MPa volar-dorsally; 1.375–110 MPa transversely), skin-fat and thenar muscle initial shear modulus (1.6–160 kPa for skin-fat; 0.425–42.5 kPa for muscle), and intratunnel pressure (60–480 mmHg). Predictions of TCL tensile strain under different intratunnel pressures were validated with the experimental data obtained on the same cadaveric hand. Results showed that skin, fat and muscles had little effect on the TCL tensile strain and CAA changes. However, TCL tensile strain and CAA increased with decreased elastic modulus of TCL and increased intratunnel pressure. The TCL tensile strain and CAA increased linearly with increased pressure while increased exponentially with decreased elastic modulus of TCL. Softening the TCL by decreasing the elastic modulus may be an alternative clinical approach to carpal tunnel expansion to accommodate elevated intratunnel pressure and alleviate median nerve compression neuropathy.