Subject-specific finite element analysis of the carpal tunnel cross-sectional to examine tunnel area changes in response to carpal arch loading.
Subject-specific finite element analysis of the carpal tunnel cross-sectional to examine tunnel area changes in response to carpal arch loading.
复制标题
DOI：
10.1016/j.clinbiomech.2017.01.004
复制
发表时间：
2017-02
期刊：
影响因子：
--
通讯作者：
Li ZM
中科院分区：
文献类型：
--
作者：
Walia P;Erdemir A;Li ZM
有人建议控制腕弓宽度（即钩骨和梯形骨之间的距离）作为增加腕管横截面积和减轻正中神经压迫的方法。本研究的目的是开发腕管的有限元模型并确定最大化面积的最佳力方向。根据 MRI 重建了钩骨水平腕骨的平面几何模型，其中腕骨关节间隙充满了线弹性替代组织。使用离散腕管压力（50、100、150 和 200 mmHg）和相应腕骨运动的实验数据，通过逆有限元分析获得替代组织的材料特性。所得模型用于模拟腕弓宽度和面积随着施加在钩骨钩上的单位力的方向变化而变化。逆有限元模型对实验区域数据的预测误差在1.5%以内。力施加模拟表明，腕弓宽度和面积取决于力施加的方向，最小弓宽度和最大面积发生在相对于钩骨到梯形轴的 138°（即掌侧径向方向）处。在此力方向上，宽度从最初的 25.1 mm 变为 24.4 mm（减少 3%），面积从 290.3 mm2 变为 301.6 mm2（增加 4%）。当前研究的结果指导生物力学操作来增加隧道面积，可能有助于降低腕管压力并缓解压迫性正中神经病的症状。
Manipulating the carpal arch width (i.e. distance between hamate and trapezium bones) has been suggested as a means to increase carpal tunnel cross-sectional area and alleviate median nerve compression. The purpose of this study was to develop a finite element model of the carpal tunnel and to determine an optimal force direction to maximize area. A planar geometric model of carpal bones at hamate level was reconstructed from MRI with inter-carpal joint spaces filled with a linear elastic surrogate tissue. Experimental data with discrete carpal tunnel pressures (50, 100, 150, and 200 mmHg) and corresponding carpal bone movements were used to obtain material property of surrogate tissue by inverse finite element analysis. The resulting model was used to simulate changes of carpal arch widths and areas with directional variations of a unit force applied at the hook of hamate. Inverse finite element model predicted the experimental area data within 1.5% error. Simulation of force applications showed that carpal arch width and area were dependent on the direction of force application, and minimal arch width and maximal area occurred at 138° (i.e. volar-radial direction) with respect to the hamate-to-trapezium axis. At this force direction, the width changed to 24.4 mm from its initial 25.1 mm (3% decrease), and the area changed to 301.6 mm2 from 290.3 mm2 (4% increase). The findings of the current study guide biomechanical manipulation to gain tunnel area increase, potentially helping reduce carpal tunnel pressure and relieve symptoms of compression median neuropathy.