Biomechanical Properties of the Transverse Carpal Ligament

描述（由申请人提供）： 腕管综合征（CTS）是最突出的手部疾病，对国民医疗保健费用，工人生产力和日常生活活动产生巨大的负面影响。尽管其患病率和公共卫生负担不断增加，但我们对CTS的认识相当有限，我们对CTS的治疗有待改进。 本项目的目的是阐明腕横韧带（TCL）的力学特性，理解TCL力学对CTS的影响，并利用我们的研究结果来指导替代CTS治疗方法的发展。我们将使用互补的实验和理论方法来实现这一目标。在实验上，我们将使用尸体标本研究TCL的材料特性和腕管的结构特性。实验数据将允许创建和验证腕管的有限元模型。验证模型将提供一个有价值的工具，在众多的解剖结构和生物力学边界条件下的腕管力学和病理力学的预测。我们的中心假设是，TCL的机制，可用于开发一种微创手术治疗CTS。具体来说，我们将测试的假设，即腕管可以通过拉伸TCL而不损害腕管的结构完整性，并在TCL上的长期负载后，可以获得永久性的腕管残余扩张。本项目的具体目的是（1）通过拉伸试验表征TCL的材料特性，（2）通过从腕管内拉伸TCL检查腕管的膨胀和蠕变行为，以及（3）建立计算模型，用于确定各种解剖结构和载荷条件下的腕管形态测量。 我们的研究代表了一种新的生物工程方法，以增强CTS的管理。我们的研究结果将有助于发现CTS的替代病因，并开发CTS的替代治疗方法。我们的长期目标是科学地了解腕管实体的力学和病理力学及其与CTS的相关性，并帮助提供预防，评估和治疗CTS的策略。

DESCRIPTION (provided by applicant): 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.