Biomechanical Properties of the Transverse Carpal Ligament

描述(由申请人提供)： 腕管综合征(CTS)是最突出的手部疾患，对国民医疗费用、工人生产力和日常生活能力造成极大的负面影响。尽管其发病率和公共卫生负担日益增加，但我们对CTS的了解相当有限，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)的力学性质，了解TCL力学对CTS的影响，并利用我们的研究结果指导CTS治疗的替代方案的发展。我们将通过实验和理论相辅相成的方法实现这一目标。在实验方面，我们将使用身体标本来研究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。经过验证的模型将为预测多种解剖结构和生物力学边界条件下的腕管力学和病理力学提供有价值的工具。我们的中心假设是TCL的机制可以被用于开发CTS的微创手术治疗。具体地说，我们将测试这样的假设，即通过拉伸TCL可以在不损害腕管的结构完整性的情况下显著扩张腕管，并且在TCL上加载较长时间后可以获得腕管的永久残余扩张。本项目的具体目标是(1)通过拉伸测试来表征TCL的材料特性，(2)通过从腕管内拉伸TCL来检测腕管的扩张和蠕变行为，以及(3)建立在不同解剖结构和载荷条件下确定腕管形态的计算模型。 我们的研究代表了一种新的生物工程方法来加强对CTS的管理。我们的研究结果将有助于发现CTS的替代发病机制，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机制及其与CTS的相关性，并帮助为CTS的预防、评估和治疗提供策略。

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.