Brett Allan W, Oliver Michele L, Agur Anne M R, Edwards A Michelle, Gordon Karen D
School of Engineering, University of Guelph, Canada.
Division of Anatomy, Department of Surgery, University of Toronto, Canada.
Clin Biomech (Bristol). 2014 Jun;29(6):601-6. doi: 10.1016/j.clinbiomech.2014.05.003. Epub 2014 May 19.
The transverse carpal ligament is an integral factor in the etiology of carpal tunnel syndrome. The purpose of this study was to report the biomechanical properties of this ligament and quantify sex-based differences and regional variation in tissue response. We hypothesized that the mechanical response would not be uniform across the surface, and that female ligament properties would have higher strain profiles and lower mechanical properties.
Uniaxial testing of twelve (six males, six females) human fresh frozen cadaveric transverse carpal ligaments was carried out using an Instron Materials Testing Machine. Strain was measured via a non-contact optical method.
The following biomechanical properties of the transverse carpal ligament were reported in this work: failure strain (male: 9.2 (SD 5.0), female: 15.5 (SD 7.1)%), strength (male: 4.9 (SD 1.5), female: 4.5 (SD 1.6) MPa), and modulus of elasticity (male: 52.9 (SD 19.6), female: 38.2 (SD 21.9) MPa). The radial side displayed significantly more strain at failure compared to ulnar (P<0.0001).
The results of this study provide evidence that manipulative treatments should focus stretching on the radial half of the tissue, which experiences larger strains under uniform loading conditions. In addition, this work suggests possible sex-based differences in mechanical properties of the transverse carpal ligament, which could provide a basis for the development of improved non-surgical treatment methods for carpal tunnel syndrome. The results can also be applied to generate more accurate computational models of the wrist.
腕横韧带是腕管综合征病因中的一个重要因素。本研究的目的是报告该韧带的生物力学特性，并量化基于性别的差异以及组织反应的区域变化。我们假设整个表面的力学反应并不均匀，并且女性韧带特性会有更高的应变曲线和更低的力学性能。
使用英斯特朗材料试验机对12条（6条男性、6条女性）人类新鲜冷冻尸体的腕横韧带进行单轴测试。通过非接触光学方法测量应变。
本研究报告了腕横韧带的以下生物力学特性：破坏应变（男性：9.2（标准差5.0），女性：15.5（标准差7.1）%）、强度（男性：4.9（标准差1.5），女性：4.5（标准差1.6）兆帕）和弹性模量（男性：52.9（标准差19.6），女性：38.2（标准差21.9）兆帕）。与尺侧相比，桡侧在破坏时显示出显著更多的应变（P<0.0001）。
本研究结果提供了证据，表明手法治疗应侧重于拉伸组织的桡侧半部分，该部分在均匀加载条件下承受更大的应变。此外，这项工作表明腕横韧带的力学性能可能存在基于性别的差异，这可为开发改进的腕管综合征非手术治疗方法提供依据。这些结果还可用于生成更精确的腕部计算模型。
