TY - JOUR
T1 - In vivo tissue interaction between the transverse carpal ligament and finger flexor tendons
AU - Gabra, Joseph N.
AU - Gordon, Joshua L.
AU - Marquardt, Tamara L.
AU - Li, Zong Ming
N1 - Funding Information:
The authors thank Raviraj Nataraj for assisting with data processing programs. Research reported in this publication was partially supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers R01AR068278 and R21AR064957 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2016 IPEM
PY - 2016/10/1
Y1 - 2016/10/1
N2 - The transverse carpal ligament (TCL) is a component of the flexor pulley system of the wrist, keeping the flexor tendons in place by resisting their volar displacement. The purpose of this study was to investigate the in vivo biomechanical interaction between the TCL and flexor tendons in response to tendon tensioning with the wrist at various postures. In eight healthy subjects, the flexor digitorum superficialis and profundus tendons were tensioned by isometrically applying loads (5, 10, and 15 N) to the index finger while the wrist posture was at 20° extension, neutral, 20° flexion, and 40° flexion. The TCL and flexor tendons were imaged at the distal carpal tunnel cross section using ultrasound. The volar-dorsal positions of the tendons, TCL arch height, and TCL-tendon distances were calculated. With increasing wrist flexion, the flexor tendons moved volarly, the TCL arch height increased, and the TCL-tendon distances decreased, indicating that the flexor tendons contacted the TCL and pushed it volarly. The TCL-tendon interaction was amplified by the combination of finger loading and wrist flexion. This study provides in vivo evidence of the biomechanical interaction between the TCL and flexor tendons. Repetitive TCL-tendon interactions may implicate the interacting tissues and the median nerve resulting in tissue maladaptation and nerve compression.
AB - The transverse carpal ligament (TCL) is a component of the flexor pulley system of the wrist, keeping the flexor tendons in place by resisting their volar displacement. The purpose of this study was to investigate the in vivo biomechanical interaction between the TCL and flexor tendons in response to tendon tensioning with the wrist at various postures. In eight healthy subjects, the flexor digitorum superficialis and profundus tendons were tensioned by isometrically applying loads (5, 10, and 15 N) to the index finger while the wrist posture was at 20° extension, neutral, 20° flexion, and 40° flexion. The TCL and flexor tendons were imaged at the distal carpal tunnel cross section using ultrasound. The volar-dorsal positions of the tendons, TCL arch height, and TCL-tendon distances were calculated. With increasing wrist flexion, the flexor tendons moved volarly, the TCL arch height increased, and the TCL-tendon distances decreased, indicating that the flexor tendons contacted the TCL and pushed it volarly. The TCL-tendon interaction was amplified by the combination of finger loading and wrist flexion. This study provides in vivo evidence of the biomechanical interaction between the TCL and flexor tendons. Repetitive TCL-tendon interactions may implicate the interacting tissues and the median nerve resulting in tissue maladaptation and nerve compression.
KW - Carpal tunnel
KW - Flexor tendons
KW - Transverse carpal ligament
KW - Ultrasound imaging
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U2 - 10.1016/j.medengphy.2016.06.023
DO - 10.1016/j.medengphy.2016.06.023
M3 - Article
C2 - 27401044
AN - SCOPUS:84991071269
SN - 1350-4533
VL - 38
SP - 1055
EP - 1062
JO - Medical Engineering and Physics
JF - Medical Engineering and Physics
IS - 10
ER -