Finite element simulation of the mechanical impact of computer work on the carpal tunnel syndrome

Mouzakis, Dionysios E.; Rachiotis, George; Zaoutsos, Stefanos; Eleftheriou, Andreas; Malizos, Konstantinos N.

doi:10.1016/j.jbiomech.2014.07.004

Cited by 19 publications

(20 citation statements)

References 29 publications

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“…In recent years, many researchers conducted a signi cant amount of study on distal radius fractures [11][12][13][14][15] mainly through biomechanical tests on specimen. Nevertheless, due to different kinds of restrictive conditions, the physiological conditions are hard to be truly re ected in the experiment.…”

Section: Introductionmentioning

confidence: 99%

Numerical Modeling of Rehabilitation Exercise when Distal Radius Fracture Treated by Splint

Hua

Liu

et al. 2020

Preprint

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Background Rehabilitation exercise plays a key role in bone fracture healing. Although traditional clinical experiments and observations are adopted to evaluate the effect of rehabilitation exercise, the biomechanical mechanism is still unclear. There are few reports on the mechanical analysis model of elbow flexion rehabilitation exercise of the complete upper limb model previously. Because the upper limb structure is complex, the previous model is so simplified that soft tissue structure is not considered. It cannot reflect the change and distribution of the stress and stress state during elbow flexion exercise. Methods From the perspective of biomechanics, based on the CT scanning images of forearm for an aged female volunteer, a 3-D distal radius fracture forearm model is established. By introducing the soft tissues and the splint, a complete 3-D forearm model is finally reconstructed. The model includes ulna, radius, humerus, muscle, ligament, joint, wrist, skin and splint. The correctness of the model is verified by comparing the results of numerical simulation with the results of previous literature and clinical experiments. Results When the elbow flexion angle increases from 0 to 120 degrees, the stress increases from 0.21 Mpa to 0.83 Mpa. When the elbow flexion angle increases from 0 to 120 degrees, the strain increases from 2–23%, and the maximum strain at the fracture end is about 22.5%. Also an analytical formula of the relationship fracture end strain and different elbow flexion angles is obtained by nonlinear fitting based on the simulation results, which is convenient for clinicians to predict fracture end strain. Conclusions During elbow flexion rehabilitation exercise, the stress of biceps brachii is large, and with the increase of elbow flexion angle, the stress shows an increasing trend. The stress in the area of distal radius fracture is also concentrated. Moderate stress concentration is helpful to the process of bone remodeling, so as to shorten the time of fracture healing. There was no obvious stress concentration in metacarpal bone and has little effect on the activity of metacarpophalangeal joint. The fretting strain at the fracture site can improve the speed of fracture healing, because the generation of early callus can absorb a lot of energy generated by fretting strain, which has an impact on the mechanical properties and plastic deformation ability of callus, and plays an important role in the stimulation of late osteogenesis.

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Section: Introductionmentioning

confidence: 99%

Numerical Modeling of Rehabilitation Exercise when Distal Radius Fracture Treated by Splint

Hua

Liu

et al. 2020

Preprint

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“…The TCL, skin, fat and thenar muscles might constrain the carpal arch through their structural and mechanical interactions. For the carpal tunnel pressure, previous FE modeling has been used to examine the effect of increased carpal tunnel pressure caused by awkward wrist postures on the deformation of median nerve (Mouzakis et al, 2014). The intratunnel pressure might also alter the carpal arch and TCL geometry.…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis for transverse carpal ligament tensile strain and carpal arch area

Yao

Erdemir

2018

Journal of Biomechanics

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Mechanics of carpal tunnel soft tissue, such as fat, muscle and transverse carpal ligament (TCL), around the median nerve may render the median nerve vulnerable to compression neuropathy. The purpose of this study was to understand the roles of carpal tunnel soft tissue mechanical properties and intratunnel pressure on the TCL tensile strain and carpal arch area (CAA) using finite element analysis (FEA). Manual segmentation of the thenar muscles, skin, fat, TCL, hamate bone, and trapezium bone in the transverse plane at distal carpal tunnel were obtained from B-mode ultrasound images of one cadaveric hand. Sensitivity analyses were conducted to examine the dependence of TCL tensile strain and CAA on TCL elastic modulus (0.125-10 MPa volar-dorsally; 1.375-110 MPa transversely), skin-fat and thenar muscle initial shear modulus (1.6-160 kPa for skin-fat; 0.425-42.5 kPa for muscle), and intratunnel pressure (60-480 mmHg). Predictions of TCL tensile strain under different intratunnel pressures were validated with the experimental data obtained on the same cadaveric hand. Results showed that skin, fat and muscles had little effect on the TCL tensile strain and CAA changes. However, TCL tensile strain and CAA increased with decreased elastic modulus of TCL and increased intratunnel pressure. The TCL tensile strain and CAA increased linearly with increased pressure while increased exponentially with decreased elastic modulus of TCL. Softening the TCL by decreasing the elastic modulus may be an alternative clinical approach to carpal tunnel expansion to accommodate elevated intratunnel pressure and alleviate median nerve compression neuropathy.

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“…Specific to the wrist, FE analysis has been used to investigate the load transmission through the carpal bones (Carrigan et al, 2003; Gislason et al, 2009), the effects of pathological conditions on wrist joint (Bajuri et al, 2012), wrist mechanics in response to tendon loading (Majors and Wayne, 2011), and changes in carpal load transmission associated with carpal tunnel release (Guo et al, 2009). FE modeling was also used to analyze stress of the carpal tunnel contents and showed that median nerve compression is attributable to structural contact force rather than fluid pressure (Ko and Brown, 2007; Mouzakis et al, 2014). The FE model of the carpal tunnel presented in the current study permits the exploration of different force conditions applied between the trapezium and hamate bone to evaluate the change in CSA using individualized model.…”

Section: Introductionmentioning

confidence: 99%

Subject-specific finite element analysis of the carpal tunnel cross-sectional to examine tunnel area changes in response to carpal arch loading

Walia

Erdemir

2017

Clinical Biomechanics

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Background 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. Methods 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. Findings 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). Interpretation 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.

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Finite element simulation of the mechanical impact of computer work on the carpal tunnel syndrome

Cited by 19 publications

References 29 publications

Numerical Modeling of Rehabilitation Exercise when Distal Radius Fracture Treated by Splint

Numerical Modeling of Rehabilitation Exercise when Distal Radius Fracture Treated by Splint

Finite element analysis for transverse carpal ligament tensile strain and carpal arch area

Subject-specific finite element analysis of the carpal tunnel cross-sectional to examine tunnel area changes in response to carpal arch loading

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