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Huang F, Tan R, Wang MW, Hu LC, Wang Z, Sun SD, Huang JW, Luo YW. Three‑dimensional finite element analysis: Anatomical splint fixation for Colles fractures. Exp Ther Med 2024; 27:98. [PMID: 38356671 PMCID: PMC10865454 DOI: 10.3892/etm.2024.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024] Open
Abstract
With the rapid development of digital research in clinical orthopedics, the efficacy and safety of splint fixation can be better evaluated through biomechanical analysis based on a three-dimensional (3D) finite element model. It is essential to address the current gap in understanding the biomechanical implications of anatomical splint fixation for Colles fractures. By employing advanced 3D finite element analysis, the present study aimed to provide a comprehensive evaluation, offering valuable insights that can contribute to enhancing the effectiveness of anatomical splint fixation in the clinical management of Colles fractures. The 3D finite element models of the forearm and hand were constructed using Mimics 15.0 according to data from computed tomography of a patient with a Colles fracture. After the validity of the model was verified, the corresponding material properties of the models were adjusted to simulate a Colles fracture. Subsequently, the reduction functions, such as radial inclination and ulnar deviation, of the simulated fracture were completed and the mechanical changes of the tissues surrounding the fracture were calculated. Anatomical splints were then placed on the surfaces of the 3D finite element models of Colles fractures at various positions to analyze the changes in the stress cloud diagram, such as for the soft tissue and anatomical splints. In the present study, the constructed 3D finite element models were accurate and valid. The maximum stress of the anatomical splints and soft tissues was 2.346 and 0.106 MPa in pronation, 1.780 and 0.069 MPa in median rotation and 3.045 and 0.057 MPa in supination, respectively. Splint stress reached the highest level in supination and soft tissue stress achieved the highest level in pronation. The peak of splint stress occurred during supination, which contrasts to the peak of soft tissue stress observed in pronation, suggesting splint fixation median rotation can effectively avoid compression of the local soft tissue.
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Affiliation(s)
- Fei Huang
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Rui Tan
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Meng-Wei Wang
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Liu-Chao Hu
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Zhi Wang
- Department of Operating Room, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Shi-Dong Sun
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Jie-Wen Huang
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
| | - Yi-Wen Luo
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510000, P.R. China
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Mena A, Wollstein R, Baus J, Yang J. Finite Element Modeling of the Human Wrist: A Review. J Wrist Surg 2023; 12:478-487. [PMID: 38213568 PMCID: PMC10781520 DOI: 10.1055/s-0043-1768930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/13/2023] [Indexed: 01/13/2024]
Abstract
Background Understanding wrist biomechanics is important to appreciate and treat the wrist joint. Numerical methods, specifically, finite element method (FEM), have been used to overcome experimental methods' limitations. Due to the complexity of the wrist and difficulty in modeling, there is heterogeneity and lack of consistent methodology in the published studies, challenging our ability to incorporate information gleaned from the various studies. Questions/Purposes This study summarizes the use of FEM to study the wrist in the last decade. Methods We included studies published from 2012 to 2022 from databases: EBSCO, Research4Life, ScienceDirect, and Scopus. Twenty-two studies were included. Results FEM used to study wrist in general, pathology, and treatment include diverse topics and are difficult to compare directly. Most studies evaluate normal wrist mechanics, all modeling the bones, with fewer studies including cartilage and ligamentous structures in the model. The dynamic effect of the tendons on wrist mechanics is rarely accounted for. Conclusion Due to the complexity of wrist mechanics, the current literature remains incomplete. Considering published strategies and modeling techniques may aid in the development of more comprehensive and improved wrist model fidelity.
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Affiliation(s)
- Andres Mena
- Human-Centric Design Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas
| | - Ronit Wollstein
- Department of Orthopedic Surgery, School of Medicine, New York University, New York, New York
| | - Juan Baus
- Human-Centric Design Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas
| | - James Yang
- Human-Centric Design Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas
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Peng L, Wu Y, Lakshminarayanan K, Zhang A, Gan Y, Li Y, Yao Y. The relationship between shear wave velocity in transverse carpal ligament and carpal tunnel pressure: A finite element analysis. Med Eng Phys 2023; 116:103995. [PMID: 37230698 DOI: 10.1016/j.medengphy.2023.103995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023]
Abstract
Elevated carpal tunnel pressure in carpal tunnel syndrome (CTS) patients is one of the major causes of nerve damage but cannot be measured non-invasively. This study proposed to use shear wave velocity (SWV) in the transverse carpal ligament (TCL) to measure the surrounding carpal tunnel pressure. The relationship between the carpal tunnel pressure and the SWV in the TCL was investigated through a subject-specific carpal tunnel finite element model reconstrued by MRI imaging. Parametric analysis was conducted to study the effect of TCL Young's modulus and carpal tunnel pressure on the TCL SWV. The SWV in TCL was found to be strongly dependent on the carpal tunnel pressure and TCL Young's modulus. The calculated SWV ranged from 8.0 m/s to 22.6 m/s under a combination of carpal tunnel pressure (0-200 mmHg) and TCL Young's modulus (1.1-11 MPa). An empirical equation was used to fit the relationship between the SWV in TCL and carpal tunnel pressure, with TCL Young's modulus as a confounding factor. The equation proposed in this study provided an approach to estimate carpal tunnel pressure by measuring the SWV in the TCL for a potential non-invasive diagnosis of CTS and may shed light on the mechanical nerve damage mechanism.
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Affiliation(s)
- Linjing Peng
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China
| | - Yu Wu
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Olin College of Engineering, 1000 Olin Way, Needham, 02492, US
| | - Kishor Lakshminarayanan
- Department of Sensors and Biomedical Engineering, Vellore Institute of Technology, Ranipet Katpadi Road Vellore, 632 014, Tamil Nadu, India
| | - Aili Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China
| | - Yaokai Gan
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Department of Orthopedics, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China, 200011
| | - Yiming Li
- Department of Orthopedics, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China, 200011
| | - Yifei Yao
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.
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4
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Yu L, Jia J, Lakshminarayanan K, Li Y, Gan Y, Yao Y. A finite element analysis of the carpal arch with various locations of carpal tunnel release. Front Surg 2023; 10:1134129. [PMID: 37206350 PMCID: PMC10189137 DOI: 10.3389/fsurg.2023.1134129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/13/2023] [Indexed: 05/21/2023] Open
Abstract
Objective The purpose of this study was to investigate the effects of the location of transverse carpal ligament (TCL) transection on the biomechanical property of the carpal arch structure. It was hypothesized that carpal tunnel release would lead to an increase of the carpal arch compliance (CAC) in a location-dependent manner. Methods A pseudo-3D finite element model of the volar carpal arch at the distal carpal tunnel was used to simulate arch area change under different intratunnel pressures (0-72 mmHg) after TCL transection at different locations along the transverse direction of the TCL. Results The CAC of the intact carpal arch was 0.092 mm2/mmHg, and the simulated transections ranging from 8 mm ulnarly to 8 mm radially from the center point of the TCL led to increased CACs that were 2.6-3.7 times of that of the intact carpal arch. The CACs after radial transections were greater than those ulnarly transected carpal arches. Conclusion The TCL transection in the radial region was biomechanically favorable in reducing carpal tunnel constraint for median nerve decompression.
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Affiliation(s)
- Lu Yu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyi Jia
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Kishor Lakshminarayanan
- Department of Sensors and Biomedical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Yiming Li
- Orthopedic Department, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaokai Gan
- Orthopedic Department, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Correspondence: Yaokai Gan Yifei Yao
| | - Yifei Yao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Correspondence: Yaokai Gan Yifei Yao
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The Effects of Paraspinal Muscle Volume on Physiological Load on the Lumbar Vertebral Column: A Finite-Element Study. Spine (Phila Pa 1976) 2021; 46:E1015-E1021. [PMID: 34517397 DOI: 10.1097/brs.0000000000004014] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Analytical biomechanical study using a finite-element (FE) model. OBJECTIVE We investigated the effects of paraspinal muscle volume to the physiological loading on the lower lumbar vertebral column using a FE model. SUMMARY OF BACKGROUND DATA The FE model analysis can measure the physiological load on the lumbar vertebral column. Which changes as the surrounding environment changes. In this study, our FE model consisted of the sacrum, lumbar spine (L3-L5), intervertebral discs, facet joints, and paraspinal muscles. METHODS Three-dimensional FE models of healthy lumbar spinal units were reconstructed. The physiological loads exerted on the lumbar vertebra column were evaluated by applying different paraspinal muscle volumes (without muscles, 50%, 80%, and 100% of healthy muscle volume). RESULTS As the paraspinal muscle volume increased, the loads exerted on the vertebral column decreased. The mean load on the intervertebral disc was 1.42 ± 0.75 MPa in the model without muscle, 1.393 ± 0.73 MPa in the 50% muscle volume model, 1.367 ± 0.71 MPa in the 80% muscle volume model, and 1.362 ± 0.71 MPa in the 100% muscle volume model. The mean loads exerted on the posterior column of lumbar spine were 11.79 ± 4.70 MPa in the model without muscles, 11.57 ± 4.57 MPa in the model with 50% muscle volume, and 11.13 ± 4.51 MPa in the model with 80% muscle volume, and 10.92 ± 4.33 MPa in the model with 100% muscle volume. The mean pressure on the vertebral body in the model without paraspinal muscle, and with 50%, 80%, and 100% paraspinal muscle volume were 14.02 ± 2.82, 13.82 ± 2.62, 13.65 ± 2.61, and 13.59 ± 2.51 MPa, respectively. CONCLUSION Using FEM, we observed that the paraspinal muscle volume decreases pressure exerted on the lumbar vertebral column. Based on these results, we believe that exercising to increase paraspinal muscle volume would be helpful for spinal pain management and preventing lumbar spine degeneration.Level of Evidence: N/A.
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Glenday JD, Steinhilber B, Jung F, Haeufle DFB. Development of a musculoskeletal model of the wrist to predict frictional work dissipated due to tendon gliding resistance in the carpal tunnel. Comput Methods Biomech Biomed Engin 2020; 24:973-984. [PMID: 33356567 DOI: 10.1080/10255842.2020.1862094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Carpal tunnel syndrome is an entrapment neuropathy that has been associated with the aggravation of tendon gliding resistance due to forceful, high velocity, awkwardly angled, and repetitive wrist motions. Cadaveric and epidemiological studies have shown that combinations of these risk factors have a more than additive effect. The aim of the current study was to develop a musculoskeletal model of the wrist that could evaluate these risk factors by simulating frictional work dissipated due to the gliding resistance of the third flexor digitorum superficialis tendon. Three flexion angle zones, three extension angle zones, five levels of task repetitiveness, and five levels of task effort were derived from ergonomic standards. Of the simulations performed by systematically combining these parameters, the extreme wrist flexion zone, at peak task repetitiveness and effort, dissipated the most frictional work. This zone dissipated approximately double the amount of frictional work compared to its equivalent zone in extension. For all motions, a multiplicative effect of the combination of task repetitiveness and effort on frictional work was identified by the musculoskeletal model, corroborating previous epidemiological and experimental studies. Overall, these results suggest that the ergonomic standards for wrist flexion-extension may need to be adjusted to reflect equivalent biomechanical impact and that workplace tasks should be designed to minimise exposure to combinations of highly repetitive and highly forceful work, especially when the wrist is highly flexed.
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Affiliation(s)
- J D Glenday
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - B Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard-Karls University, Tübingen, Germany
| | - F Jung
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany.,Institute of Occupational and Social Medicine and Health Services Research, Eberhard-Karls University, Tübingen, Germany
| | - D F B Haeufle
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
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Yao Y, Erdemir A, Li ZM. Finite element analysis for transverse carpal ligament tensile strain and carpal arch area. J Biomech 2018; 73:210-216. [PMID: 29678419 DOI: 10.1016/j.jbiomech.2018.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 03/21/2018] [Accepted: 04/02/2018] [Indexed: 11/18/2022]
Abstract
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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Affiliation(s)
- Yifei Yao
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Ahmet Erdemir
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Zong-Ming Li
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, United States; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, United States; Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH 44195, United States.
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Hua Z, Wang JW, Lu ZF, Ma JW, Yin H. The biomechanical analysis of three-dimensional distal radius fracture model with different fixed splints. Technol Health Care 2018; 26:329-341. [PMID: 29439370 DOI: 10.3233/thc-171050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The distal radius fracture is one of the common clinical fractures. At present, there are no reports regarding application of the finite element method in studying the mechanism of Colles fracture and the biomechanical behavior when using splint fixation. OBJECTIVE To explore the mechanism of Colles fracture and the biomechanical behavior when using different fixed splints. METHODS Based on the CT scanning images of forearm for a young female volunteer, by using model construction technology combined with RPOE and ANSYS software, a 3-D distal radius fracture forearm finite element model with a real shape and bioactive materials is built. The material tests are performed to obtain the mechanical properties of the paper-based splint, the willow splint and the anatomical splint. The numerical results are compared with the experimental results to verify the correctness of the presented model. Based on the verified model, the stress distribution of different tissues are analyzed. Finally, the clinical tests are performed to observe and verify that the anatomical splint is the best fit for human body. RESULTS Using the three kinds of splints, the transferred bone stress focus on the distal radius and ulna, which is helpful to maintain the stability of fracture. Also the stress is accumulated in the distal radius which may be attributed to flexion position. Such stress distribution may be helpful to maintain the ulnar declination. By comparing the simulation results with the experimental observations, the anatomical splint has the best fitting to the limb, which can effectively avoid the local compression. CONCLUSION The anatomical splint is the most effective for fixing and curing the fracture. The presented model can provide theoretical basis and technical guide for further investigating mechanism of distal radius fracture and clinical application of anatomical splint.
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Affiliation(s)
- Zhen Hua
- Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Jian-Wei Wang
- Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Zhen-Fei Lu
- Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Jian-Wei Ma
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai, China
| | - Heng Yin
- Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
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Yeap Loh P, Liang Yeoh W, Nakashima H, Muraki S. Impact of keyboard typing on the morphological changes of the median nerve. J Occup Health 2017; 59:408-417. [PMID: 28701627 PMCID: PMC5635149 DOI: 10.1539/joh.17-0058-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: The primary objective was to investigate the effects of continuous typing on median nerve changes at the carpal tunnel region at two different keyboard slopes (0° and 20°). The secondary objective was to investigate the differences in wrist kinematics and the changes in wrist anthropometric measurements when typing at the two different keyboard slopes. Methods: Fifteen healthy right-handed young men were recruited. A randomized sequence of the conditions (control, typing I, and typing II) was assigned to each participant. Wrist anthropometric measurements, wrist kinematics data collection and ultrasound examination to the median nerve was performed at designated time block. Results: Typing activity and time block do not cause significant changes to the wrist anthropometric measurements. The wrist measurements remained similar across all the time blocks in the three conditions. Subsequently, the wrist extensions and ulnar deviations were significantly higher in both the typing I and typing II conditions than in the control condition for both wrists (p<0.05). Additionally, the median nerve cross-sectional area (MNCSA) significantly increased in both the typing I and typing II conditions after the typing task than before the typing task. The MNCSA significantly decreased in the recovery phase after the typing task. Conclusions: This study demonstrated the immediate changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°. The main findings suggest wrist posture near to neutral position caused lower changes of the median nerve.
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Affiliation(s)
- Ping Yeap Loh
- Department of Human Science, Faculty of Design, Kyushu University.,Research Fellow of Japan Society for the Promotion of Science
| | - Wen Liang Yeoh
- Department of Human Science, Graduate School of Design, Kyushu University
| | - Hiroki Nakashima
- Department of Human Science, Graduate School of Design, Kyushu University
| | - Satoshi Muraki
- Department of Human Science, Faculty of Design, Kyushu University
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Seomun G, Pyun SB, Lee JA, Kim EJ, Noh W. A comparison of carpal tunnel syndrome between digital and paper textbook users in elementary schools. Work 2017; 53:909-15. [PMID: 26967042 DOI: 10.3233/wor-162278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There are advantages to using digital textbooks, but also health concerns yet to be evaluated. OBJECTIVE This study examines the use of digital textbooks' effects on carpal tunnel, considered one of the potential health risks in students using digital textbooks. METHODS Data were obtained from 43 elementary school students in the sixth grade, selected from two groups who had used digital and paper textbooks, respectively. To assess carpal tunnel function, this study performed median motor nerve and median sensory nerve conduction studies. RESULTS There were no statistically significant differences between the groups, indicating that there were no functional differences related to carpal tunnel syndrome between the groups. CONCLUSION Usage of digital textbook is expanding nationwide in the Republic of Korea. There is no short-term risk of carpal tunnel syndrome in this population of elementary school students.
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Affiliation(s)
| | | | - Jung-Ah Lee
- University of California Irvine, Irvine, CA, USA
| | - Eun-Jung Kim
- Pyeongtaek University, Pyeongtaek, Republic of Korea
| | - Wonjung Noh
- Gachon University, Incheon, Republic of Korea
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Walia P, Erdemir A, Li ZM. Subject-specific finite element analysis of the carpal tunnel cross-sectional to examine tunnel area changes in response to carpal arch loading. Clin Biomech (Bristol, Avon) 2017; 42:25-30. [PMID: 28073093 PMCID: PMC5319899 DOI: 10.1016/j.clinbiomech.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 02/07/2023]
Abstract
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 200mmHg) 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 24.4mm from its initial 25.1mm (3% decrease), and the area changed to 301.6mm2 from 290.3mm2 (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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Affiliation(s)
- Piyush Walia
- Hand Research Laboratory, Cleveland Clinic, Cleveland, OH, United States,Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States
| | - Ahmet Erdemir
- Computational Biomodeling (CoBi) Core, Cleveland Clinic, Cleveland, OH, United States,Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States
| | - Zong-Ming Li
- Hand Research Laboratory, Cleveland Clinic, Cleveland, OH, United States,Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States,Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, United States,Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, United States
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