TCL Stretch
TCL Stretch
TCL Stretch
Zong-Ming Li, Jie Tang, Matthew C. Chakan, Rodrigo Kaz, Ashish D. Nimbarte
Area (mm*mm)
200 6
Height (mm)
fulcrum. The lever was then made parallel to 4
the table surface and loaded, at a distance of 160
2
450 mm from the fulcrum. With this lever
device, the TCL was stretched by a palmarly 120 0
directed force from within the carpal tunnel. 0 50 100 150 200
A steel plate was passed through the carpal Stretching force (N)
tunnel to stabilize the hand. The palmar Figure 3: Average cross-areas of the carpal
surface of the TCL was digitized while the tunnel and TCL arch heights with increasing
TCL was being stretched. Eight constant stretching forces
force levels were applied to the TCL,
ranging from 10 N to 200 N. The cross- DISSCUSSION
sectional area was determined at the middle
level between the trapezium and scaphoid. Our study demonstrates the stretchability of
the TCL and the resulting expansion of the
RESULTS carpal tunnel. The result of about 30%
carpal tunnel expansion by a small
The area defined by the carpal bones stretching force of 10 N suggests that the
without the TCL-formed arch was 128.2 ± TCL is accommodating with the variation of
24.2 mm2. The TCL formed an arch that carpal tunnel pressure in a physiological
expanded the carpal tunnel with increasing environment. Greater than 50% carpal
loading (Figure 2 and Figure 3). With the tunnel expansion is available under
TCL stretching and arch formation, the relatively large stretching force (> 200 N).
cross-sectional areas of the carpal tunnel Future studies are needed to investigate the
were 165.0 ± 24.9 mm2 at 10 N, and 194.3 ± viscoelastic properties of the TCL and to
21.4 mm2 at 200 N, representing increases explore the potential of permanent residual
of 28.7% and 51.6%, respectively. The TCL deformation. The mechanical properties of
arch heights were 2.8 ± 0.3 mm at 10 N and the TCL may be exploited for the
5.4 ± 0.4 mm at 200 N. development of alternative carpal tunnel
syndrome treatments, such as manipulative
procedures (Sucher, 1993) and balloon
carpal tunnel plasty (Berger, 2005).
REFERENCES