title: Quantification of the transverse carpal ligament elastic properties by sex and region.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Engineering, University of Guelph, Canada.
authors.forename: Allan W
authors.initials: AW
authors.lastname: Brett
authors.affiliation: School of Engineering, University of Guelph, Canada.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Oliver
authors.affiliation: Division of Anatomy, Department of Surgery, University of Toronto, Canada.
authors.forename: Anne M R
authors.initials: AM
authors.lastname: Agur
authors.affiliation: Research Data Centre, University of Guelph, Canada.
authors.forename: A Michelle
authors.initials: AM
authors.lastname: Edwards
authors.affiliation: School of Engineering, University of Guelph, Canada. Electronic address: kgordon@uoguelph.ca.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Gordon
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D002102:Cadaver; D002349:Carpal Tunnel Syndrome / Q000209:etiology; D004548:Elasticity / Q000502:physiology*; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000033:anatomy & histology / Q000502:physiology*; D008297:Male; D012737:Sex Factors; D014955:Wrist Joint / Q000033:anatomy & histology
keywords: Biaxial testing; Biomechanical properties; Carpal tunnel syndrome; Transverse carpal ligament