title: The effect of tendon excursion velocity on longitudinal median nerve displacement: differences between carpal tunnel syndrome patients and controls.
abstract: The subsynovial connective tissue (SSCT) is a viscoelastic structure connecting the median nerve (MN) and the flexor tendons in the carpal tunnel. Increased strain rates increases stiffness in viscoelastic tissues, and thereby its capacity to transfer shear load. Therefore, tendon excursion velocity may impact the MN displacement. In carpal tunnel syndrome (CTS) the SSCT is fibrotic and may be ruptured, and this may affect MN motion. In this study, ultrasonography was performed on 14 wrists of healthy controls and 25 wrists of CTS patients during controlled finger motions performed at three different velocities. Longitudinal MN and tendon excursion were assessed using a custom speckle tracking algorithm and compared across the three different velocities. CTS patients exhibited significantly less MN motion than controls (p ≤ 0.002). While in general, MN displacement increased with increasing tendon excursion velocity (p ≤ 0.031). These findings are consistent with current knowledge of SSCT mechanics in CTS, in which in some patients the fibrotic SSCT appears to have ruptured from the tendon surface.
authors: Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, Minnesota; Department of Plastic, Reconstructive and Hand Surgery, and the Department of Rehabilitation Medicine and Physical Therapy, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Anika
authors: A
authors: Filius
authors: Andrew R
authors: AR
authors: Thoreson
authors: Yuexiang
authors: Y
authors: Wang
authors: Sandra M
authors: SM
authors: Passe
authors: Chunfeng
authors: C
authors: Zhao
authors: Kai-Nan
authors: KN
authors: An
authors: Peter C
authors: PC
authors: Amadio
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D013710:Tendons / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography
keywords: carpal tunnel; flexor tendons; median nerve; ultrasound; velocity
references: Chir Main. 2010 Jun;29(3):155-66
references: 20537576
references: J Bone Joint Surg Am. 2012 Mar 7;94(5):394-402
references: 22398732
references: J Orthop Res. 2007 Feb;25(2):185-90
references: 17106876
references: J Orthop Res. 2011 Jan;29(1):62-6
references: 20607819
references: J Musculoskelet Neuronal Interact. 2005 Mar;5(1):85-90
references: 15788874
references: Plast Reconstr Surg. 2006 Nov;118(6):1413-22
references: 17051112
references: Muscle Nerve. 2013 Oct;48(4):525-31
references: 23897643
references: Arch Phys Med Rehabil. 2007 May;88(5):569-76
references: 17466724
references: J Orthop Res. 2013 Oct;31(10 ):1533-9
references: 23729391
references: J Hand Surg Am. 1990 May;15(3):497-503
references: 2348074
references: Ultrasound Med Biol. 2014 Jan;40(1):53-61
references: 24210862
references: J Bone Joint Surg Am. 2004 Jul;86-A(7):1458-66
references: 15252093
references: J Biomech. 2010 May 7;43(7):1373-9
references: 20152983
references: J Ultrasound Med. 2012 Jul;31(7):1091-8
references: 22733858
references: Int J Artif Organs. 2006 Sep;29(9):852-7
references: 17033992
references: Biomed Sci Instrum. 1997;33:246-51
references: 9731366
references: J Orthop Res. 2014 Jan;32(1):123-8
references: 24038298
references: J Hand Surg Am. 1992 Nov;17(6):1028-30
references: 1430930
references: J Biomech Eng. 1997 Nov;119(4):400-5
references: 9407277
references: Clin Anat. 2007 Apr;20(3):292-9
references: 16944527
references: J Biomech. 2008;41(2):292-8
references: 17953971
references: J Biomech Eng. 2003 Oct;125(5):726-31
references: 14618932
references: Clin Neurophysiol. 2002 Jan;113(1):71-7
references: 11801427
references: Muscle Nerve. 2012 Dec;46(6):871-8
references: 23041984
references: Acta Neurol Scand. 1997 Oct;96(4):211-7
references: 9325471
references: Muscle Nerve. 2012 May;45(5):721-9
references: 22499100
references: J Hand Surg Br. 1992 Apr;17(2):209-12
references: 1588206
references: J Appl Physiol. 1966 Jul;21(4):1231-6
references: 5916656
references: Clin Biomech (Bristol, Avon). 2010 Aug;25(7):660-5
references: 20605292
references: J Biomech. 1986;19(11):951-5
references: 3793742
references: Clin Biomech (Bristol, Avon). 2007 Nov;22(9):999-1003
references: 17822815
references: Proc Inst Mech Eng H. 2004;218(2):109-19
references: 15116898
references: J Neurol Neurosurg Psychiatry. 2008 Jan;79(1):63-7
references: 17470471
references: Orthop Rev. 1992 Apr;21(4):451-3
references: 1579357
references: J Biomech. 2010 Oct 19;43(14):2785-91
references: 20678772