The relationship between shear wave velocity in transverse carpal ligament and carpal tunnel pressure: A finite element analysis

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.

Response of the Thoroughbred forelimb to perturbations caused by a change in ground surface

Thoroughbred racehorses are often affected by musculoskeletal injuries, leading to involuntary rest, early retirement or death. Hardness and consistency of the track surface have been implicated as major risk factors for limb injury. The purpose was to test the utility of a preliminary AnyBody musculoskeletal model of the equine forelimb for its responses on two perturbing surfaces. A musculoskeletal model was developed using CT, muscle, tendon and ligament properties, and kinematic data were applied from ridden trials using five Thoroughbred horses. Horses were ridden at trot and canter on a baseline sand surface, and through two perturbation pits containing a harder and a softer surface for one stance phase. In response to the hard perturbation, the proximal limb was more compliant at trot and canter, as measured by increased shoulder flexion in the perturbed stance phase and increased elbow and carpal flexion in the subsequent swing phase. The suspensory ligaments and muscle-tendon units were less strained while lacertus fibrosus was more strained. In response to the soft perturbation, the coffin joint was more flexed and the elbow was more extended in the acute stance phase at trot, resulting in increased strain to the DDF, extensor branches and lacertus fibrosus. At canter, the coffin was more flexed, the fetlock less hyperextended and so the suspensory structures were less strained in the perturbed stance phase, but more strained in the second stance phase. Changes in ground surface affect both the perturbed stance phase, and the following stance phase.

Development of An Anybody Musculoskeletal Model of The Thoroughbred Forelimb

Musculoskeletal injuries in horses are the main cause of retirement, rest, and death. To understand these injuries, it is necessary to study loads in muscles, tendons and ligaments. A musculoskeletal model makes it possible to consider all structures simultaneously and avoids invasive measurements. At present, most computational models of the equine limb described in the literature have been limited to the distal limb. The aim of this study was to create a preliminary musculoskeletal model of the whole equine forelimb and to run it with kinematic data collected during gait. The model was developed with the AnyBody Modelling System. It includes six limb segments, 11 muscle groups and 17 ligaments. Kinematic data were collected from the right forelimb of four Thoroughbreds at trot, right and left lead canter, and were then used in the model to compute sagittal plane joint excursions and ligament and tendon strains. The modelled joint excursions were in reasonable agreement with previous reports in the literature despite breed, gait and surface differences. Strain patterns of the tendons of the suspensory apparatus agreed with the literature, with maxima in mid-stance or at the end of stance. Strains in the distal palmar ligaments peaked in mid-stance, while strain in lacertus fibrosus peaked at the stance-swing transition. Tendon and ligament strains at canter were greatest when the measured forelimb was the trailing limb. Strain amplitudes varied against earlier models and these differences are discussed in relation to variations in methods, and especially in relation to attachment points of tendons and ligaments.