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THE STRUCTURE OF THE TRANSVERSE CARPAL LIGAMENT: ITS COLLAGEN FIBER ORIENTATION AND THE EFFICACY OF COLLAGENASE IN DECREASING ITS STIFFNESS

Prantil, Ryan/RKP (2012) THE STRUCTURE OF THE TRANSVERSE CARPAL LIGAMENT: ITS COLLAGEN FIBER ORIENTATION AND THE EFFICACY OF COLLAGENASE IN DECREASING ITS STIFFNESS. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Carpal tunnel syndrome (CTS) currently affects more than three million Americans each year. Hand surgeons treat CTS by targeting the transverse carpal ligament (TCL) which acts as the palmar roof of the carpal tunnel. Based on general observation, the TCL appears to be an inextensible collagenous matrix with fibers roughly oriented along the transverse direction. Several studies on the TCL’s configuration argue for different fiber orientations consisting of either oblique or transverse orientations; whereas, most findings were based on an observational methodology. Very few studies have determined such fiber orientations; whereas, even fewer studies have researched the ligament’s mechanical properties. Furthermore, the potential of altering the TCL’s microstructure may provide a potential, alternative to the currently accepted, invasive standards. Previous studies attempting to lengthen the TCL found that such procedures can effectively diminish CTS symptoms and also decrease the progression of several post-operative complications. However, these procedures consist of transecting the transverse carpal ligament in an attempt to increase its length. Furthermore, mechanical stimuli cannot alter the ligament because it is too stiff. In addition, such procedures also require invasive surgery and can cause complications that arise from carpal tunnel release. Therefore, a solution might lie in the application of collagenase where antecedent works have shown its capacity to reduce the v-mechanical properties of a tissue.

The following studies have emphasized the transverse carpal ligament’s collagen orientation and its mechanical response to subsequent collagenase treatment. The preferential
collagen direction was quantified through the use of small angle light scattering (SALS). Results showed that transverse orientation was the most prevalent with minimal changes found within its orientation along its thickness. As for the TCL’s response to collagenase, standard concentrations of collagenase were applied to the TCL for each specimen through successive mechanical loading protocols along with successive observations to analyze the progressive changes within the ligament by slowly eliminating its collagen network. Collagenase effectively decreased the transverse carpal ligament’s stiffness without significantly changing its mechanical properties. Furthermore, these studies could contribute to a more sophisticated model of the TCL and lead to the development of a minimally invasive therapy contrary to current, invasive standards.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Prantil, Ryan/RKPrkp12@pitt.eduRKP12
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairLi, Zong-Ming/ZMLliz4@ccf.org
Committee MemberWoo, Savio L-Y/SLWslyw@pitt.eduSLYW
Committee MemberAbramowitch, Steven/SDAsdast9@pitt.eduSDAST9
Date: 30 January 2012
Date Type: Publication
Defense Date: 12 July 2011
Approval Date: 30 January 2012
Submission Date: 22 November 2011
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 101
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Bioengineering
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Carpal Tunnel Mechanics Carpal Tunnel Syndrome Collagenase Collagen Fiber Orientation Small Angle Light Scattering Transverse Carpal Ligament
Related URLs:
Date Deposited: 30 Jan 2012 20:51
Last Modified: 10 Jun 2024 18:41
URI: http://d-scholarship.pitt.edu/id/eprint/10541

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