Application of the carpal tunnel compression technique: a comparison of two cases

Carpal tunnel syndrome or carpal tunnel syndrome (CTS) is a disease of the peripheral nervous system associated with compression of the median nerve by surrounding tissues in the carpal tunnel of the human hand. CTS can often be observed against the background of a number of other diseases. However, the pressure exerted on the median nerve in any case is the primary cause of neurological complications. At the same time, there are no techniques to non-invasively measure the pressure inside the carpal tunnel, and invasive technology is controversial, traumatic and not recommended in medical practice. It is also known that CTS can occur not only against the background of other diseases, but also in connection with prolonged mechanical loads on the hand. It is difficult to experimentally measure the pressure inside the carpal tunnel under such loads. This article discusses the development and application of a methodology for determining carpal tunnel pressure based on biomechanical modeling. The technique consists of several interrelated stages (computed tomography, segmentation, motion capture, creation of a computational model and modeling of various hand movements). The development of the technique was based on the principle of personalization. The application of this technique for two patients is shown. The calculated intra-carpal pressure of one patient was almost three times higher than that of the other, but the values obtained by both models are within the acceptable range and correspond to the experimental data.