Finite element simulation of the mechanical impact of computer work on the carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) is a clinical disorder resulting from the compression of the median nerve. The available evidence regarding the association between computer use and CTS is controversial. There is some evidence that computer mouse or keyboard work, or both are associated with the development of CTS. Despite the availability of pressure measurements in the carpal tunnel during computer work (exposure to keyboard or mouse) there are no available data to support a direct effect of the increased intracarpal canal pressure on the median nerve. This study presents an attempt to simulate the direct effects of computer work on the whole carpal area section using finite element analysis. A finite element mesh was produced from computerized tomography scans of the carpal area, involving all tissues present in the carpal tunnel. Two loading scenarios were applied on these models based on biomechanical data measured during computer work. It was found that mouse work can produce large deformation fields on the median nerve region. Also, the high stressing effect of the carpal ligament was verified. Keyboard work produced considerable and heterogeneous elongations along the longitudinal axis of the median nerve. Our study provides evidence that increased intracarpal canal pressures caused by awkward wrist postures imposed during computer work were associated directly with deformation of the median nerve. Despite the limitations of the present study the findings could be considered as a contribution to the understanding of the development of CTS due to exposure to computer work.