Biomechanical properties of the transverse carpal ligament under biaxial strain

The transverse carpal ligament (TCL) influences carpal stability and carpal tunnel mechanics, yet little is known about its mechanical properties. We investigated the tissue properties of TCLs extracted from eight cadaver arms and divided into six tissue samples from the distal radial, distal middle, distal ulnar, proximal radial, proximal middle, and proximal ulnar regions. The 5% and 15% strains were applied biaxially to each sample at rates of 0.1, 0.25, 0.5, and 1%/s. Ligament thickness ranged from 1.22 to 2.90 mm. Samples from the middle of the TCL were thicker proximally than distally (p < 0.013). Tissue location significantly affected elastic modulus (p < 0.001). Modulus was greatest in the proximal radial samples (mean 2.8 MPa), which were 64% and 44% greater than the distal radial and proximal ulnar samples, respectively. Samples from the middle had a modulus that was 20-39% greater in the proximal versus more distal samples. The TCL exhibited different properties within different locations and in particular greater moduli were found near the carpal bone attachments. These properties contribute to the understanding of carpal tunnel mechanics that is critical to understanding disorders of the wrist.