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Intraoperative muscle measurements reveal a relationship between contracture formation and muscle remodeling
Author(s) -
Pontén Eva,
Gantelius Stefan,
Lieber Richard L.
Publication year - 2007
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.20780
Subject(s) - sarcomere , contracture , flexor carpi ulnaris , medicine , anatomy , wrist , muscle contracture , spasticity , anesthesia , surgery , myocyte , ulnar nerve , elbow
Children with cerebral palsy often have spasticity of both the extensors and flexors, but how and why a flexion contracture of the wrist will develop during growth is not thoroughly understood. In order to understand the muscle adaptations that occur during contracture formation, the relationship between intraoperative sarcomere length and the extent of contracture was measured in 23 children (average age, 14.3 ± 2.9 years) undergoing tendon transfers involving the flexor carpi ulnaris (FCU) or extensor carpi radialis brevis (ECRB) muscles. For both ECRB and FCU, sarcomere lengths measured intraoperatively were longer compared to sarcomere lengths predicted from a regression relationship obtained from “control” patients with radial nerve injury ( P < 0.001). The most interesting aspect of the long FCU sarcomere lengths measured was that there was a highly significant correlation between the degree of contracture formation and intraoperative sarcomere length ( r 2 = 0.5, P < 0.005). These data clearly show that greater contracture severity is associated with longer intraoperative FCU sarcomere length. No such correlation was observed for the ECRB. The data suggest that the clinical presentation of the contracture is related to degree of FCU, but not ECRB adaptation, to the central nervous system lesion. Muscle Nerve, 2007