Flexor carpi ulnaris tenotomy alone does not eliminate its contribution to wrist torque

Bruin, M. de; Smeulders, M.J.C.; Kreulen, M.

doi:10.1016/j.clinbiomech.2011.03.007

Cited by 22 publications

(13 citation statements)

References 20 publications

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“…Present effects of tenotomy and MT dissection in the control group are in agreement with those reported for patients with cerebral palsy tested exclusively for the neutral position of the wrist (corresponding to 0° in Figure 2) [15]. Our results extend those observations by showing decrements in wrist moment as a result of post-tenotomy MT dissection, also for more flexed and extended wrist positions.…”

Section: Discussionsupporting

confidence: 91%

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Dissection of a Single Rat Muscle-Tendon Complex Changes Joint Moments Exerted by Neighboring Muscles: Implications for Invasive Surgical Interventions

2013

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The aim of this paper is to investigate mechanical functioning of a single skeletal muscle, active within a group of (previously) synergistic muscles. For this purpose, we assessed wrist angle-active moment characteristics exerted by a group of wrist flexion muscles in the rat for three conditions: (i) after resection of the upper arm skin; (ii) after subsequent distal tenotomy of flexor carpi ulnaris muscle (FCU); and (iii) after subsequent freeing of FCU distal tendon and muscle belly from surrounding tissues (MT dissection). Measurements were performed for a control group and for an experimental group after recovery (5 weeks) from tendon transfer of FCU to extensor carpi radialis (ECR) insertion. To assess if FCU tenotomy and MT dissection affects FCU contributions to wrist moments exclusively or also those of neighboring wrist flexion muscles, these data were compared to wrist angle-moment characteristics of selectively activated FCU. FCU tenotomy and MT dissection decreased wrist moments of the control group at all wrist angles tested, including also angles for which no or minimal wrist moments were measured when activating FCU exclusively. For the tendon transfer group, wrist flexion moment increased after FCU tenotomy, but to a greater extent than can be expected based on wrist extension moments exerted by selectively excited transferred FCU. We conclude that dissection of a single muscle in any surgical treatment does not only affect mechanical characteristics of the target muscle, but also those of other muscles within the same compartment. Our results demonstrate also that even after agonistic-to-antagonistic tendon transfer, mechanical interactions with previously synergistic muscles do remain present.

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Section: Discussionsupporting

confidence: 91%

“…Recently, significant acute effects of tenotomy and partial dissection of flexor carpi ulnaris muscle (FCU) on wrist moment exerted by several wrist flexion muscles were reported for patients with cerebral palsy [15]. However, wrist moment was quantified in neutral wrist position only.…”

Section: Introductionmentioning

confidence: 99%

Dissection of a Single Rat Muscle-Tendon Complex Changes Joint Moments Exerted by Neighboring Muscles: Implications for Invasive Surgical Interventions

2013

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“…In a previous in-vivo study, 82% of the original torque was maintained after flexor carpi ulnaris tenotomy (de Bruin et al, 2011). Our results confirm these observations on knee flexor tendons.…”

Section: Moment Arm Determination and Limitationssupporting

confidence: 90%

Tendon and fascial structure contributions to knee muscle excursions and knee joint displacement

Snoeck

Beyer

Feipel

et al. 2014

Clinical Biomechanics

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“…Epimuscular loads exerted on a muscle can have distal or proximal directions [60], [61], [62]. In CP patients, the presence of enhanced distal loads on FCU seems evident from the observations that after distal FCU tenotomy the muscle is kept at length and that subsequently extending the wrist stretches both passive (Movie S1) and active FCU muscle [63], [64]. These distal loads applied to FCU are exerted via extramuscular connective tissue structures (Fig.…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Connective Tissue Differences in Spastic and Control Muscle: A Mechanical and Histological Study

et al. 2014

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Cerebral palsy (CP) of the spastic type is a neurological disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks. Secondary to the spasticity, muscle adaptation is presumed to contribute to limitations in the passive range of joint motion. However, the mechanisms underlying these limitations are unknown. Using biopsies, we compared mechanical as well as histological properties of flexor carpi ulnaris muscle (FCU) from CP patients (n = 29) and healthy controls (n = 10). The sarcomere slack length (mean 2.5 µm, SEM 0.05) and slope of the normalized sarcomere length-tension characteristics of spastic fascicle segments and single myofibre segments were not different from those of control muscle. Fibre type distribution also showed no significant differences. Fibre size was significantly smaller (1933 µm2, SEM 190) in spastic muscle than in controls (2572 µm2, SEM 322). However, our statistical analyses indicate that the latter difference is likely to be explained by age, rather than by the affliction. Quantities of endomysial and perimysial networks within biopsies of control and spastic muscle were unchanged with one exception: a significant thickening of the tertiary perimysium (3-fold), i.e. the connective tissue reinforcement of neurovascular tissues penetrating the muscle. Note that this thickening in tertiary perimysium was shown in the majority of CP patients, however a small number of patients (n = 4 out of 23) did not have this feature. These results are taken as indications that enhanced myofascial loads on FCU is one among several factors contributing in a major way to the aetiology of limitation of movement at the wrist in CP and the characteristic wrist position of such patients.

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Flexor carpi ulnaris tenotomy alone does not eliminate its contribution to wrist torque

Cited by 22 publications

References 20 publications

Dissection of a Single Rat Muscle-Tendon Complex Changes Joint Moments Exerted by Neighboring Muscles: Implications for Invasive Surgical Interventions

Dissection of a Single Rat Muscle-Tendon Complex Changes Joint Moments Exerted by Neighboring Muscles: Implications for Invasive Surgical Interventions

Tendon and fascial structure contributions to knee muscle excursions and knee joint displacement

Intramuscular Connective Tissue Differences in Spastic and Control Muscle: A Mechanical and Histological Study

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