Muscle Growth in Normal and Spastic Mice

Ziv, Israel; Blackburn, N. K.; Rang, Mercer; Koreska, Jan

doi:10.1111/j.1469-8749.1984.tb04412.x

Cited by 165 publications

(51 citation statements)

References 21 publications

(28 reference statements)

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“…During tibial lengthening, these are not always successful, and in that setting, GSR is commonly performed before, during, or after a tibial lengthening to prevent or relieve equinus contracture [6,21]. However, the risk factors associated with gastrocsoleus contracture severe enough to warrant surgery during tibial lengthening and the consistency with which GSR results in a plantigrade foot in this setting have not been well defined.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Maffulli et al [11] found an even greater threshold of 18% bone lengthening for joint contracture. The slightly higher threshold in these studies can be attributed to a pediatric population whose muscle fibers may have a greater ability to stretch and grow [6,15,21]. In a case series of 80 tibial lengthenings over an intramedullary nail, Kim et al [9] reported a 72% equinus contracture rate.…”

Section: Discussionmentioning

confidence: 99%

“…Complications may arise from the bone or soft tissues during tibial lengthening. An important soft tissue complication is joint contracture involving the ankle and knee [18,21]. The ankle is more often involved than the knee and most commonly results in ankle equinus [21].…”

Section: Introductionmentioning

confidence: 99%

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What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

Rozbruch

Zonshayn

Muthusamy

et al. 2014

Clin Orthop Relat Res

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Background Tibial lengthening is frequently associated with gastrocsoleus contracture and some patients are treated surgically. However, the risk factors associated with gastrocsoleus contracture severe enough to warrant surgery during tibial lengthening and the consistency with which gastrocsoleus recession (GSR) results in a plantigrade foot in this setting have not been well defined. Questions/purposes We compared patients treated with or without GSR during tibial lengthening with respect to (1) clinical risk factors triggering GSR use, (2) ROM gains and patient-reported outcomes, and (3) complications after GSR. Methods Between 2002 and 2011, 95 patients underwent tibial lengthenings excluding those associated with bone loss; 82 (83%) were available for a minimum followup of 1 year. According to our clinical algorithm, we performed GSR when patients had equinus contractures of greater than 10°while lengthening or greater than 0°before or after lengthening. Forty-one patients underwent GSR and 41 did not. Univariate analysis was performed to assess independent associations between surgical characteristics and likelihood of undergoing GSR. A multivariate regression model and receiver operating characteristic curves were generated to adjust for confounders and to establish risk factors and any threshold for undergoing GSR. Chart review determined ROM, patient-reported outcomes, and complications. Results Amount and percentage of lengthening, age, and etiology were risk factors for GSR. Patients with lengthening of greater than 42 mm (odds ratio [OR]: 4.13; 95% CI: 1.82, 9.40; p = 0.001), lengthening of greater than 13% of lengthening (OR: 3.88; 95% CI: 1.66, 9.11; p = 0.001), and congenital etiology (OR: 1.90; 95% CI: 0.86, 4.15; p = 0.109) were more likely to undergo GSR. Adjusting for all other variables, increased amount lengthened (adjusted OR: 1.05; 95% CI: 1.02, 1.07; p \ 0.001) and age (adjusted OR: 1.02; 95% CI: 0.99, 1.05; p = 0.131) were associated with undergoing GSR. Patients gained 24°of ankle dorsiflexion after GSR. Selfreported functional outcomes were similar between patients with or without GSR. Complications included stretch injury to the posterior tibial nerve leading to temporary and partial loss of plantar sensation in two patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

Rozbruch

Zonshayn

Muthusamy

et al. 2014

Clin Orthop Relat Res

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“…In a comparative study, longitudinal muscle growth was reduced by 45% in spastic mice, compared with normal mice. 41 This restricted longitudinal muscle growth and increased tension of the muscle can result in limb deformities, joint dislocations, and poor motor function. 42 There are many factors to consider when treating children with spasticity.…”

Section: Pediatric Considerationsmentioning

confidence: 99%

Optimal management for people with severe spasticity

Shilt¹,

Seibert²,

Kadyan³

2012

DNND

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Spasticity is characterized by velocity-dependent increase in tonic stretch reflexes and tendon jerks. Many people affected by spasticity receive late treatment, or no treatment, which greatly reduces the potential to regain full motor control and restore function. There is much to consider before determining treatment for people with spasticity. Treatment of pediatric patients increases the complexity, because of the substantial difference between adult and pediatric spasticity. Proper patient evaluation, utilization of scales and measures, and obtaining patient and caregiver history is vital in determining optimal spasticity treatment. Further, taking into consideration the limitations and desires of individuals serve as a guide to best management. We have grouped contributing factors into the IDAHO Criteria to elucidate a multidisciplinary approach, which considers a person's complete field of experience. This model is applied to goal setting, and recognizes the importance of a spasticity management team, comprising the treatment subject, his/her family, the environment, and a supportive, well-informed medical staff. The criteria take into account the complexity associated with diagnosing and treating spasticity, with the ultimate goal of improved function.

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“…Affected muscles usually present with fewer myofibrils and their decreased longitudinal length. Studies have demonstrated that decrease in the longitudinal length of myofibrils of 50% leads to the onset of contractures and fixed deformities of the skeletal-joint system [4][5][6][7] . In the spastic type of CP, contractures are present in early stages.…”

Section: Introductionmentioning

confidence: 99%