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Sample records for abductor pollicis longus

  1. The influence of an abductor pollicis longus strengthening ...

    African Journals Online (AJOL)

    African Journal for Physical Activity and Health Sciences ... The influence of an abductor pollicis longus strengthening programme on symptoms experienced by elderly females with osteoarthritis of the 1st carpo-metacarpal joint ... Keywords: Osteoarthritis, elderly, carpo-metacarpal joint, abductor pollicis longus, exercise ...

  2. Tendon variations of extensor digitorum and abductor pollicis longus muscles

    OpenAIRE

    Kocabiyik N; Tatar I; Yalcin B; Yazar F; Ozan H

    2009-01-01

    Tendon variations of extensor digitorum and abductor pollicis longus muscles were observed in a 65-year-old male formalin fixed cadaver, during the dissections for second year medical students at the Gulhane Military Medical Academy Anatomy Dissection Laboratory. In the right forearm, the extensor digitorum muscle had a tripled tendon for the 3rd finger and a doubled tendon for the ring finger. The extensor digiti minimi muscle also had a doubled tendon. There was also a communicating tendon ...

  3. Variant Abductor Pollicis Longus Muscle: a Case Report

    Directory of Open Access Journals (Sweden)

    Paul Shipra

    2007-01-01

    Full Text Available Abductor pollicis longus (APL muscle is known to exhibit different variations with respect to its attachments. Various studies have reported the splitting of the APL muscle. Comparative anatomical findings of split insertion of APL is commonly found in chimpanzees, gorillas and gibbons. In the present study, we describe an anomalous APL muscle, which originated from the posterior surface of the shaft of the radius and ulna and traversed a course deep to the extensor retinaculum. Interestingly, immediately after emerging form the deeper aspect of extensor retinaculum, the thin tendon of the APL muscle continued again as a muscular belly in relation to the dorsolateral part of the 1st metacarpal bone, to end as a tendon with its attachment to the base of the proximal phalanx. Such an unusual variation of APL with its attachment into proximal phalanx is a rare finding and may be of importance in altering the mechanics of the thumb during abduction. The clinical significance of such an anatomical variation of APL may be important during reconstructive surgeries involving thumb and also of academic interest.

  4. Abductor pollicis longus tendon interposition for arthrosis of the first carpo-metacarpal joint. Long-term results.

    Science.gov (United States)

    Lied, Line; Bjørnstad, Kari; Woje, Ann K N; Finsen, Vilhjalmur

    2016-02-01

    We performed an interposition arthroplasty using the abductor pollicis longus tendon for arthrosis in the basal joint of the thumb that needed surgery from 1995 to 2010. In 2001 47 patients (55 thumbs) were reviewed after 3.5 (1-5) years. The pain relief was excellent in 32 thumbs, and 25 patients improved their ability to perform daily tasks. Mobility was well preserved. Key pinch and grip strengths averaged 78% and 89%, respectively, of those in unaffected hands. We have now re-examined all 33 available patients (36 thumbs) 11-14 years after surgery. Fourty one of the originally examined patients were still alive. Seven were too ill to attend a follow-up and one refused. The remainder were examined in a fashion as similar as possible to that at the original review. The patients' subjective estimations of pain during the last week and satisfaction with the cosmetic and general results were recorded on visual analogue scales. The patients' ability to perform various activities of daily living were recorded and they completed the Disability of the arm, shoulder and hand (DASH) questionnaire. The mobility of the wrist and abduction of the thumb of the operated hands were recorded with a goniometer. Grip and pinch strength were measured and new radiographs were obtained. Key pinch strength had increased significantly over the last 10 years. The mobility was still good, except for thumb abduction, which had decreased with time. The median DASH score had fallen from 28 to 20 between the two reviews. There was insignificant further median loss of distance between the scaphoid and the metacarpal since the earlier review. The good results of this procedure found soon after surgery are maintained long-term.

  5. Rerouting extensor pollicis longus tendon transfer.

    Science.gov (United States)

    Colantoni Woodside, Julie; Bindra, Randip R

    2015-04-01

    Following radial nerve palsy, loss of the extensor pollicis longus (EPL), abductor pollicis longus and extensor pollicis brevis tendons results in loss of thumb extension and radial abduction. Multiple tendon transfers are described to address the loss of thumb extension following radial palsy utilizing the palmaris longus or flexor digitorum sublimis transferred to the EPL tendon. Owing to its ulnar vector of pull, the EPL tendon is a secondary adductor of the thumb, and in order to mitigate the tendency for thumb adduction, the EPL tendon is divided at the wrist and brought subcutaneously to the radial side of the wrist for repair to the donor tendon to improve the line of pull for the donor tendon. We describe the use of a technique to reroute the EPL tendon through the first compartment in a retrograde fashion prior to repair with the donor tendon on the radial side of the wrist. The use of the first dorsal compartment provides a pulley to maintain the position of the transfer and to prevent potential bowstringing of the tendon as wrist flexion and thumb extension are attempted. because the repair is performed proximal to the extensor retinaculum, the donor tendon length is not compromised. Because the tendon is redirected through the first dorsal compartment and inserts into the distal phalanx, a single transfer attempts to restores both thumb extension and radial abduction. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. EMG biofeedback of the abductor pollicis brevis in piano performance.

    Science.gov (United States)

    Montes, R; Bedmar, M; Sol Martin, M

    1993-06-01

    The aim of the present study was to apply EMG biofeedback as an auxiliary to piano teaching techniques. We studied the changes in integrated electromyographic activity, using the abductor pollicis brevis functioning as an agonist during the teaching of identical selective movements of piano playing in two groups, one with EMG biofeedback and the other following traditional method of instruction. The analysis of variance revealed an increase in the peak amplitude and the relaxation rate values for the biofeedback group. These results have implications for the application of piano playing techniques and reveal EMG biofeedback as an aid in the teaching of thumb attack with the abductor pollicis brevis as agonist.

  7. Bilateral congenital absence of the abductor pollicis brevis muscle: a case report.

    Science.gov (United States)

    Aydin, Ali; Topal, Murat; Tuncer, Kutsi; Kilic, Mesut

    2013-01-01

    Congenital absence of the abductor pollicis brevis is a very rare condition and is usually associated with other congenital anomalies. Here we report a case of bilateral congenital absence of the abductor pollicis brevis without any other abnormalities, which has not been previously reported. A 24-year-old Caucasian male patient presented to our clinic with flattening in the palmar region, pain and discomfort in writing, and weakness in both hands. USG and MRI revealed bilateral absence of the abductor pollicis brevis muscle. Bilateral congenital absence of the abductor pollicis brevis muscle requires no treatment due to satisfactory hand function, and results in cosmetic problems. Congenital absence of the abductor pollicis brevis muscle should be kept in mind in patients with flattening of the thenar eminences.

  8. Flexor pollicis longus tenosynovitis in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Manfield, Laura; Thomas, Mark; Lee, Se Won

    2014-06-01

    Carpal tunnel syndrome is typically diagnosed from history and physical examination then confirmed with electrodiagnosis. Electrodiagnosis provides only limited anatomic information and evaluation of space-occupying lesions. The authors present two cases in which demonstrated flexor pollicis longus tenosynovitis coexistent with carpal tunnel syndrome was diagnosed with ultrasonography. Ultrasonography is an effective modality that enhances the investigation of diseases in the soft tissues of the wrist and the hand. It can be useful in directing specific treatment by increasing diagnostic accuracy.

  9. Anomalous bilateral contribution of extensor pollicis longus and muscle fusion of the first compartment of the wrist

    Directory of Open Access Journals (Sweden)

    Rodrigo César Rosa

    2016-04-01

    Full Text Available Knowledge of the anatomical variations of the muscles of the first dorsal compartments of the wrist is clinically relevant to De Quervain's tenosynovitis and to reconstructive surgeries. In the literature, there are many reports of the presence of multiple insertion tendons in the first dorsal compartment of the wrist, but few reports describe occurrences of fusion and muscle contributions. This case report describes an anomalous bilateral contribution of the extensor pollicis longus. This anomalous contribution was found through a slender auxiliary tendon that crossed laterally under the extensor retinaculum, entered the first dorsal compartment of the wrist and merged with the tendon of the extensor pollicis brevis muscle. In the same cadaver in which this contribution was present, there was atypical muscle fusion of the abductor pollicis longus muscle and extensor pollicis brevis muscle. In conclusion, anomalous bilateral contribution of the extensor pollicis longus muscle and atypical muscle fusion, concomitant with a variant insertion pattern, are the highlight of this case report. Furthermore, it is concluded that additional tendons may be effectively used in reconstructive surgeries, but that there is a need for knowledge of the possible numerical and positional variations of these tendons, with a view to making more effective surgical plans.

  10. Occasional head of flexor pollicis longus muscle: a study of its morphology and clinical significance.

    Directory of Open Access Journals (Sweden)

    Hemmady M

    1993-01-01

    Full Text Available A cadaveric dissection study of 54 upper extremities to determine the incidence of occurrence, morphology and relations of the occasional head of the flexor pollicis longus muscle is presented. The occasional head of the flexor pollicis longus muscle was found to be present more frequently (66.66% than absent. It mainly arose from the medical epicondyle of the humerus (55.55% and the medial border of the coronoid process of the ulna (16.66%. It was found to be in close association with the median nerve (anteriorly and the anterior interosseous nerve (posteriorly. The clinical implications of these findings are discussed viz. entrapment neuropathies of the median and anterior interosseous nerves, cicatricial contraction of the occasional head leading to flexion deformity of the thumb and the likely necessity to lengthen/release the occasional head in spastic paralysis of the flexor pollicis longus muscle.

  11. Spontaneous Rupture of the Extensor Pollicis Longus Tendon due to Unusual Etiology

    Directory of Open Access Journals (Sweden)

    Süleyman Taş

    2014-03-01

    Full Text Available Background: The etiology of spontaneous rupture of the extensor pollicis longus tendon includes systemic or local steroid injections, wrist fracture, tenosynovitis, synovitis, rheumatoid arthritis, and repetitive wrist motions. Case Report: We encountered a case of extensor pollicis longus tendon rupture with an unusual etiology, cow milking. In this case, transfer of the extensor indicis proprius tendon was performed successfully. At 1 year after surgery, extension of the thumb was sufficient. Conclusion: It appears that patients with occupations involving repetitive motions are at a high risk of closed tendon ruptures.

  12. Isolated flexor pollicis longus nerve fascicle lesion – a rare differential diagnosis of thumb flexion deficiency

    Directory of Open Access Journals (Sweden)

    Glauser, Eva

    2016-12-01

    Full Text Available A rare differential diagnosis of thumb flexion deficiency is an isolated flexor pollicis longus (FPL nerve fascicle lesion. We present a 42-year-old otherwise healthy female patient who developed a weak thumb-to-index pinch and deficient right thumb flexion following the removal of osteosynthesis plates after a forearm fracture. Clinically,the flexor pollicis longus function was absent, yet index flexion and sensibility were unimpaired. Tendon rupture was excluded using a tenodesis test and the electro-physiological result of isolated interosseus nerve fascicle lesion was confirmed intraoperatively by inspection and electrostimulation. Tendon transfer using the extensor carpi radialis longus reconstruct strong thumb flexion during pinch. In summary, due to its specific location and anatomy, the FPL branch is more prone to isolated neuropathy, e.g. by injections or operations, than to other fascicles of the anterior interosseus nerve. When confronted with sudden and isolated thumb flexion deficiency, specialists should be aware of this rare phenomenon.

  13. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation.

    Science.gov (United States)

    Sabat, Dhananjaya; Dabas, Vineet; Dhal, Anil

    2014-07-01

    Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  14. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation

    Directory of Open Access Journals (Sweden)

    Dhananjaya Sabat

    2014-01-01

    Full Text Available Late rupture of extensor pollicis longus (EPL tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP. He was managed with extensor indicis proprius (EIP transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  15. Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years.

    Science.gov (United States)

    Pal, Jitendra Nath; Bera, Amiya Kumar; Roy, Amarendra Nath; Bari, Wasim

    2016-01-01

    Spontaneous ruptures of extension pollicis longus tendon predominantly occur after undisplaced or minimally displaced distal radial fracture near Lister tubercle. Systemic inflammatory diseases and systemic or local steroid, mechanical causes like bony ridges, presence of bone plate or external fixator pin may precipitate this. Repetitive uses in certain occupation like cooking, cow milking, tailoring and direct trauma in kick boxer are also identified as cause. In this study it is caused by screw tip that also after 20 years. Instead of tendon transfer, interposition tendon grafting is preferred. A 36-year-old male manual worker was plated for distal radial shaft fracture of left side. Distal most screw length was 3 mm in excess. After 20 years he developed rupture of extensor pollicislongus spontaneously. After excluding probable other causes and confirming by USG tendon ends were explored through dorsal incision. Offending slotted head screw was removed using hollow mill. Ipsilateral Palmaris longus tendon was grafted. Tension was set by extension of thumb and neutral position of the wrist. Removal of stitch after 2 weeks, short arm cast immobilization for 6 week and intermittent splinting and exercises for another 6 weeks yield excellent result. Timely removal of implant when it is applied over tendon rich areas is preferable. In late situation surgeon should be equipped and careful to remove it. To avoid chance of transferring a diseased tendon interposition grafting using Palmaris longus is justified.

  16. Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer's muscles)

    Science.gov (United States)

    JONES, M.; ABRAHAMS, P. H.; SAÑUDO, J. R.; CAMPILLO, M.

    1997-01-01

    In 1813 Gantzer described 2 accessory muscles in the human forearm which bear his name (Wood, 1868; Macalister, 1875; Testut, 1884; Le Double, 1897). The more frequent of the 2 accessory muscles or ‘accessorius ad pollicem’ was found to arise from the coronoid process of the ulna, coursing distally to attach into the flexor pollicis longus muscle (flexor pollicis longus accessory head, FPLah). The less frequently observed or ‘accessorius ad flexorem profundum digitorum’ was again found to arise from the coronoid process and course to join into the flexor digitorum profundus (flexor digitorum profundus accessory head, FDPah). Since their initial description, they have been examined in further detail by a number of authors (Wood, 1868; Macalister, 1875; Le Double, 1897; Dykes & Anson, 1944; Mangini, 1960; Malhotra et al. 1982; Dellon & McKinnon, 1987; Kida, 1988). These studies, most of them focusing on the FPLah, all show different results of prevalence, origin, insertion, relations and nerve supply. We undertook this study with the aim of providing a more accurate account of the detailed morphology of both accessory muscles because of the above-mentioned inconsistent anatomical descriptions and the lack of information as to important aspects such as vascular supply, morphology (shape and length) and the coexistence of both accessory heads. PMID:9419002

  17. Flexor pollicis longus repair in a patient with Linburg-Comstock anomaly: A case report

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    Mehmet Unal

    2016-08-01

    Results: At the end of the rehabilitation program, the thumb recovered full range of motion, and physical examination revealed synchronous flexion movement (synkinesis of the thumb and index finger. Conclusion: Flexor pollicis longus tendon lacerations are common in the clinical practice of hand surgeons. Making a separate proximal wrist incision is a very useful technique to reach a proximal tendon stump. Otherwise, aggressive maneuvers may cause additional damage to the tendons involved and result in unpredicted outcomes. The attempts to retrieve the tendon at the injury site resulted in failure and gave a tethering sensation to the surgeon who recalled the Linburg-Comstock anomaly. [Hand Microsurg 2016; 5(2.000: 88-91

  18. A New Rerouting Technique for the Extensor Pollicis Longus in Palliative Treatment for Wrist and Finger Extension Paralysis Resulting From Radial Nerve and C5C6C7 Root Injury.

    Science.gov (United States)

    Laravine, Jennifer; Cambon-Binder, Adeline; Belkheyar, Zoubir

    2016-03-01

    Wrist and finger extension paralysis is a consequence of an injury to the radial nerve or the C5C6C7 roots. Despite these 2 different levels of lesions, palliative treatment for this type of paralysis depends on the same tendon transfers. A large majority of the patients are able to compensate for a deficiency of the extension of the wrist and fingers. However, a deficiency in the opening of the first web space, which could be responsible for transfers to the abductor pollicis longus, the extensor pollicis brevis, and the extensor pollicis longus (EPL), frequently exists. The aim of this work was to evaluate the feasibility of a new EPL rerouting technique outside of Lister's tubercle. Another aim was to verify whether this technique allows a better opening of the thumb-index pinch in this type of paralysis. In the first part, we performed an anatomic study comparing the EPL rerouting technique and the frequently used technique for wrist and finger extension paralyses. In the second part, we present 2 clinical cases in which this new technique will be practiced. Preliminary results during this study favor the EPL rerouting technique. This is a simple and reproducible technique that allows for good opening of the first web space in the treatment of wrist and finger extension paralysis.

  19. Attritional rupture of extensor pollicis longus: a rare complication following elastic stable intramedullary nailing of a paediatric radial fracture.

    LENUS (Irish Health Repository)

    Sproule, James A

    2011-01-01

    Elastic stable intramedullary nail fixation has become established as an acceptable method of treatment for diaphyseal fractures of both forearm bones in the paediatric population. It is considered safe, minimally invasive and does not compromise physeal growth. We report a case of delayed rupture of extensor pollicis longus due to attrition over the sharp edges of a protruding nail end after elastic stable intramedullary nailing of a paediatric radial diaphyseal fracture.

  20. [Operative treatment of flexor pollicis longus tendon with Krackow suture, functional results--preliminary results].

    Science.gov (United States)

    Bumbasirević, Marko Z; Andjelković, Sladjana; Lesić, Aleksandar R; Sudjić, Vojo S; Palibrk, Tomislav; Tulić, Goran Dz; Radenković, Dejan V; Bajec, Djordje D

    2010-01-01

    Surgical treatment of the injuried flexor tensons is the important part of hand surgery. Tendon adhesions, ruptures, joint contcatures-stifness are only one part of the problem one is faced during the tendon treatment. In spite of improvement in surgical technique and suture material, the end result of sutured flexor tendons still represent a serious problem. To present of operative treatment of flexor pollicis longus injury with Krakow suture technique. All patients are treated in the first 48 hours after the accident. The regional anesthesia was performed with use of turniquet. Beside spare debridement, the reconstruction of digital nerves was done. All patients started with active and pasive movements-excercises on the first postoperative day. Follow-up was from 6 to 24 months. In evaluation of functional recovery the grip strenght, pinch strenght, range of movements of interphalangeal and metacarpophalangeal joiht and DASH score were used. In the last two years there were 30 patients, 25 males (83.33%) and 5 females (16.66%). Mean age was 39.8 years, ranged from 17 to 65 years. According to mechanism of injury the patients were divided in two groups: one with sharp and other with wider zone of injury. Concomitant digital nerve lesions was noticed in 15 patients (50%). the Krackow sutrue allowed early rehabilitation, which prevent tendon adhesions, enabled faster and better functional recovery.

  1. Transfer of either index finger extensor tendon to the extensor pollicis longus tendon

    Science.gov (United States)

    Meads, Bryce M; Bogoch, Earl R

    2004-01-01

    BACKGROUND: Extensor pollicis longus (EPL) tendon ruptures have been treated succesfully with the transfer of the extensor indicis proprius (EIP) tendon. Situations exist in which, due to intraoperative observations, another tendon transfer may be considered preferable to the standard EIP transfer method. OBJECTIVES: To determine whether transfer of the extensor digitorum communis II (EDC II) tendon from the index finger to the EPL tendon, leaving the EIP tendon to the index finger intact, would serve as an equally efficient transfer and not adversely affect the function of the hand. METHODS: Two patients who had the EDC II tendon transferred to the ruptured EPL tendon, and two patients who had the EIP tendon transferred, were retrospectively reviewed. In each transfer type, one patient had suffered an EPL tendon rupture after a Colles’ fracture, and the other had rheumatoid arthritis. The rupture occurred on the non-dominant side in one patient in each transfer type. Each patient was examined and subjected to range of motion and power testing at least one year following surgery. RESULTS: All four patients showed a minimal extension lag with the lift off test, but there was no noticeable difference in range of motion, pinch grip and hand grip strength between the transfer types. Both EDC II transfer patients demonstrated an 8° to 15° loss of thumb interphalangeal joint flexion compared with the unoperated side; EIP transfer patients demonstrated less than a 5° loss. Three patients demonstrated a minor extension lag in the index finger and middle finger. Extension power of the thumb and index finger in all patients varied with wrist flexion and extension and ranged from 50% to 150% of the unoperated side. CONCLUSIONS: These case reports suggest that either index finger tendon may be successfully transferred in EPL tendon ruptures. PMID:24115870

  2. Presence of Multiple Tendinous Insertions of Palmaris Longus: A ...

    African Journals Online (AJOL)

    Case Details: We report here a unique case of palmaris longus presenting variation distally as its tendon divides to gain multiple attachments with the fascia covering the abductor pollicis brevis, flexor retinaculum and the tendon of flexor carpi ulnaris. In addition, it also continues as palmar aponeurosis as its normal course.

  3. Measurement of gliding resistance of the extensor pollicis longus and extensor digitorum communis II tendons within the extensor retinaculum.

    Science.gov (United States)

    Kutsumi, Keiji; Amadio, Peter C; Zhao, Chunfeng; Zobitz, Mark E; An, Kai-Nan

    2004-03-01

    The etiology of spontaneous extensor pollicis longus (EPL) tendon rupture is still largely unknown. It is possible that friction within the sheath may play a role. The purposes of this study were to compare gliding resistance of the EPL tendon with that of the extensor digitorum communis tendon of the index finger (EDC II) and to find the wrist position that gives the EPL tendon the lowest gliding resistance. Fifteen fresh-frozen cadavers were used. Gliding resistance was measured directly in 7 different wrist positions. The mean gliding resistance of the EPL tendon was 0.16 +/- 0.08 N and that of the EDC II tendon was 0.11 +/- 0.06 N. This difference was significant. There was also a significant effect on gliding resistance due to wrist position. For the EPL tendon, the gliding resistance was significantly greater in 60 degrees wrist flexion compared with all other wrist positions tested. Additionally the gliding resistance of the EPL in 30 degrees flexion, 60 degrees extension, and 15 degrees radial deviation was significantly higher than wrist positions of 30 degrees extension, neutral, and 30 degrees ulnar deviation. Positioning the wrist close to neutral flexion/extension and in some ulnar deviation minimizes the friction within the EPL sheath. Such positions may be advantageous for splinting patients at risk for EPL rupture.

  4. Rupture of the extensor pollicis longus tendon after fracture of the lower end of the radius--a clinical and microangiographic study.

    Science.gov (United States)

    Engkvist, O; Lundborg, G

    1979-02-01

    The pathogenesis of the late post-traumatic rupture of the extensor pollicis longus tendon has never been satisfactorily explained. In the present series of fifty-nine ruptures two were partial, making possible an exact localization of the rupture. Microangiographic studies performed on amputated arms showed that this part of the tendon was poorly vascularized. Our study confirms earlier observations that ruptures most commonly occur after undisplaced fractures. It is suggested that increased pressure within the non-ruptured tendon sheath jeopardizes the blood flow in the already poorly vascularized parts of the tendon, leading to degeneration and rupture, usually within eight weeks. An haematoma inside the sheath interfering with the production of synovial fluid, could deprive the tendon of an alternative nutrition via diffusional pathways.

  5. Estudo anatômico das inserções distais do tendão extensor longo do polegar Anatomical studies of the distal insertion of the extensor pollicis longus

    Directory of Open Access Journals (Sweden)

    Maurício Benedito Ferreira Caetano

    2004-06-01

    . During its passage through metacarpophalangeal joint we recorded its insertion in the joint capsule in 14 observations (23,3%, however the bone insertion there was not observed in this place.. The most common pattern about this (EPL extensor pollicis longus muscle was the presence of a tendon, passing through the osteofibroses dorsal of wrist compartment with a bone insertion at the base of distal pollicis phalanx.

  6. Revisiting the functional anatomy of the palmaris longus as a thenar synergist.

    Science.gov (United States)

    Moore, Colin W; Fanous, Jacob; Rice, Charles L

    2017-11-27

    Surgical studies describe the palmaris longus (PL) as a synergist in thumb abduction, which may facilitate its use in restoring thumb function using opponensplasty. However, beyond morphological descriptions and isometric thenar abduction strength measures, the evidence supporting the PL as a thenar synergist in-vivo is limited. The purpose here was to determine whether the PL provides synergistic contributions to thenar musculature by: (1) recording PL muscle activity using indwelling electromyography (EMG) during thumb movements; and (2) quantifying changes in PL muscle architecture using ultrasonography. In 10 healthy males, PL muscle activity was recorded during maximal thenar muscle contractions (abduction, flexion, opposition, adduction, and extension) with the wrist secured in a neutral position. The PL EMG was normalized to its maximal EMG recorded during isometric wrist flexion. Dynamic changes in PL muscle thickness (M T ) were determined during abduction and adduction using ultrasound imaging. The results indicate that the PL is activated during thenar movements with greatest relative PL EMG recorded during thenar abduction (46%), flexion (35%) and opposition (37%). Compared to rest, PL M T significantly increased (21%) during maximal thenar abduction. With direct measures in vivo, this study supports morphological and surgical observations indicating the PL acts as an extrinsic hand muscle in enhancing thenar muscle actions. Knowledge of the synergistic relationship between the PL and thenar musculature may allow for further development of surgical opponensplasty approaches using the abductor pollicis brevis and PL as a functional digastric unit. Clin. Anat, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. Peroneus longus tenosynovitis.

    OpenAIRE

    Folan, J. C.

    1981-01-01

    Tenosynovitis of the tendon of peroneus longus has rarely been described in the literature (Aberle-Horstenegg, 1932; Burman and Lapidus, 1931). This is a report on the condition in two athletes and in one of whom the os peroneum was absent on the side of the tenosynovitis. It emphasises the importance of a detailed review of athletes' training patterns when assessing their injuries.

  8. Abductor Reconstruction with Gluteus Maximus Transfer in Primary Abductor Deficiency during Total Hip Arthroplasty.

    Science.gov (United States)

    Jang, Se Ang; Cho, Young Ho; Byun, Young Soo; Gu, Tae Hoe

    2016-09-01

    Abductor deficiency in native hip joint may cause severe limping and pain. It is more serious situation in case of arthroplasty due to instability and recurrent dislocation. Well-known causes of abductor deficiency are repeated surgery, chronic trochanteric bursitis, superior gluteal nerve injury, failure of repair of abductor tendon insertion to the greater trochanter. Author had experienced primary abductor deficiency during total hip replacement and treated successfully with the transfer of gluteus maximus. We'd like to introduce the operation technique with the review of literature.

  9. [Extensor digitorum longus transfer in flexible overlapping fifth toe deformity].

    Science.gov (United States)

    Fuhrmann, R A; Pillukat, T

    2014-02-01

    Pain relief through realignment of the fifth toe by dorsomedial capsular release at the fifth metatarsophalaneal joint and transfer of the extensor digitorum longus tendon to the aponeurosis of the abductor digiti quinti muscle. Flexible overlapping fifth toe deformity. Fixed deformity. Angular toe deformity distal to the metatarsophalangeal joint (e.g. delta phalanx). Lateral drift of all lesser toes. Dorsolateral approach to the fifth metatarsophalangeal joint. Release of the dorsomedial capsule. Tenotomy of the fifth extensor digitorum longus tendon at the dorsum of the foot. Transfer of the distally based tendon around the proximal phalanx to the aponeurosis of the abductor digiti quinti muscle. Correction of the deformity by tensioning the tendon graft appropriately. Ambulation with full weightbearing in a postoperative shoe. Toe alignment dressing for 6 weeks. A total of 48 patients (56 feet; average age 37 years) with a flexible overlapping fifth toe deformity were followed up after soft tissue release and transfer of the extensor digitorum longus tendon; 40 patients (48 feet) were re-evaluated clinically after 11.4 months (range 9-26 months). Postoperative complications were sensory disturbance at the lateral side of the fifth toe (n = 5), superficial wound slough (n = 3). Follow-up results included broad and hypertrophic scars at the fifth metatarsophalangeal joint (n = 16), physiological alignment of the fifth toe in 37 feet (77.1%), overcorrection (interdigital space 4/5 > 3 mm) in 4 feet (8.3%), undercorrection in 7 feet (14.6%). In 4 feet the undercorrection could be attributed to a Tailor's bunion deformity, which was not treated appropriately.

  10. The hip abductors at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, A., E-mail: adrienne.hoffmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland); Pfirrmann, C.W.A., E-mail: christian.pfirrmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland)

    2012-12-15

    Imaging of the hip abductors plays an increasing role for the evaluation of greater trochanteric pain in patients with and without total hip arthroplasty. This review article addresses the anatomy of the hip abductors and their intervening bursae. It highlights different possible imaging appearances such as tendinopathy or partial and full thickness tears of the gluteal tendons. Muscle atrophy or fatty degeneration of the gluteal muscles is an important reason for limping. Inflammatory diseases such as hydroxyapatite crystal deposition disease or spondylarthritis have to be considered. Knowledge of these different entities is important to achieve optimal treatment and outcomes.

  11. Lesion of the hip abductor mechanism

    Directory of Open Access Journals (Sweden)

    Caviglia Horacio

    2016-01-01

    Full Text Available Introduction: The disruption of the abductor muscles of the hip after hip revision surgery often causes limping, pain, and instability of the implant. The purpose of our paper is to describe a mesh technique to repair hip abductor mechanism injuries after hip revision. Patients and methods: Forty-six patients with hip abductor damage after prosthetic revision were treated. Inclusion criteria were: patients presenting with prosthetic loosening, complaint of pain, and with a positive Trendelenburg sign due to deficient abductor muscle mechanisms. Thirty-one were women (67.39% with an average age of 64 years (34–82 years. The number of previous revision surgeries was three (two to seven. The Merle d’Aubigné score and variants before and after treatment were also reported. Results: In the postoperative follow-up after hip revision with the mesh technique, the Merle d’Aubigné score improved and the Trendelenburg sign was negative in 78.3% of the patients (p < 0.001. Also, the Trendelenburg test with the knee flexed was negative in 60.9% (p < 0.001 and the stair-climbing test was negative in 60.9% of cases (p < 0.001. The gluteus medius test in the lateral position was negative in 52.2% of patients, and in the lateral position with the knee flexed it was negative in 47.8% of patients (p < 0.001. Discussion: Repair of the abductor mechanism with the mesh technique has proven effective for both partial and total lesions.

  12. Adductor pollicis muscle: potential anthropometric parameter in hospitalized individuals

    Directory of Open Access Journals (Sweden)

    Teresa Cristina Abranches Rosa

    2015-07-01

    Full Text Available This study evaluated the measurement of adductor pollicis muscle thickness as a parameter for the assessment of nutritional status in patients admitted to a University Hospital in Campo Grande, Mato Grosso do Sul State. This is a prospective cross-sectional study with 64 adults and elderly patients. We evaluated the percentage of weight loss based on the usual weight, arm circumference, triceps skinfold thickness, arm muscle circumference, laboratory parameters and measurement of adductor pollicis muscle thickness. The measurements were performed only once, in the first 72 hours of hospitalization. Data were analyzed using statistical software BioEstat 5.0, with a significance level of 0.05. The average thickness of the adductor pollicis muscle was 17.5 + 5.3 mm. We found a significant negative association of muscle with age. There was a significant association between the measure of muscle and parameters such as body mass index, arm circumference, arm muscle circumference, albumin and nutritional status assessed by physical examination. The adductor pollicis muscle allows easy measurement, direct assessment, fast results, low cost and good correlation with anthropometric parameters. However, further studies should be conducted to validate this new method.

  13. Treating abductor deficiency: a transference technique.

    Science.gov (United States)

    Whiteside, Leo A

    2011-09-09

    Loss of abduction power is a common problem after total hip arthroplasty (THA) and may lead to severe limp and instability. A surgical reconstruction technique using a gluteus maximus flap transfer was developed to repair deficient abductor muscles and capsule. The gluteus maximus muscle was split as in a posterior approach to the hip, and the anterior portion of the muscle was elevated as a flap, separating it from the fascia lata and fashioning a triangular distal fascial end. The lateral surface of the greater trochanter was decorticated, and the anterior half of the gluteus maximus was sutured to the greater trochanter with multiple nonabsorbable sutures through drill holes in the bone. The distal fascial end was sutured beneath the vastus lateralis muscle with heavy absorbable sutures. The posterior portion of the gluteus maximus (approximately one-sixth of the muscle body and half the length) was passed beneath the primary flap to substitute for the gluteus minimus and capsule. The tensioning of the flap was done with the hip in 15° to 20° abduction to ensure adequate tension in the transferred muscle. The lower half of the gluteus maximus muscle and fascia lata were also closed over the greater trochanter and transferred muscle flap with the hip abducted and then closed proximally, leaving the anterior edge of the gluteus maximus flap unsutured so that the transferred muscle would be allowed to pull directly on the greater trochanter. Gradual rehabilitation included 2-handed support for 8 weeks and careful gradual abduction exercises beginning 4 weeks postoperatively. Copyright 2011, SLACK Incorporated.

  14. The United States Army Medical Department Journal. The United States Army Dental Corps: A Century of Commitment, Service, and Care

    Science.gov (United States)

    2011-03-01

    extremity. Motor Strength – Subject 19 had 4/5 strength right flexor pollicis longus and flexor digitorum profundus digit 2 (anterior interosseous nerve...subject 24 had 4/5 strength left elbow extensors , left wrist extensors , left wrist flexors, and left abductor pollicis brevis; subject 30 had 4/5...Otherwise, all subjects were assessed to have normal (5/5) muscle strength for the neck flexors, extensors , and rotators (C1-5); and both upper

  15. Linear atrophy and vascular fragility following ultrasoundguided triamcinolone injection for DeQuervain tendonitis

    OpenAIRE

    Willardson, Hal B; Buck, Shannon; Neiner, James

    2017-01-01

    A 64 year-old woman presented with a one-yearhistory of purpuric, atrophic, linear patches alongthe left lateral forearm. The patient had receivedtwo ultrasound-guided triamcinolone injectionsone year earlier into her left extensor pollicis brevisand abductor pollicis longus tendon sheathsfor DeQuervain tendonitis. In the seven monthsfollowing the second injection, the patient developedatrophy, purpura, and telangiectasias starting at thesite of injection and extending proximally, followingth...

  16. Endolaryngeal Surgery of Bilateral Vocal Cord Abductor Paralysis

    African Journals Online (AJOL)

    1971-12-04

    Dec 4, 1971 ... Bilateral abductor paralysis of the vocal cords is uncommon ... Spontaneous recovery of neuromuscular function may .... Her exercise tolerance is far greater than at any time over the past 20 years. The voice deteriorated considerably during the first few post- operative weeks, but later returned to its ...

  17. Morphological Study Of Palmaris Longus Muscle

    Directory of Open Access Journals (Sweden)

    Humberto Ferreira Arquez

    2017-07-01

    Full Text Available Background: The palmaris longus is one of the most variable muscle in the human body, this variations are important not only for the anatomist but also radiologist, orthopaedic, plastic surgeons, clinicians, therapists. In view of this significance is performed this study with the purpose to determine the morphological variations of palmaris longus muscle. Methods and Findings: A total of 17 cadavers with different age groups were used for this study. The upper limbs region (34 sides were dissected carefully and photographed in the Morphology Laboratory at the University of Pamplona. Of the 34 limbs studied, 30 showed normal morphology of the Palmaris longus muscle (PL (88,2%; PL was absent in 3 subjects (8,85% of all examined forearm. Unilateral absence was found in 1 male subject (2,95% of all examined forearm; bilateral agenesis was found in 2 female subjects (5,9% of all examined forearm. Duplicated PL muscle was found in 1 male subject (2,95 % of all examined forearm. The palmaris longus muscle was innervated by branches of the median nerve .The accessory palmaris longus muscle was supplied by the deep branch of the ulnar nerve.  Palmaris longus muscle is a muscle located in the superficial layer of the anterior compartment of the forearm. It has a small belly arising from the medial epicondyle of the humerus, and its long thin tendon inserts into the palmar aponeurosis in the hand, the muscle has importance in medical clinic, surgery, radiological analysis, in studies about high-performance athletes, in genetics and anthropologic studies. Conclusions: The anatomical variations of the palmaris longus muscle must be documented of their clinical significance and their potential use in orthopaedic and reconstructive surgery.

  18. REHABILITATATION FOR EXTENSOR HALLUCIS LONGUS AND EXTENSOR DIGITORUM LONGUS TENDINOPATHY – AN EXERCISE PACKAGE

    OpenAIRE

    Oskar, Sten

    2016-01-01

    The purpose of this thesis was to create an exercise package containing research proven evidence based exercises for Extensor Hallucis Longus and Extensor Digitorum Longus muscles for strengthening purposes. The exercise package consists of eccen-tric exercises that have been proven to be beneficial in treating tendon problems. The exercise package will be provided to be implemented by the players and coaches of the co-operating bandy team. The thesis was done in collaboration with Pori N...

  19. Variation in the insertion of the palmaris longus tendon

    Science.gov (United States)

    Sunil, Vinutha; Rajanna, Shubha; Gitanjali; Kadaba, Jayanthi

    2015-01-01

    The palmaris longus is harvested as a tendon graft in various surgical procedures. We herein report the variations in the insertion of the palmaris longus tendon. During a routine dissection, a rare variation in the insertion of the palmaris longus tendon was observed. In the left forearm, the palmaris longus tendon bifurcated, while in the right forearm, the palmaris longus tendon trifurcated, giving rise to an accessory muscle, which passed superficial to the ulnar artery and ulnar nerve. The accessory muscle was supplied by a deep branch of the ulnar nerve, and the ulnar artery was observed to be tortuous. During reconstructive surgeries, surgeons should bear in mind the accessory muscle. Also, since the palmaris longus muscle provides a very useful graft in tendon surgery, every surgeon should be aware of the variations in the insertion of the palmaris longus tendon. PMID:25640108

  20. Hip abductor moment arm - a mathematical analysis for proximal femoral replacement

    Directory of Open Access Journals (Sweden)

    Temple H Thomas

    2011-01-01

    Full Text Available Abstract Background Patients undergoing proximal femoral replacement for tumor resection often have compromised hip abductor muscles resulting in a Trendelenberg limp and hip instability. Commercially available proximal femoral prostheses offer several designs with varying sites of attachment for the abductor muscles, however, no analyses of these configurations have been performed to determine which design provides the longest moment arm for the hip abductor muscles during normal function. Methods This study analyzed hip abductor moment arm through hip adduction and abduction with a trigonometric mathematical model to evaluate the effects of alterations in anatomy and proximal femoral prosthesis design. Prosthesis dimensions were taken from technical schematics that were obtained from the prosthesis manufacturers. Manufacturers who contributed schematics for this investigation were Stryker Orthopaedics and Biomet. Results Superior and lateral displacement of the greater trochanter increased the hip abductor mechanical advantage for single-leg stance and adduction and preserved moment arm in the setting of Trendelenberg gait. Hip joint medialization resulted in less variance of the abductor moment arm through coronal motion. The Stryker GMRS endoprosthesis provided the longest moment arm in single-leg stance. Conclusions Hip abductor moment arm varies substantially throughout the hip's range of motion in the coronal plane. Selection of a proximal femur endoprosthesis with an abductor muscle insertion that is located superiorly and laterally will optimize hip abductor moment arm in single-leg stance compared to one located inferiorly or medially.

  1. Dorsal forearm muscles: US anatomy Pictorial Essay

    Science.gov (United States)

    Precerutti, M.; Garioni, E.; Ferrozzi, G.

    2010-01-01

    The dorsal compartment of the forearm contains nine muscles: four belong to the superficial group (extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris and anconeus) and five to the deep group (supinator, abductor longus, extensor pollicis brevis, extensor pollicis longus, and extensor indices). Of these nine muscles the following details are considered: origin, course, distal insertion and their anatomical connection with those structures which are most often affected by pathologies. The radiologist must have a thorough knowledge of this complex topographic anatomy in order to perform ultrasound (US) and magnetic resonance imaging (MRI) examinations and correctly interpret the images. PMID:23396199

  2. An ergonomics study of thumb movements on smartphone touch screen.

    Science.gov (United States)

    Xiong, Jinghong; Muraki, Satoshi

    2014-01-01

    This study investigated the relationships between thumb muscle activity and thumb operating tasks on a smartphone touch screen with one-hand posture. Six muscles in the right thumb and forearm were targeted in this study, namely adductor pollicis, flexor pollicis brevis, abductor pollicis brevis (APB), abductor pollicis longus, first dorsal interosseous (FDI) and extensor digitorum. The performance measures showed that the thumb developed fatigue rapidly when tapping on smaller buttons (diameter: 9 mm compared with 3 mm), and moved more slowly in flexion-extension than in adduction-abduction orientation. Meanwhile, the electromyography and perceived exertion values of FDI significantly increased in small button and flexion-extension tasks, while those of APB were greater in the adduction-abduction task. This study reveals that muscle effort among thumb muscles on a touch screen smartphone varies according to the task, and suggests that the use of small touch buttons should be minimised for better thumb performance.

  3. Hip abductor muscle volume in hip osteoarthritis and matched controls.

    Science.gov (United States)

    Zacharias, A; Pizzari, T; English, D J; Kapakoulakis, T; Green, R A

    2016-10-01

    Hip abductor muscle strength and function is negatively impacted by the presence of hip osteoarthritis (OA). This study aimed to quantify differences in hip abductor muscle volume, fatty infiltration and strength in a unilateral hip OA population when compared to a control group. Impact of radiographic severity of OA on these variables was also examined. Volumes of gluteus maximus (GMax), medius (GMed) minimus (GMin) and tensor fascia lata (TFL) was measured using MRI and muscle volume asymmetry between limbs was calculated. Fatty infiltrate within muscles was graded using the Goutallier classification system. Hip abduction and rotation strength was tested using a dynamometer. Differences between groups or limbs were analysed using t-tests and differences in fatty infiltration using non-parametric tests. A statistically significant decrease in muscle volume was identified in GMax (P abduction and internal rotation strength was reduced in the OA group. Increased levels of fatty infiltration were identified in the affected limbs of the OA group for GMax (P = 0.01) and GMin (P = 0.04). Gluteal muscle atrophy, increased gluteal fatty infiltration and hip strength deficits were evident in the affected hips of OA participants. Since severity of OA was related to the extent of atrophy and fatty deposits, rehabilitation programs targeting these muscles could reverse or halt the progression of these structural and functional deficits. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  4. Contractile speed and fatigue of adductor pollicis muscle in multiple sclerosis.

    NARCIS (Netherlands)

    Ruiter, C.J. de; Jongen, P.J.H.; Woude, L.H.V. van der; Haan, A. de

    2001-01-01

    The purpose of the study was to investigate differences in contractile speed, force, and fatigability of the adductor pollicis muscle between 12 patients with multiple sclerosis (MS) and 8 sedentary control subjects matched for age and gender. There were no differences between the patients with MS

  5. Contractile speed and fatigue of adductor pollicis muscle in multiple sclerosis

    NARCIS (Netherlands)

    de Ruiter, C.J.; Jongen, P.J.H.; van der Woude, L.H.V.; de Haan, A.

    2001-01-01

    The purpose of the study was to investigate differences in contractile speed, force, and fatigability of the adductor pollicis muscle between 12 patients with multiple sclerosis (MS) and 8 sedentary control subjects matched for age and gender. There were no differences between the patients with MS

  6. Stabilization and stability of twitch force during mechanomyography of the adductor pollicis muscle

    NARCIS (Netherlands)

    van Santen, G; Fidler, [No Value; Wierda, JMKH

    1998-01-01

    Objective. In order to study the stabilization time, the increase in twitch force during stabilization and the maintenance of stability during mechanomyography of the adductor pollicis muscle, neuromuscular function was monitored in 20 patients anaesthetized without the use of a neuromuscular

  7. Flexor hallucis longus and extensor digitorum longus tendon transfers for balancing the foot following transmetatarsal amputation.

    Science.gov (United States)

    Roukis, Thomas S

    2009-01-01

    Transmetatarsal amputation is a useful surgical procedure that is applicable to the treatment of the dysvascular, neuropathic, and/or traumatized forefoot. Because of the loss of the insertions of some of the extrinsic pedal musculature, transmetatarsal amputation is known to be associated with imbalance of the residual foot, and this can lead to complications related to cutaneous compromise, as well as difficulties with bracing and shoe fit. In this techniques report, we describe a combination of tendon transfers that use flexor hallucis longus and extensor digitorum longus, which can be useful in preventing pedal imbalance following transmetatarsal amputation.

  8. SUBCUTANEOUS PERONEUS LONGUS TENDON RUPTURE ASSOCIATED WITH OS PERONEUM FRACTURE

    Directory of Open Access Journals (Sweden)

    Shinichi Yoshiya

    2009-12-01

    Full Text Available We report a rare case of subcutaneous peroneus longus tendon rupture associated with os peroneum fracture. Three dimensional computed tomographic scan was useful to understand this disorder. We treated the patient with excision of fractured os peroneum and tenodesis of the proximal stump of the ruptured peroneus longus tendon to the lateral aspect of the calcaneus

  9. The function and the strength of the thumb is not affected when the extensor pollicis longus tendon is left out of the extensor retinaculum

    Directory of Open Access Journals (Sweden)

    Fatih Kabakas

    2016-08-01

    Conclusion: It was determined that leaving the EPL tendon out of the retinaculum in cases with increased risk of adhesions and rupture did not cause marked muscle weakness or loss of range of movement. [Hand Microsurg 2016; 5(2.000: 56-61

  10. Checkrein deformity due to extensor hallucis longus hypotrophy treated with extensor digitorum longus tendon transfer.

    Science.gov (United States)

    Kurashige, Toshinori; Kawabata, Kensuke; Suzuki, Seiichi

    2014-06-01

    Checkrein deformity is a relatively rare condition caused by hypotrophy or adhesion of a tendon after a lower leg injury. The occurrence of this condition due to the dysfunction of the extensor hallucis longus (EHL) is extremely rare. Only a few related case reports have been published, and Z-lengthening of the EHL tendon was performed for almost all patients. We report a case of checkrein deformity due to EHL hypotrophy. The patient was involved in a traffic accident 7 years ago. He sustained left tibial and fibular closed diaphyseal fractures and underwent minimally invasive plate osteosynthesis. He continued to have left great toe symptoms characterized by dorsiflexion of the great toe during ankle plantarflexion. The EHL had become an insufficient power source because of considerable hypotrophy. Therefore, a tendon transfer using the extensor digitorum longus to the second toe was performed as a primary treatment. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  11. Unilateral Variation in Extensor digitorum longus muscle.

    Science.gov (United States)

    Banerje, A; Singh, S; Raza, K; Rani, N; Kaler, S

    2016-01-01

    During a routine dissection of an adult embalmed male cadaver for educational purpose in the department of anatomy at AIIMS, New Delhi, India, a rare unilateral variation of extensor digitorum longus (EDL) was found which is a muscle of anterior compartment of the leg. There was a split tendon of EDL muscle in the anterior compartment of left leg which became a common tendon in front of the ankle joint. This common tendon of EDL muscle again divided into four slips and were inserted in to the lateral four toes. In the upper part of the leg, the anterior tibial vessel and deep fibular nerve lie between the EDL and tibialis anterior. Knowledge of this type of anomaly is useful in diagnosis and treatment of compartmental syndrome. One of the tendon from the split tendon of EDL muscle can be used as a graft in tendon replacement surgeries. The split tendon may also be capable for some precise movements of the toes.

  12. A rare anomaly of the extensor digitorum longus.

    Science.gov (United States)

    Sakuma, Eisuke; Kato, Hiroyuki; Honda, Nobuhiko; Mabuchi, Yoshio; Soji, Tsuyoshi

    2004-12-01

    We encountered the absence of the tendon to the fourth toe of the extensor digitorum longus muscle of the right leg in the body of a 73-year-old Japanese woman during the course of educational dissection at Nagoya City University Medical School. The tendon to the fourth toe of the extensor digitorum longus muscle was solely absent. To our knowledge, this anatomical variation has never been cited in the medical literature. We document the precise gross anatomical findings with some morphometric measurements. Moreover, we discuss the morphology of this anomaly in relation to previously described variations and anomalies of the extensor digitorum longus muscle.

  13. Intermuscular interaction via myofascial force transmission: Effects of tibialis anterior and extensor digitorum longus length on force transmission from rat extensor digitorum longus muscle

    NARCIS (Netherlands)

    Maas, Huub; Baan, Guus C.; Huijing, P.A.J.B.M.

    2001-01-01

    Force transmission in rat anterior crural compartment, containing tibialis anterior (TA), extensor hallucis longus (EHL) and extensor digitorum longus (EDL) muscles, was investigated. These muscles together with the muscles of the peroneal compartment were excited maximally. Force was measured at

  14. Intermuscular interaction via myofascial force transmission: Effects of tibialis anterior and extensor digitrum longus length on force transmission from rat extensor digitorum longus muscle

    NARCIS (Netherlands)

    Maas, H.; Baan, G.C.; Huijing, P.A.J.B.M.

    2001-01-01

    Force transmission in rat anterior crural compartment, containing tibialis anterior (TA), extensor hallucis longus (EHL) and extensor digitorum longus (EDL) muscles, was investigated. These muscles together with the muscles of the peroneal compartment were excited maximally. Force was measured at

  15. The acute effects of hip abductors fatigue on postural balance

    Directory of Open Access Journals (Sweden)

    Nejc Sarabon

    2016-03-01

    Full Text Available The aim of this study was to investigate the effects of unilateral hip abductor fatigue on body sway in ipsilateral and contralateral single legged stance. Acute effects repeated measurements design. Thirteen recreationally active middle aged subjects participated in the study. All subjects performed two 30s repetitions of unilateral stance on each leg. The first measurement was obtained at baseline, the second followed a control protocol of active hip abduction in supine position without additional resistance and the third measurement was conducted as aforementioned second protocol, only against elastic resistance. The center of pressure (CoP movement characteristics during single-leg quiet stance (i.e. body sway were analyzed by calculating the average velocity of the CoP movement and direction specific (medial-lateral and anterior-posterior average velocity, amplitude and frequency of the CoP mo¬ve¬ment. The results of this study indicate that fatigue significantly affected body sway in both single leg stances (p < 0.05 and in both medial-lateral and anterior-posterior direction. However, medial-lateral body sway tended to be increased more than in anterior-posterior direction. A significant crossover effect of increased body sway on the opposing limb suggests that in addition to local muscle fatigue, changes in central nervous system might have taken place. The above findings are of greater importance as they allow a more thorough insight into the mechanisms responsible for controlling balance that could have an important implication on designing training programs.

  16. Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption

    Science.gov (United States)

    Hoffman, Matthew R.; Jiang, Jack J.; Rieves, Adam L.; McElveen, Kelsey A.B.; Ford, Charles N.

    2009-01-01

    Objective To measure the laryngeal resistance (RL), subglottal pressure (Ps), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter. Methods The RL of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and Ps via mechanical balloon valve interruption. Subjects performed ten trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow. Results Mean RL for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH2O/l/s and 14.51 cmH2O/l/s, respectively (p = 0.04). Mean RL at 70 dB were 40.02 cmH2O/l/s and 15.84 cmH2O/l/s (p = 0.014). Ps for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH2O and 8.32 cmH2O, respectively (p = 0.582). At the 70 dB level, Ps were 12.39 cmH2O and 11.78 cmH2O (p = 0.886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 ml/s and 746 ml/s (p = 0.205). Mean MFR at 70 dB were 518 ml/s and 848 ml/s (p = 0.198). Conclusion Noninvasive measurements of RL may be useful for differentiating between ADSD and ABSD. This simple objective test which produces a quantitative output could be used to evaluate laryngeal function in patients with spasmodic dysphonia. PMID:19554636

  17. Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption.

    Science.gov (United States)

    Hoffman, Matthew R; Jiang, Jack J; Rieves, Adam L; McElveen, Kelsey A B; Ford, Charles N

    2009-09-01

    To measure the laryngeal resistance (R(L)), subglottal pressure (P(s)), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter. The R(L) of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and P(s) via mechanical balloon valve interruption. Subjects performed 10 trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow. Mean R(L) for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH(2)O/L/s and 14.51 cmH(2)O/L/s, respectively (P = .04). Mean R(L) at 70 dB were 40.02 cmH(2)O/L/s and 15.84 cmH(2)O/L/s (P = .014). P(s) for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH(2)O and 8.32 cmH(2)O, respectively (P = .582). At the 70 dB level, P(s) were 12.39 cmH(2)O and 11.78 cmH(2)O (P = .886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 mL/s and 746 mL/s (P = .205). Mean MFR at 70 dB were 518 mL/s and 848 mL/s (P = .198). Noninvasive measurements of R(L) may be useful for differentiating between ADSD and ABSD. This simple objective test, which produces a quantitative output, could be used to evaluate laryngeal function in patients with spasmodic dysphonia.

  18. Ultrasound evaluation of the abductor hallucis muscle: Reliability study

    Directory of Open Access Journals (Sweden)

    Hing Wayne A

    2008-09-01

    Full Text Available Abstract Background The Abductor hallucis muscle (AbdH plays an integral role during gait and is often affected in pathological foot conditions. The aim of this study was to evaluate the within and between-session intra-tester reliability using diagnostic ultrasound of the dorso-plantar thickness, medio-lateral width and cross-sectional area, of the AbdH in asymptomatic adults. Methods The AbdH muscles of thirty asymptomatic subjects were imaged and then measured using a Philips HD11 Ultrasound machine. Interclass correlation coefficients (ICC with 95% confidence intervals (CI were used to calculate both within and between session intra-tester reliability. Results The within-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.99–0.99; medio-lateral width an ICC: of 0.97 (95% CI: 0.92–0.97 and cross-sectional area an ICC of 0.98 (95% CI: 0.98–0.99. Between-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.95 to 0.98; medio-lateral width an ICC of 0.94 (95% CI 0.90 to 0.96 and for cross-sectional area an ICC of 0.79 (95% CI 0.65 to 0.88. Conclusion Diagnostic ultrasound has the potential to be a reliable tool for evaluating the AbdH muscle in asymptomatic subjects. Subsequent studies may be conducted to provide a better understanding of the AbdH function in foot and ankle pathologies.

  19. Peroneus longus tears associated with pathology of the os peroneum.

    Science.gov (United States)

    Stockton, Kristopher G; Brodsky, James W

    2014-04-01

    There is a range of different types of tears and pathology of the peroneal tendons. One of the least common types is the tear of the peroneus longus associated with fracture, enlargement, or entrapment at the cuboid tunnel of the os peroneum. The purpose of this study was to evaluate the pathologic patterns of these uncommon peroneal tendon tears, to review the treatment, and to report the patient outcomes following treatment with excision of the os peroneum, debridement, and tenodesis of the peroneus longus to the peroneus brevis. A 5-year retrospective review of all patients with peroneal tendon tears identified 12 patients operatively treated for peroneus longus tendon tears with associated pathology of the os peroneum, and in whom there was a viable peroneus brevis. All patients were treated with an operative procedure consisting of excision of the os peroneum, debridement, and tenodesis of the peroneus longus to the peroneus brevis. Mean age was 51.5 (range, 33 to 73) years, including 7 males and 5 females. Operative and radiographic records were reviewed to characterize the nature of the peroneus longus tears and associated pathology. Preoperative and postoperative AOFAS hindfoot, SF-36 questionnaires, and Visual Analog Scale (VAS) pain scores were compiled and patient records were reviewed for complications. Mean follow-up after surgery was 63.3 (range, 12 to 114) months. All of the patients had an os peroneum associated with a complex, irreparable tear of the peroneus longus tendon. The peroneus longus was typically enlarged, fibrotic, and adhered to the surrounding tissues. In 8 patients, the peroneus longus tendon tear was associated with a fracture of the os peroneum, and in 4 patients with an enlarged and entrapped os peroneum which prevented movement at the cuboid tunnel. Of the 12 patients, 9 had partial tears of the peroneus brevis, which were treated with debridement and suture repair. AOFAS hindfoot scores increased from a preoperative mean of 61

  20. MR imaging of flexor digitorum accessorius longus

    International Nuclear Information System (INIS)

    Cheung, Y.Y.; Rosenberg, Z.S.; Colon, E.; Jahss, M.

    1999-01-01

    Objective The flexor digitorum accessorius longus muscle (FDAL), an anomalous muscle about the ankle, has recently been implicated in tarsal tunnel syndrome. The purpose of this study is to document the prevalence of the FDAL, its MR appearance and its relation to the neurovascular bundle in the tarsal tunnel. Design and patients The prevalence of the FDAL was determined from 100 ankle MR examinations in asymptomatic individuals. The appearance of the FDAL was summarized from 20 examples of FDAL: six gathered from the asymptomatic group and 14 acquired from a group of randomly collected cases of patients with ankle complaints. Results The prevalence of the FDAL was 6%, calculated from the group of 100 asymptomatic individuals. Possessing a dominant fleshy component in the tarsal tunnel, the FDAL accompanies the posterior neurovascular bundle as it descends the ankle. Conclusion The FDAL is encountered in 6% of asymptomatic individuals. Its prominent fleshy component in the tarsal tunnel and its close proximity to the posterior tibial neurovascular bundle readily differentiate the FDAL from other medial anomalous muscles on MR imaging. (orig.)

  1. Effects of hip abductor muscle fatigue on gait control and hip position sense in healthy older adults.

    NARCIS (Netherlands)

    Arvin, M.; Hoozemans, M.J.M.; Burger, B.J.; Rispens, S.M.; Verschueren, S.; van Dieen, J.H.; Pijnappels, M.A.G.M.

    2015-01-01

    We experimentally investigated whether unilateral hip abductor muscle fatigue affected gait control and hip position sense in older adults. Hip abductor muscles were fatigued unilaterally in side-lying position in 17 healthy older adults (mean age 73.2 SD 7.7 years). Hip joint position sense was

  2. FATIGUE ASSOCIATED EMG BEHAVIOR OF THE FIRST DORSAL INTEROSSEOUS AND ADDUCTOR POLLICIS MUSCLES IN DIFFERENT GROUPS OF SUBJECTS

    NARCIS (Netherlands)

    ZIJDEWIND, Inge; KERNELL, D

    We have studied the fatigue-associated behavior of surface EMG in two histochemically different muscles of the hand: fi rst dorsal interosseous (FDI) and adductor pollicis (AP; relatively more type I fibers in AP than in FDI). During a fatigue test evoked by electrical stimulation of the ulnar

  3. Clinical recovery of two hip adductor longus ruptures

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Petersen, Jesper; Nielsen, Michael Bachmann

    2013-01-01

    longus ruptures, using novel, reliable and validated assessment methods. CASE PRESENTATION: A 22-year old male soccer player (Caucasian) sustained two subsequent acute adductor longus ruptures, one in each leg. The injuries occurred 10 months apart, and were treated non-surgically in both situations. He...... was evaluated using hip-strength assessments, self-report and ultrasonography until complete muscle-strength recovery of the hip adductors had occurred. The player was able to participate in a full soccer training session without experiencing pain 15 weeks after the first rupture, and 12 weeks after the second...... rupture. Full hip adductor muscle-strength recovery was obtained 52 weeks after the first rupture and 10 weeks after the second rupture. The adductor longus injuries, as verified by initial ultrasonography (10 days post-injury), showed evidence of a complete tendon rupture in both cases, with an almost...

  4. Eccentric hip abductor weakness in patients with symptomatic external snapping hip

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Thorborg, Kristian; Søballe, K

    2012-01-01

    . Eccentric hip abduction strength was 16% lower in patients with external snapping hip compared with healthy matched controls (1.50 ± 0.47 Nm/kg versus 1.82 ± 0.48 Nm/kg, P = 0.01). No other strength differences were measured between patients and controls (P > 0.05). Eccentric hip abductor weakness...

  5. Isolated atrophy of the abductor digiti quinti in patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Andrade Fernandes de Mello, Ricardo; Garcia Rondina, Ronaldo; Valim, Valeria; Santos Belisario, Stephano; Batista, Elton Francisco [Universidade Federal do Espirito Santo, Department of Internal Medicine, Vitoria, ES (Brazil); Burgomeister Lourenco, Rafael [HUCAM/UFES, Division of Medical Imaging, Vitoria, ES (Brazil); Duque, Ruben Horst [HUCAM/UFES, Division of Rheumatology, Vitoria, ES (Brazil)

    2017-12-15

    We aim to discuss the association of isolated atrophy of the abductor digiti quinti muscle in patients with rheumatoid arthritis as well as review the anatomy and imaging findings of this condition on MRI. A consecutive series of 55 patients diagnosed with rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria were recruited. MRI of the clinically dominant feet was performed using a 1.5-T scanner. The study population was predominantly female (94.5%), and the age range was 31-79 years (mean 57.5 ± 11). A total of 55 ankles were examined by MRI, and 20 patients (36.3%), all females, showed abductor digiti quinti denervation signs. Seven patients demonstrated severe fatty atrophy of the abductor digiti quinti, corresponding to Goutallier grade 4, 2 patients showed moderate fatty atrophy (Goutallier grade 3), and the remaining 11 patients showed less than 50% fatty atrophy, corresponding to a Goutallier grade 2. Substantial agreement was found for both intra- and interobserver agreement regarding the Goutallier grading system. Prevalence of signs of abductor digiti quinti denervation on MRI was high in the studied population, suggesting that rheumatoid arthritis may be associated with inferior calcaneal nerve compression. (orig.)

  6. Effect of Vibram FiveFingers Minimalist Shoes on the Abductor Hallucis Muscle.

    Science.gov (United States)

    Campitelli, Nicholas A; Spencer, Scott A; Bernhard, Kaitlyn; Heard, Kristen; Kidon, Alan

    2016-09-02

    This study investigated the effect of Vibram FiveFingers Bikila minimalist shoes on intrinsic foot musculature. We hypothesized that a gradual transition into minimalist shoes will increase the thickness of the abductor hallucis muscle. Forty-one individuals were divided into four groups: control (traditional shod) (n = 9), restricted walking in Vibram FiveFingers (n = 11), running in Vibram FiveFingers (n = 10), and unlimited walking in Vibram FiveFingers (n = 11). At baseline, 12 weeks, and 24 weeks, the thickness of the abductor hallucis muscle was determined using ultrasound. Statistical analysis was performed to determine the significance of differences in muscle thickness at the three different time points. The mean thickness of the abductor hallucis muscle at 24 weeks was significantly greater than that at baseline for the restricted walking (P = .005) and running (P < .001) groups. In the unlimited walking group, the mean thickness of the muscle at 12 weeks was significantly greater than that at baseline (P < .05) but not at 24 weeks. There were no significant differences in muscle thickness among the three time points for the control group (P = .432). This study demonstrated that wearing Vibram FiveFinger Bikila footwear over a controlled period of time, an unlimited amount of time, as well as transitioning runners over a 6-month period of time using the 10% philosophy for increasing mileage, significantly increases intrinsic muscle thickness of the abductor hallucis. The abductor hallucis muscle aids in support of the medial longitudinal arch, and an increase in this muscle thickness may help reduce running-related injuries thought to arise from arch weakness.

  7. Intra-tester Reliability and Construct Validity of a Hip Abductor Eccentric Strength Test.

    Science.gov (United States)

    Brindle, Richard A; Ebaugh, D David; Milner, Clare E

    2017-11-15

    Side-lying hip abductor strength tests are commonly used to evaluate muscle strength. In a 'break' test the tester applies sufficient force to lower the limb to the table while the patient resists. The peak force is postulated to occur while the leg is lowering, thus representing the participant's eccentric muscle strength. However, it is unclear whether peak force occurs before or after the leg begins to lower. To determine intra-rater reliability and construct validity of a hip abductor eccentric strength test. Intra-rater reliability and construct validity study. Twenty healthy adults (26 ±6 years; 1.66 ±0.06 m; 62.2 ±8.0 kg) made two visits to the laboratory at least one week apart. During the hip abductor eccentric strength test, a hand-held dynamometer recorded peak force and time to peak force and limb position was recorded via a motion capture system. Intra-rater reliability was determined using intra-class correlation (ICC), standard error of measurement (SEM), and minimal detectable difference (MDD). Construct validity was assessed by determining if peak force occurred after the start of the lowering phase using a one-sample t-test. The hip abductor eccentric strength test had substantial intra-rater reliability (ICC( 3,3 ) = 0.88; 95% confidence interval: 0.65-0.95), SEM of 0.9%BWh, and a MDD of 2.5%BWh. Construct validity was established as peak force occurred 2.1s (±0.6s; range 0.7s to 3.7s) after the start of the lowering phase of the test (p ≤ 0.001). The hip abductor eccentric strength test is a valid and reliable measure of eccentric muscle strength. This test may be used clinically to assess changes in eccentric muscle strength over time.

  8. Resisted side-stepping: the effect of posture on hip abductor muscle activation

    Science.gov (United States)

    Berry, Justin W.; Lee, Theresa S.; Foley, Hanna D.; Lewis, Cara L.

    2016-01-01

    Study Design Controlled laboratory study, repeated-measures design. Objectives To compare hip abductor muscle activity and hip and knee joint kinematics in the moving limb to the stance limb during resisted side-stepping and also to determine if muscle activity was affected by the posture (upright standing versus squat) used to perform the exercise. Background Hip abductor weakness has been associated with a variety of lower extremity injuries. Resisted side-stepping is often used as an exercise to increase strength and endurance of the hip abductors. Exercise prescription would benefit from knowing the relative muscle activity level generated in each limb and for different postures during the side-stepping exercise. Methods Twenty-four healthy adults participated in this study. Kinematics and surface electromyographic (EMG) data from the gluteus maximus, gluteus medius, and tensor fascia lata (TFL) were collected as participants performed side-stepping with a resistive band around the ankle while maintaining each of 2 postures: 1) upright standing and 2) squat. Results Mean normalized EMG signal amplitude of the gluteus maximus, gluteus medius, and TFL was higher in the stance limb than the moving limb (P≤.001). Gluteal muscle activity was higher, while TFL muscle activity was lower, in the squat posture compared to the upright standing posture (P<.001). Hip abduction excursion was greater in the stance limb than in the moving limb (P<.001). Conclusions The 3 hip abductor muscles respond differently to the posture variations of side-stepping exercise in healthy individuals. When prescribing resisted side-stepping exercises, therapists should consider the differences in hip abductor activation across limbs and variations in trunk posture. PMID:26161629

  9. Resisted Side Stepping: The Effect of Posture on Hip Abductor Muscle Activation.

    Science.gov (United States)

    Berry, Justin W; Lee, Theresa S; Foley, Hanna D; Lewis, Cara L

    2015-09-01

    Controlled laboratory study, repeated-measures design. To compare hip abductor muscle activity and hip and knee joint kinematics in the moving limb to the stance limb during resisted side stepping, and to determine whether muscle activity was affected by the posture (upright standing versus squat) used to perform the exercise. Hip abductor weakness has been associated with a variety of lower extremity injuries. Resisted side stepping is often used as an exercise to increase strength and endurance of the hip abductors. Exercise prescription would benefit from knowing the relative muscle activity level generated in each limb and for different postures during the side-stepping exercise. Twenty-four healthy adults participated in this study. Kinematics and surface electromyographic data from the gluteus maximus, gluteus medius, and tensor fascia lata were collected as participants performed side stepping with a resistive band around the ankle, while maintaining each of 2 postures: (1) upright standing and (2) squat. Mean normalized electromyographic signal amplitude of the gluteus maximus, gluteus medius, and tensor fascia lata was higher in the stance limb than in the moving limb (P≤.001). Gluteal muscle activity was higher, whereas tensor fascia lata muscle activity was lower, in the squat posture compared to the upright standing posture (Pabduction excursion was greater in the stance limb than in the moving limb (P<.001). The 3 hip abductor muscles respond differently to the posture variations of the side-stepping exercise in healthy individuals. When prescribing resisted side-stepping exercises, therapists should consider the differences in hip abductor activation across limbs and variations in trunk posture.

  10. Hip-abductor fatigue and single-leg landing mechanics in women athletes.

    Science.gov (United States)

    Patrek, Mary F; Kernozek, Thomas W; Willson, John D; Wright, Glenn A; Doberstein, Scott T

    2011-01-01

    Reduced hip-abductor strength and muscle activation may be associated with altered lower extremity mechanics, which are thought to increase the risk for anterior cruciate ligament injury. However, experimental evidence supporting this relationship is limited. To examine the changes in single-leg landing mechanics and gluteus medius recruitment that occur after a hip-abductor fatigue protocol. Descriptive laboratory study. Twenty physically active women (age  =  21.0 ± 1.3 years). Participants were tested before (prefatigue) and after (postfatigue) a hip-abductor fatigue protocol consisting of repetitive side-lying hip abduction. Outcome measures included sagittal-plane and frontal-plane hip and knee kinematics at initial contact and at 60 milliseconds after initial contact during 5 single-leg landings from a height of 40 cm. Peak hip and knee sagittal-plane and frontal-plane joint moments during this time interval were also analyzed. Measures of gluteus medius activation, including latency, peak amplitude, and integrated signal, were recorded. A small (hip-abduction angle at initial contact and a small (hip at initial contact or at 60 milliseconds after initial contact. Peak external knee-adduction moment decreased 27% and peak hip adduction moment decreased 24% during the postfatigue landing condition. Gluteus medius activation was delayed after the protocol, but no difference in peak or integrated signal was seen during the landing trials. Changes observed during single-leg landings after hip-abductor fatigue were not generally considered unfavorable to the integrity of the anterior cruciate ligament. Further work may be justified to study the role of hip-abductor activation in protecting the knee during landing.

  11. Anatomy and variations of palmaris longus in fetuses.

    Science.gov (United States)

    Albay, S; Kastamoni, Yadigar; Sakalli, Büşra; Tunali, S

    2013-01-01

    The aim of this study was to assess the absence of the palmaris longus, the proportion of the lengths of tendon and muscle belly, the development of the tendon and the belly during the fetal period, look for any difference between sides and gender. Fifty-eight spontaneously aborted human fetuses (26 female, 32 male, 116 upper extremities) were studied. The presence or absence of the palmaris longus was determined. The lengths of the belly and tendon were measured, and belly/tendon length ratio was calculated. Correlation with gestational age, body side and gender were studied. The muscle was absent in 44 forearms (37.93%; 20 right side, 34.48%; 24 left side, 41.38%); being bilateral in 19 of 58 fetuses (32.76%) and unilateral in six (10.34%). The unilateral absence rate was higher on the left side with a statistically significant difference. The absence of palmaris longus was more common in females, and the difference was statistically significant. The belly/tendon length ratio was 1.04 ± 0.35 on the right side and 1.09 ± 0.3 on the left. It did not show any difference according the fetal age. A sound knowledge on the anatomy and variations of palmaris longus is of great importance during surgical interventions; because it is the first choice for tendon grafts, by the virtue of its structure and function. Thus, this study is of academic interest for anatomists and hand surgeons alike.

  12. A Fleshy Palmaris Longus Muscle | Ramesh | Anatomy Journal of ...

    African Journals Online (AJOL)

    The most commonly reported variations of the Palmaris longus muscle are in its presence and the number of bellies. We however report a new variation, in which the muscle was entirely fleshy, instead of the predominantly tendinous muscle. This rare variant can pose a challenge to a surgeon in the exploration of the carpal ...

  13. Clinical Assessment of the Palmaris Longus – Accuracy of common ...

    African Journals Online (AJOL)

    tending the orthopaedic surgical outpatient clinic. The subjects were recruited consecutively and subjected to 10 tests to detect the presence of the Palmaris Longus. The patients were examined by a resident in orthopaedics as- sisted by two students of clinical medicine (equivalent of physician assistant) who had all been ...

  14. Adequacy of palmaris longus and plantaris tendons for tendon grafting.

    Science.gov (United States)

    Jakubietz, Michael G; Jakubietz, Danni F; Gruenert, Joerg G; Zahn, Robert; Meffert, Rainer H; Jakubietz, Rafael G

    2011-04-01

    The reconstruction of tendon defects is challenging. The palmaris longus and plantaris tendon are generally considered best for tendon grafting. Only a few studies have examined whether these tendons, when present, meet criteria for successful grafting. The purpose of this study was to evaluate these tendons in regard to adequacy as tendon grafts. To evaluate adequacy for grafting, the palmaris longus and plantaris tendons were harvested from 92 arms and legs of 46 cadavers. Macroscopic evaluation and measurements concerning presence, length, and diameter of the tendons were obtained. Criteria for adequacy were a minimum length of 15 cm with diameter of 3 mm or, alternatively, 30 cm with a diameter of 1.5 mm. The palmaris longus tendon was present bilaterally in 36 cases and was absent bilaterally in 4 cases. The plantaris tendon was present bilaterally in 38 cases and absent bilaterally in 4 cases. In 29 cadavers, the palmaris longus tendon did not meet the criteria to be used as a tendon graft. Only in 8 cases were the tendons satisfactory for grafting bilaterally. The plantaris tendon met criteria for grafting in 20 cases bilaterally. In 17 cases, the tendons were considered inadequate bilaterally. Despite their presence, the palmaris longus and plantaris tendons are adequate for grafting less often than previously thought. In less than 50%, the tendons, although present, would serve as useful grafts. Our findings underscore the importance of choosing a second donor site before surgery in case the primarily selected tendon is not found to be suitable. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  15. Free Neurovascular Latissimus Dorsi Muscle Transplantation for Reconstruction of Hip Abductors

    Directory of Open Access Journals (Sweden)

    Sergi Barrera-Ochoa, MD, PhD

    2017-09-01

    Full Text Available Summary:. Resection of tumors affecting the hip abductors can cause significant decrease in muscle strength and may lead to abnormal gait and poor function. We present a case report showing full functional recovery after resection of a synovial sarcoma affecting the right gluteus medius and minimus muscles with reconstruction free neurovascular latissimus dorsi muscle transplantation. The latissimus dorsi muscle was harvested following standard technique and fixed to the ilium and the greater trochanter. Receptor vessels were end-to-end anastomosed to the subscapular vessels followed by an end-to-end epineural suture between the superior gluteal nerve and the thoracodorsal nerve. A year after surgery, there is no evidence of recurrent disease; electromyographic analysis shows complete reinnervation of the latissimus dorsi muscle flap, and the patient has achieved full functional recovery. Free functional latisimus dorsi transfer could be considered as a viable reconstruction technique after hip abductors resection in tumor surgery.

  16. "Pollical palmar interosseous muscle" (musculus adductor pollicis accessorius): attachments, innervation, variations, phylogeny, and implications for human evolution and medicine.

    Science.gov (United States)

    Bello-Hellegouarch, Gaelle; Aziz, M Ashraf; Ferrero, Eva M; Kern, Michael; Francis, Nadia; Diogo, Rui

    2013-03-01

    Most atlases and textbooks dealing with human anatomy do not refer to the "pollical palmar interosseous" (PPI) muscle of Henle. In order to undertake a fresh and detailed study of this muscle and to thus better understand human comparative anatomy and evolution, we: 1) analyze the frequency of the PPI in a large sample of human hands; 2) describe the attachments, innervation and varieties of the PPI in these hands; 3) compare the data obtained with the information available in the literature; and 4) discuss the phylogenetic origin of the PPI and the implications of our observations and comparisons for medicine and for the understanding of human evolutionary history. Within the 72 hands dissected by us, the PPI is present in 67 hands (93%), commonly having a single muscular branch, originating from the medial side of the base of metacarpal I only, inserting onto the medial side of the base of the pollical proximal phalanx and/or surrounding structures (e.g., ulnar sesamoid bone, wing tendon of extensor apparatus), and passing at least partially, and usually mainly, medial to the princeps pollicis artery. A careful study of the human PPI, as well as a detailed comparison with other mammals, strongly suggest that the muscle is evolutionarily derived from the adductor pollicis, and namely from its oblique head. Therefore, we propose that PPI should be designated by the name musculus adductor pollicis accessorius, which indicates that the muscle is most likely a de novo structure derived from the adductor pollicis. Copyright © 2012 Wiley Periodicals, Inc.

  17. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study

    OpenAIRE

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric re...

  18. Ultrasonic evaluation of the abductor hallucis muscle in hallux valgus: a cross-sectional observational study

    Directory of Open Access Journals (Sweden)

    Stewart Sarah

    2013-01-01

    Full Text Available Abstract Background The aim of the study was to investigate the abductor hallucis muscle characteristics, defined as dorso-plantar (DP thickness, medio-lateral (ML width, and cross-sectional area (CSA in relation to the severity of hallux valgus using musculoskeletal ultrasound. One hundred and two feet, mean (SD age of 60.3 (20.54 years old, displaying varying severities of hallux valgus were stratified into four groups representing the four grades of the Manchester Scale (grade 0: no deformity, grade 1: mild deformity, grade 2: moderate deformity and grade 3: severe deformity. Methods The abductor hallucis muscle was imaged in each foot using a portable ultrasound system. The mean (SD DP thickness, ML width, and CSA measurements were compared across the four Manchester Scale grades using a one-way ANOVA. Results Significant differences in DP thickness were found between feet with no hallux valgus (grade 0 and feet with hallux valgus grade 2 (p = 0.001 and 3 (p  0.0125. Conclusions We speculate that morphological changes to the abductor hallucis muscle occur early in the development of the deformity.

  19. Surgical technique: Transfer of the anterior portion of the gluteus maximus muscle for abductor deficiency of the hip.

    Science.gov (United States)

    Whiteside, Leo A

    2012-02-01

    Loss of the abductor portions of the gluteus medius and gluteus minimus muscles due to THA causes severe limp and often instability. To minimize the symptoms of limp and instability, the anterior ½ of the gluteus maximus was transferred to the greater trochanter and sutured under the vastus lateralis. A separate posterior flap was transferred under the primary flap to substitute for the gluteus minimus and capsule. To ensure tight repair, the flaps were attached and tensioned in abduction. The technique was performed in 11 patients (11 hips) with complete loss of abductor attachment; the procedure was performed in nine patients during THA and in two later as a secondary procedure. Preoperatively, all patients had abductor lurch, positive Trendelenburg sign, and no abduction of the hip against gravity. Minimum followup was 16 months (mean, 33 months; range, 16-42 months). Postoperatively, nine patients had strong abduction of the hip against gravity, no abductor lurch, and negative Trendelenburg sign. One patient had weak abduction against gravity, negative Trendelenburg sign, and slight abductor lurch. One patient failed to achieve strong abduction, had severe limp after 6 months of protection and physical therapy, and was lost to followup. Gluteus maximus transfer can restore abductor function in THA with a high success rate.

  20. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Science.gov (United States)

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Golanó, Pau; Vega, Jordi

    2015-01-01

    Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion. PMID:26060592

  1. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

    Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

  2. Extensor Pollicis Brevis tendon damage presenting as de Quervain's disease following kettlebell training.

    Science.gov (United States)

    Karthik, Karuppaiah; Carter-Esdale, Charles William; Vijayanathan, Sanjay; Kochhar, Tony

    2013-06-03

    Kettlebell exercises are more efficient for an athlete to increase his or her muscle strength. However it carries the risk of injury especially in the beginners. A 39 year old gentleman came to our clinic with radial sided wrist pain following kettlebell exercises. Clinically patient had swelling and tenderness over the tendons in the first dorsal wrist compartment, besides Finklesten test was positive. Patient had a decreased excursion of the thumb when compared to the opposite side. Ultrasound/MRI scan revealed asymmetric thickening of the 1st compartment extensors extending from the base of the thumb to the wrist joint. Besides injury to the Extensor Pollicis Brevis (EPB) tendon by repetitive impact from kettlebell, leading to its split was identified. Detailed history showed that the injury might be due to off-centre handle holding during triceps strengthening exercises. Our report stresses the fact that kettlebell users should be taught about problems of off-center handle holding to avoid wrist injuries. Also, in Kettlebell users with De Quervains disease clinical and radiological evaluation should be done before steroid injection as this might lead to complete tendon rupture.

  3. Extensor Pollicis Brevis tendon damage presenting as de Quervain’s disease following kettlebell training

    Science.gov (United States)

    2013-01-01

    Kettlebell exercises are more efficient for an athlete to increase his or her muscle strength. However it carries the risk of injury especially in the beginners. A 39 year old gentleman came to our clinic with radial sided wrist pain following kettlebell exercises. Clinically patient had swelling and tenderness over the tendons in the first dorsal wrist compartment, besides Finklesten test was positive. Patient had a decreased excursion of the thumb when compared to the opposite side. Ultrasound/MRI scan revealed asymmetric thickening of the 1st compartment extensors extending from the base of the thumb to the wrist joint. Besides injury to the Extensor Pollicis Brevis (EPB) tendon by repetitive impact from kettlebell, leading to its split was identified. Detailed history showed that the injury might be due to off-centre handle holding during triceps strengthening exercises. Our report stresses the fact that kettlebell users should be taught about problems of off-center handle holding to avoid wrist injuries. Also, in Kettlebell users with De Quervains disease clinical and radiological evaluation should be done before steroid injection as this might lead to complete tendon rupture. PMID:23731737

  4. Outcomes of gluteus maximus and tensor fascia lata transfer for primary deficiency of the abductors of the hip.

    Science.gov (United States)

    Chandrasekaran, Sivashankar; Darwish, Nader; Vemula, S Pavan; Lodhia, Parth; Suarez-Ahedo, Carlos; Domb, Benjamin G

    2017-11-21

    This study aims to present 3 patients' results after undergoing gluteus maximus and tensor fascia lata (TFL) transfer for chronic abductor tears unable to be repaired primarily. 3 patients were identified intraoperatively as having an abductor tear unable to be repaired primarily. The anterior 1/3 of the gluteus maximus and the posterior 1/3 of the TFL were mobilised and transferred to the greater trochanter in order to reproduce the normal force vector of the gluteus medius and minimus. Data was prospectively collected for changes in gait, abductor strength, and the following patient reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), visual analogue scale (VAS), and satisfaction. The patients were female, 63-75 years old, with BMIs of 23-28. All patients had follow-up at mean 2.1 years (1.25-2.5) with positive Trendelenburg signs preoperatively; 2 patients normalised postoperatively. For 2 patients, abductor strength improved by 2 grades postoperatively; the other patient maintained grade four. 2 patients' PROs all improved; the other patient's PROs all improved except mHHS. Postoperative VAS scores were 0, 0, 1. 2 patients reported maximum satisfaction. This case series suggests that gluteus maximus and TFL transfer for irreparable abductor deficiency may be effective for pain relief, improving abductor strength, and reconstructing abductor function. Although this is a small series, it is to our knowledge the first report of clinical outcomes of this procedure.

  5. The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot

    OpenAIRE

    Goo, Young-Mi; Kim, Tae-Ho; Lim, Jin-Yong

    2016-01-01

    [Purpose] The purpose of the present study is to examine the effects of abductor hallucis and gluteus maximus strengthening exercises on pronated feet. [Subjects and Methods] The present study was conducted with 18 adults without no history of surgery on the foot or ankle. One group performed both gluteus maximus strengthening exercises and abductor hallucis strengthening exercises, while the other group performed only abductor hallucis strengthening exercises five times per week for four wee...

  6. Closed traumatic rupture of the extensor hallucis longus muscle.

    Science.gov (United States)

    Tadros, Ayman M A; Al-Shaeel, Rashed A

    2013-01-01

    A 23-year-old healthy laborer involved in a work-related injury, sustained excessive left ankle plantarflexion, which resulted in closed rupture of the extensor hallucis longus muscle without any predisposing factors. He had an associated fracture of the second metatarsal shaft. The muscle proximal to the musculotendinous junction was excised, and the tendon was looped through a longitudinal slit in the main extensor digitorum communis tendon and sutured to it. The second metatarsal fracture was fixed with Kirschner wires. The patient regained full function and was symptom free 6 months after surgery. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Ultrasonographic features of an adductor longus tear: case report

    Energy Technology Data Exchange (ETDEWEB)

    Goh, Lesley-Ann Hui-huan [Tan Tock Seng Hospital (Singapore); Rethy, C.K.; Wang Shih-chang [National Univ. Hospital (Singapore); Tho Kam San [Alexandra Hospital (Singapore)

    2001-08-01

    Muscle strain of the lower extremities is among the most common injuries in sports. Excessive force, rather than direct trauma, causes disruption of the muscle-tendon unit, usually at the myotendinous junction, and improper rest and rehabilitation of a minor strain can often lead to a far more disabling injury. High-resolution ultrasonography is useful for direct imaging of muscle injuries. We present a case where ultrasonography was used to detect, treat and follow-up an adductor longus tear in a soccer player. (author)

  8. Ultrasonographic features of an adductor longus tear: case report

    International Nuclear Information System (INIS)

    Goh, Lesley-Ann Hui-huan; Rethy, C.K.; Wang Shih-chang; Tho Kam San

    2001-01-01

    Muscle strain of the lower extremities is among the most common injuries in sports. Excessive force, rather than direct trauma, causes disruption of the muscle-tendon unit, usually at the myotendinous junction, and improper rest and rehabilitation of a minor strain can often lead to a far more disabling injury. High-resolution ultrasonography is useful for direct imaging of muscle injuries. We present a case where ultrasonography was used to detect, treat and follow-up an adductor longus tear in a soccer player. (author)

  9. Tensile strength comparison between peroneus longus and hamstring tendons: A biomechanical study

    Directory of Open Access Journals (Sweden)

    Rudy

    2017-01-01

    Conclusion: The tensile strength of the peroneus longus tendon, which is similar to that of hamstring, gives information that both have the same biomechanic properties. Peroneus longus should not be used as a first option in ACL reconstruction, but may be used as an alternative donor in cases involving multiple instability that require more tendon donors in the reconstruction.

  10. Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb.

    Science.gov (United States)

    Sonoo, M

    2004-01-01

    To test a new neurological sign, the "abductor sign," which can distinguish between organic and non-organic leg paresis using synergic movements of the bilateral hip abductors. The subjects were 33 patients presenting with paresis of one leg, 17 of organic origin and 16 of non-organic origin (hysteria). To test the abductor sign, the examiner told the patient to abduct each leg, and opposed this movement with his hands placed on the lateral surfaces of the patient's legs. The leg contralateral to the abducted one showed opposite actions for organic paresis and non-organic paresis: for example, when the paretic leg was abducted, the sound leg stayed fixed in organic paresis, but moved in the hyperadducting direction in non-organic paresis. Hoover's sign was used for comparison in the same patients. The abductor sign gave the correct classification for all 33 cases. Hoover's sign was reliable if the results were carefully interpreted, but it was non-diagnostic for 16 patients because of strong hip extensors and in two because of strong hip flexors. Two patients with non-organic paresis succeeded in tricking the examiner by pretending full effort to lift the paretic leg. The abductor sign is a useful test to detect non-organic paresis, because (1) it is difficult for a hysterical patient to deceive the examiner, (2) the hip abductor is one of the most commonly involved muscles in pyramidal weakness, and (3) the results are easily visible as movement or non-movement of the unabducted leg.

  11. Influence of the abductor hallucis muscle on the medial arch of the foot: a kinematic and anatomical cadaver study.

    Science.gov (United States)

    Wong, Yue Shuen

    2007-05-01

    Most studies of degenerative flatfoot have focused on the posterior tibial muscle, an extrinsic muscle of the foot. However, there is evidence that the intrinsic muscles, in particular the abductor hallucis (ABH), are active during late stance and toe-off phases of gait. The purpose of this study was to analyze the kinematic effect of a simulated contraction of the abductor hallucis muscle on a cadaver lower limb specimen. Eight below-knee cadaver specimens were prepared. The abductor hallucis muscle was exposed and the entire muscle-tendon unit excised. A suture secured to the calcaneal origin of the muscle and tendon was passed through a pulley at the ABH sesamoid attachment. The specimen was mounted on an experimental rig in a 'standing' position. Motions in the first metatarsal, tibia, and calcaneus were tracked using the 'Flock of Birds' motion analysis system (Ascension Technology, Burlington, VT). Muscle contraction was simulated by applying tension on the suture. All eight specimens showed an origin from the posteromedial calcaneus and an insertion at the tibial sesamoid. All specimens also demonstrated a fascial sling in the hindfoot, lifting the abductor hallucis muscle to give it an inverted 'V' shaped configuration. Simulated contraction of the abductor hallucis muscle caused flexion and supination of the first metatarsal, inversion of the calcaneus, and external rotation of the tibia, consistent with elevation of the arch. The abductor hallucis muscle acts as a dynamic elevator of the arch. Understanding this mechanism may change the way we understand and treat pes planus, posterior tibial tendon dysfunction, hallux valgus, and Charcot neuroarthropathy.

  12. Hip Abductor Muscle Volume and Strength Differences Between Women With Chronic Hip Joint Pain and Asymptomatic Controls.

    Science.gov (United States)

    Mastenbrook, Matthew J; Commean, Paul K; Hillen, Travis J; Salsich, Gretchen B; Meyer, Gretchen A; Mueller, Michael J; Clohisy, John C; Harris-Hayes, Marcie

    2017-12-01

    Study Design Secondary analysis, cross-sectional study. Background Chronic hip joint pain (CHJP) can lead to limitations in activity participation, but the musculoskeletal factors associated with the condition are relatively unknown. Understanding the factors associated with CHJP may help develop rehabilitation strategies to improve quality of life of individuals with long-term hip pain. Objectives To compare measures of hip abductor muscle volume and hip abductor muscle strength between women with CHJP and asymptomatic controls. Methods Thirty women, 15 with CHJP and 15 matched asymptomatic controls (age range, 18-40 years), participated in this study. Magnetic resonance imaging was used to determine the volume of the primary hip abductor muscles, consisting of the gluteus medius, gluteus minimus, a small portion of the gluteus maximus, and the tensor fascia latae, within a defined region of interest. Break tests were performed using a handheld dynamometer to assess hip abductor strength. During the strength test, the participant was positioned in sidelying with the involved hip in 15° of abduction. Independent-samples t tests were used to compare muscle volume and strength values between those with CHJP and asymptomatic controls. Results Compared to asymptomatic controls, women with CHJP demonstrated significantly increased gluteal muscle volume (228 ± 40 cm 3 versus 199 ± 29 cm 3 , P = .032), but decreased hip abductor strength (74.6 ± 16.8 Nm versus 93.6 ± 20.2 Nm, P = .009). There were no significant differences in tensor fascia lata muscle volume between the 2 groups (P = .640). Conclusion Women with CHJP appear to have larger gluteal muscle volume, but decreased hip abductor strength, compared to asymptomatic controls. J Orthop Sports Phys Ther 2017;47(12):923-930. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7380.

  13. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study.

    Science.gov (United States)

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric repetitions on the Cybex Normö dynamometer; the average torque was determined for both pre- and post-intervention measurements. These data were analyzed using the independent samples t-test with the significance level set at Phip abductor torque in the experimental group (P=0.03). The experimental group demonstrated a 17.35% increase in average torque whereas the control group demonstrated a 3.68% decrease in average torque. These findings are consistent with other studies demonstrating that the use of grade IV non-thrust mobilization improves strength immediately post-intervention in healthy individuals. The results of this pilot study provide physical therapists with further support for the utilization of manual therapy in conjunction with therapeutic exercise to enhance muscle strength.

  14. Surgical Anatomy of the Radial Nerve at the Elbow and in the Forearm: Anatomical Basis for Intraplexus Nerve Transfer to Reconstruct Thumb and Finger Extension in C7 - T1 Brachial Plexus Palsy.

    Science.gov (United States)

    Zhang, Lei; Dong, Zhen; Zhang, Chun-Lin; Gu, Yu-Dong

    2016-11-01

    Background  C7 - T1 palsy results in complete loss of finger motion and poses a surgical challenge. This study investigated the anatomy of the radial nerve in the elbow and forearm and the feasibility of intraplexus nerve transfer to restore thumb and finger extension. Methods  The radial nerves were dissected in 28 formalin-fixed upper extremities. Branching pattern, length, diameter, and number of myelinated fibers were recorded. Results  Commonly, the branching pattern (from proximal to distal) was to the brachioradialis, extensor carpi radialis longus, superficial sensory proximal to the lateral epicondyle, extensor carpi radialis brevis, supinator, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis distal to the lateral epicondyle. Conclusions  Branches to the brachioradialis, extensor carpi radialis longus, and supinator can be transferred to the posterior interosseous nerve to restore hand movement in patients with C7 - T1 brachial plexus palsies; the supinator branch is probably the best choice in this regard. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function

    Directory of Open Access Journals (Sweden)

    Gabriel Peixoto Leão Almeida

    2016-04-01

    Full Text Available OBJECTIVE: To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS. METHODS: This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. RESULTS: The q-angle did not present any significant correlation with severity of knee pain (r = -0.29; p = 0.19, functional capacity (r = -0.08; p = 0.72, FPPA (r = -0.28; p = 0.19 or isometric peak torque of the abductor muscles (r = -0.21; p = 0.35. CONCLUSION: The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS.

  16. Palmaris Longus Muscle in the South Indian Population – A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Lydia S. Quadros

    2017-07-01

    Full Text Available Introduction: Palmaris longus, one of the superficial flexor muscles of the anterior compartment of the forearm is the most variable muscle of the upper limb. Purpose: To note the variations of palmaris longus for tendon grafts. Methods: Forty formalin-fixed upper limb specimens of South Indian population were dissected to note the variations of Palmaris longus muscle. Results: Out of the forty upper limb specimens, two variants of the palmaris longus were noted. In one specimen, a reversed palmaris longus was noted. It had a long tendinous origin with a muscle belly and a short flat tendon at insertion. The tendon inserted partly into the flexor retinaculum and partly into palmar aponeurosis. In another specimen, apart from the normal palmaris longus muscle, an additional smaller muscle was noted. It was the Palmaris profundus. This muscle took origin in the form of a tendon from the middle of the shaft of the radius, continued as a muscle belly and then terminated as a tendon which later inserted into the flexor retinaculum, close to the tendon of palmaris longus muscle. At its insertion, the superficial palmar branch of radial artery hooked it. The anterior interosseous nerve supplied the Palmaris profundus. Conclusion: These variations are worthy to be noted for tendon grafts.

  17. Increase in twitch force of the adductor pollicis muscle with stabilized preload at constant thumb abduction before and after administration of muscle relaxant

    NARCIS (Netherlands)

    van Santen, G; Wierda, JMKH; Fidler, [No Value

    Objective. To determine whether the twitch force of the adductor pollicis remains stable when 0.1 Hz single twitch stimulation is started after stabilization of the thumb preload at a constant degree of thumb abduction; also to study any possible increase in twitch force before the onset of and

  18. Discharge properties of motor units of the abductor hallucis muscle during cramp contractions.

    Science.gov (United States)

    Minetto, Marco A; Holobar, Ales; Botter, Alberto; Farina, Dario

    2009-09-01

    We analyzed individual motor units during electrically elicited cramp contractions with the aim of characterizing the variability and degree of common oscillations in their discharges. Intramuscular and surface electromyographic (EMG) signals were detected from the abductor hallucis muscle of 11 healthy subjects (age 27.0+/-3.7 yr) during electrically elicited cramps. In all, 48 motor units were identified from the intramuscular EMG. These motor units were active for 23.6+/-16.2 s, during which their average discharge rate was 14.5+/-5.1 pulses/s (pps) and their minimum and maximum rates were, respectively, 6.0+/-0.8 and 25.0+/-8.0 pps (Pcramps showed a range of discharge rates similar to that observed during voluntary contractions but larger ISI variability, probably due to large synaptic noise. Moreover, the discharge rates of the active motor units showed common oscillations.

  19. Reliability of concentric and eccentric strength of hip abductor and adductor muscles in young soccer players

    Directory of Open Access Journals (Sweden)

    V Gerodimos

    2016-01-01

    Full Text Available The concentric and eccentric strength profile and muscular balance of the hip joint are important parameters for success in soccer. This study evaluated the reliability for the assessment of hip abduction and adduction isokinetic strength over a range of angular velocities (30 and 90°/s and types of muscular actions (concentric and eccentric in young soccer players. The reliability for the assessment of reciprocal (conventional and functional and bilateral torque ratios was also examined. Fifteen male soccer players (15±1 years performed two sessions, separated by three days. The testing protocol consisted of five maximal concentric and eccentric hip abductions and adductions of both legs at angular velocities of 30°/s and 90°/s. The peak torque was evaluated in young soccer players using an isokinetic dynamometer (Cybex Norm, and the reciprocal strength ratios (conventional and functional and bilateral ratios (non-preferred to preferred leg ratios were calculated. The test-retest reliability for the assessment of peak torque (lCC=0.71-0.92 and of reciprocal muscle group ratios (lCC=0.44-0.87 was found to be moderate to high. Bilateral torque ratios exhibited low to moderate reliability (|CC=0.11-0.64. In conclusion, isokinetic strength of hip abductor and adductor muscles and the conventional and functional strength ratios can be reliably assessed in young soccer players, especially at low angular velocities. The assessment, however, of bilateral strength ratios for hip abductor/adductor muscles should be interpreted with more caution.

  20. Surgical technique: Gluteus maximus and tensor fascia lata transfer for primary deficiency of the abductors of the hip.

    Science.gov (United States)

    Whiteside, Leo A

    2014-02-01

    Avulsion of the abductor muscles of the hip may cause severe limp and pain. Limited literature is available on treatment approaches for this problem, and each has shortcomings. This study describes a muscle transfer technique to treat complete irreparable avulsion of the hip abductor muscles and tendons. Ten adult cadaver specimens were dissected to determine nerve and blood supply point of entry in the gluteus maximus and tensor fascia lata (TFL) and evaluate the feasibility and safety of transferring these muscles to substitute for the gluteus medius and minimus. In this technique, the anterior portion of the gluteus maximus and the entire TFL are mobilized and transferred to the greater trochanter such that the muscle fiber direction of the transferred muscles closely matches that of the gluteus medius and minimus. Five patients (five hips) were treated for primary irreparable disruption of the hip abductor muscles using this technique between January 2008 and April 2011. All patients had severe or moderate pain, severe abductor limp, and positive Trendelenburg sign. Patients were evaluated for pain and function at a mean of 28 months (range, 18-60 months) after surgery. All patients could actively abduct 3 months postoperatively. At 1 year postoperatively, three patients had no hip pain, two had mild pain that did not limit their activity, three had no limp, and one had mild limp. One patient fell, fractured his greater trochanter, and has persistent limp and abduction weakness. The anterior portion of the gluteus maximus and the TFL can be transferred to the greater trochanter to substitute for abductor deficiency. In this small series, the surgical procedure was reproducible and effective; further studies with more patients and longer followup are needed to confirm this.

  1. Progressive retraction of a fractured os peroneum suggesting repetitive injury to the peroneus longus tendon.

    Science.gov (United States)

    Favinger, Jennifer L; Richardson, Michael L; Chew, Felix S

    2018-02-01

    The os peroneum is an accessory ossicle within the peroneus longus tendon. Prior reports have discussed fracture of the os peroneum with associated tears of the peroneus longus tendon. When the ossicle fractures, there can be varying degrees of retraction of the tendon, which can be diagnosed by malposition of the ossicle or the ossicle fragments. We report a case of a man with recurrent eversion ankle injuries with progressive retraction of a fractured os peroneum, implying injuries to the superior and inferior peroneal retinacula and the peroneus longus tendon.

  2. Extensor digitorum longus tenosynovitis caused by talar head impingement in an ultramarathon runner: a case report.

    Science.gov (United States)

    Kobayashi, H; Sakurai, M; Kobayashi, T

    2007-08-01

    Stenosing tenosynovitis of the extensor digitorum longus tendon is an injury related to ultramarathon running. A 32-year-old male ultramarathon runner developed chronic tenosynovitis of the ankle dorsiflexors. He was diagnosed with extensor digitorum longus tenosynovitis caused by talar head impingement associated with exostosis. He failed to respond to non-operative management and decided to undergo tenosynovectomy of the extensor digitorum longus tendon. The pain was relieved without functional disturbance of the foot and ankle, and the patient returned to running 3 weeks postoperatively. At the 2-year follow-up, he was participating fully in ultramarathons.

  3. Os trigonum syndrome with flexor hallucis longus tenosynovitis in a professional football referee.

    Science.gov (United States)

    Cooper, M E; Wolin, P M

    1999-07-01

    The presentation of posterior ankle pain in any patient poses a diagnostic dilemma. The os trigonum syndrome and flexor hallucis longus stenosing tenosynovitis have been reported to occur in professional and amateur ballet dancers. It is important to consider these diagnoses in a patient who is not a dancer, as is shown in the case presented here. The patient in this case is a professional referee who injured his ankle while working on artificial turf. The treatment for os trigonum syndrome and flexor hallucis longus tenosynovitis is initially conservative, but in refractory cases, surgical removal of the os and release of the flexor hallucis longus tendon can be successfully performed. This is the first reported case of os trigonum syndrome and flexor hallucis longus tenosynovitis presenting simultaneously in a patient who is not a dancer.

  4. A variant extensor indicis muscle and the branching pattern of the deep radial nerve could explain hand functionality and clinical symptoms in the living patient

    Science.gov (United States)

    Kumka, Myroslava

    2015-01-01

    The purpose of this study is to document the topographic anatomy of an extensor indicis (EI) muscle with a double tendon and the associated distribution of the deep branch of the radial nerve (DBRN). Both EI tendons were positioned deep to the tendons of the extensor digitorum as they traversed the dorsal osseofibrous tunnel. They then joined the medial slips of the extensor expansion of the second and third digits. In all other dissected forearms, a tendon of the EI muscle joined the medial slip of the extensor expansion to the index finger. The DBRN provided short branches to the superficial extensor muscles, long branches to the abductor pollicis longus and extensor pollicis brevis muscles, and terminated as the posterior interosseous nerve. Descending deep to the extensor pollicis longus muscle, the posterior interosseous nerve sent branches to the extensor pollicis brevis and EI muscles. Understanding of the topographic anatomy of an EI with a double tendon, and the associated distribution of the DBRN, may contribute to accurate diagnosis and treatment of hand lesions. PMID:25729087

  5. The Prevalence of Palmaris longus agenesis among the Ghanaian population

    Directory of Open Access Journals (Sweden)

    Osonuga A

    2012-10-01

    Full Text Available Objective: Background: Studies have documented the agenesis of Palmaris longus muscle in different populations but none has included the Ghanaian population. Methods: The study involved 226 subjects (130 females and 96 males who are students of the University of Cape Coast, Cape Coast, Ghana. The presence of the PLM was clinically determined using the Schaeffer’s test. Subjects in which the tendon was not visualized or palpable, two other tests were performed to confirm the absence. Results: The total prevalence of absence of PLM was 3.1%; absence on the left hand was commoner than on the right hand. The frequency of PLM absence was also slightly higher in females than in males representing 1.8% and 1.3% respectively. One female had the PLM absent bilaterally whiles a male subject had a trifid tendon on the right forearm with a bifid on the left. Conclusion: The prevalence of PLM agenesis in the Ghanaian population is lower compared to values coated in standard textbook on surgery. PLM is not diminishing as fast as observed in some population hence it is can be readily used as donor tendon by Ghanaian surgeons.

  6. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot

    OpenAIRE

    Chundru, Usha; Liebeskind, Amy; Seidelmann, Frank; Fogel, Joshua; Franklin, Peter; Beltran, Javier

    2008-01-01

    Objective To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter?s neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Materials and methods Prevalence of calcaneal spur formation, plantar fasciitis, calca...

  7. Effects of hip abductor muscle fatigue on gait control and hip position sense in healthy older adults.

    Science.gov (United States)

    Arvin, Mina; Hoozemans, Marco J M; Burger, Bart J; Rispens, Sietse M; Verschueren, Sabine M P; van Dieën, Jaap H; Pijnappels, Mirjam

    2015-10-01

    We experimentally investigated whether unilateral hip abductor muscle fatigue affected gait control and hip position sense in older adults. Hip abductor muscles were fatigued unilaterally in side-lying position in 17 healthy older adults (mean age 73.2 SD 7.7 years). Hip joint position sense was assessed by an active-active repositioning test while standing and was expressed as absolute and relative errors. Participants walked on a treadmill at their preferred walking speed, while 3D linear accelerations were collected by an inertial sensor at the lower back. Gait parameters, including step and stride time, local divergence exponents and harmonic ratio were quantified. In fatigued gait, stride time variability and step-to-step asymmetry in the frontal plane were significantly increased. Also a significantly slower mediolateral trunk movement in fatigued leg late stance toward the non-fatigued leg was observed. Despite these temporal and symmetry changes, gait stability in terms of the local divergence exponents was not affected by fatigue. Hip position sense was also affected by fatigue, as indicated by an increased relative error of 0.7° (SD 0.08) toward abduction. In conclusion, negative effects of fatigue on gait variability, step-to-step symmetry, mediolateral trunk velocity control and hip position sense indicate the importance of hip abductor muscles for gait control. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot.

    Science.gov (United States)

    Goo, Young-Mi; Kim, Tae-Ho; Lim, Jin-Yong

    2016-03-01

    [Purpose] The purpose of the present study is to examine the effects of abductor hallucis and gluteus maximus strengthening exercises on pronated feet. [Subjects and Methods] The present study was conducted with 18 adults without no history of surgery on the foot or ankle. One group performed both gluteus maximus strengthening exercises and abductor hallucis strengthening exercises, while the other group performed only abductor hallucis strengthening exercises five times per week for four weeks. [Results] The group that performed both gluteus maximus and abductor hallucis strengthening exercises showed smaller values in the height of navicular drop than the group that performed only abductor hallucis strengthening exercises. The muscle activity of the gluteus maximus and the vastus medialis increased during heel-strike in the group that added gluteus maximus exercises, and the muscle activity of the abductor hallucis significantly increased in both groups. [Conclusion] Given the results of the present study, it can be suggested that strengthening the gluteus maximus while also performing exercises to correct the pronated foot is an effective method for achieving normal gait.

  9. Tenosynovial (Extra-articular) Chondromatosis of the Extensor Digitorum Longus Tendon and Synovial Chondromatosis of the Ankle: Treated by Extensor Digitorum Longus Tendoscopy and Ankle Arthroscopy.

    Science.gov (United States)

    Lui, Tun Hing

    2015-10-01

    Synovial chondromatosis is a rare pathology in the foot and ankle region. We present a case of concomitant tenosynovial chondromatosis of the extensor digitorum longus tendon and synovial chondromatosis of the ankle, which was successfully treated by extensor digitorum tendon tendoscopy and ankle arthroscopy. Therapeutic, Level IV: Case study. © 2014 The Author(s).

  10. Clinical recovery of two hip adductor longus ruptures: a case-report of a soccer player.

    Science.gov (United States)

    Thorborg, Kristian; Petersen, Jesper; Nielsen, Michael Bachmann; Hölmich, Per

    2013-05-22

    Non-operative treatment of acute hip adductor longus ruptures in athletes has been described in the literature. However, very limited information concerning the recovery of this type of injury exists. This case represented a unique possibility to study the recovery of two acute adductor longus ruptures, using novel, reliable and validated assessment methods. A 22-year old male soccer player (Caucasian) sustained two subsequent acute adductor longus ruptures, one in each leg. The injuries occurred 10 months apart, and were treated non-surgically in both situations. He was evaluated using hip-strength assessments, self-report and ultrasonography until complete muscle-strength recovery of the hip adductors had occurred. The player was able to participate in a full soccer training session without experiencing pain 15 weeks after the first rupture, and 12 weeks after the second rupture. Full hip adductor muscle-strength recovery was obtained 52 weeks after the first rupture and 10 weeks after the second rupture. The adductor longus injuries, as verified by initial ultrasonography (10 days post-injury), showed evidence of a complete tendon rupture in both cases, with an almost identical imaging appearance. It was only at 6 and 10 weeks ultrasonographic follow-up that the first rupture was found to include a larger anatomical area than the second rupture. From this case we can conclude that two apparently similar hip adductor longus ruptures, verified by initial ultrasonography (10 days post-injury), can have very different hip adductor strength recovery times. Assessment of adductor strength recovery may therefore in the future be a useful and important additional measure for determining when soccer players with hip adductor longus ruptures can return safely to play.

  11. Foot varus in stroke patients: muscular activity of extensor digitorum longus during the swing phase of gait.

    Science.gov (United States)

    Reynard, F; Dériaz, O; Bergeau, J

    2009-06-01

    Hemiparetic patients often present an abnormal leg muscles balance that can lead to foot deformities like equinovarus or varus. To assess whether a muscle imbalance between tibialis anterior and extensor digitorum longus was associated with a varus deformity of the foot during the swing phase of gait in stroke patients. Twenty hemiparetic patients presenting a foot varus during the swing phase of gait were compared to 16 healthy subjects. Gait was analyzed by video recording and by surface electromyography. Duration and magnitude of electromyographic signal were collected for tibialis anterior and extensor digitorum longus. Presence of an activity of the calf muscles during the swing phase was also evaluated. Hemiparetic patients exhibited more often premature activity of the calf muscles (pextensor digitorum longus (pextensor digitorum longus activity (pextensor digitorum longus muscle during the swing phase of gait is important to balance the foot in the frontal plane. The activation of that muscle should be included in rehabilitation programs.

  12. Reattachment of the migrated ununited greater trochanter after revision hip arthroplasty: the abductor slide technique. A review of four cases.

    Science.gov (United States)

    Chin, K R; Brick, G W

    2000-03-01

    Proximal migration of the ununited greater trochanter following total hip arthroplasty may produce pain and substantial functional disability. Successful reattachment of the migrated fragment is difficult following multiple hip procedures. The purpose of this report is to describe four patients in whom a severely migrated trochanteric fragment was reattached successfully with a modified Charnley-Harris wiring technique after subperiosteal advancement of the abductor muscles from their origin on the iliac wing. This series consisted of one man and three women with an average age of sixty years (range, fifty-one to sixty-eight years) at the time of the index procedure. The patients were followed for an average of eighty-one months (range, fifty-five to ninety-six months). All patients had undergone mobilization of the abductor muscles based on the superior gluteal neurovascular pedicle to aid with trochanteric reattachment, and all had undergone prior hip operations (average, two). Advancement of the abductor muscles was achieved through a separate transverse curvilinear incision over the iliac crest, and subperiosteal releases of the entire origins of the gluteus minimus, medius, and maximus muscles from the ilium were performed. Roentgenographic union of the trochanteric fragment occurred in all four patients. There were three excellent functional outcomes (Harris hip scores of 90, 94, and 96 points) and one fair functional outcome (76 points). The average improvement in the Harris hip score was 47.5 points (range, 35 to 58 points). Two patients continued to have a mild or moderate Trendelenburg gait postoperatively. Two patients had heterotopic bone formation of no clinical importance. Use of this technique resulted in union of the greater trochanter, pain relief, and decreased functional disability without major complications in these four patients. More widespread use of this technique may be indicated for the treatment of symptomatic non-union of the greater

  13. ABERRANT ABDUCTOR DIGITI MINIMI MUSCLE FOUND DURING OPEN SURGICAL DECOMPRESSION OF THE CARPAL TUNNEL: CASE REPORT. Músculo abductor digiti minimi aberrante hallado durante una cirugía abierta descompresiva del tunel carpiano: reporte de caso

    Directory of Open Access Journals (Sweden)

    Svetoslav A Slavchev

    2016-03-01

    Full Text Available En este artículo reportamos un caso interesante de músculo hipotenar aberrante encontrado durante una descompresión del túnel carpiano. La variante muscular surgía de la fascia antebraquial voloradial, y pasaba sobre la arteria y el nervio ulnar en el canal de Guyón, y se insertaba en la cara ulnar hipotenar. La tensión en el vientre muscular produjo ligera abducción de la quinta articulación metacarpofa-lángica, lo que confirmó que el músculo era abductor digiti minimi aberrante. Observamos asimismo las diferentes variaciones de este músculo y ponemos énfasis en su potencial implicancia clínica. Herein, we present an interesting case of an aberrant hypothenar muscle found during carpal tunnel decompression. The variant muscle arised from the voloradial antebrachial fascia and coursed over the ulnar artery and nerve in the Guyon canal, and inserted into the ulnar aspect of the hypothenar. Tension on the muscle belly provided slight abduction of the fifth metacarpophalangeal joint, which confirmed it to be an aberrant abductor digiti minimi muscle. We also discuss different variations of this muscle and emphasize its potential clinical implications.

  14. Age-related changes of elements in the tendons of the peroneus longus muscles in Thai, Japanese, and monkeys.

    Science.gov (United States)

    Tohno, Yoshiyuki; Suwanahoy, Patipath; Tohno, Setsuko; Sinthubua, Apicha; Azuma, Cho; Nishiwaki, Fumio; Moriwake, Yumi; Kumai, Tsukasa; Minami, Takeshi; Laowatthanaphong, Sikrai; Mahakkanukrauh, Pasuk; Oishi, Takao; Hayashi, Motoharu

    2010-03-01

    To elucidate compositional changes of the tendon of the peroneus longus muscle with aging, the authors investigated age-related changes of elements in the insertion of tendons of the peroneus longus muscle (peroneus longus tendons) in Thai, Japanese, and monkeys and the relationships among element contents by direct chemical analysis. After ordinary dissections at Chiang Mai University and Nara Medical University were finished, the peroneus longus tendons were resected from the subjects. The peroneus longus tendons were also resected from rhesus and Japanese monkeys bred in Primate Research Institute, Kyoto University. The wraparound regions of the insertion tendons of the peroneus longus muscle in contact with the cuboid bone were used as the peroneus longus tendon. After ashing with nitric acid and perchloric acid, element contents were determined with an inductively coupled plasma-atomic emission spectrometer. It was found that there were no significant correlations between age and the seven elements, such as Ca, P, S, Mg, Zn, Fe, and Na, in the peroneus longus tendons of Thai and Japanese. The Ca content higher than 10 mg/g was contained in seven cases out of 34 peroneus longus tendons of Thai (incidence = 20.6%) and in one case out of 22 peroneus longus tendons of Japanese (incidence = 4.5%), respectively. All of the peroneus longus tendons with the Ca content higher than 10 mg/g were found in Thai and Japanese men. In the peroneus longus tendons of monkeys, the Ca and P content increased suddenly at 2 years of age and reached to about 40 mg/g at 5 years of age. Thereafter, the Ca and P content did not increase in the peroneus longus tendons of monkeys at old age. Regarding the relationships among element contents, significant direct correlations were found among the contents of Ca, P, Mg, Zn, and Na in Thai and monkeys, whereas significant inverse correlations were found between S and element contents, such as Ca, P, Mg, Zn, and Na, in Thai and monkeys.

  15. Morphometric and Statistical Analysis of the Palmaris Longus Muscle in Human and Non-Human Primates

    Directory of Open Access Journals (Sweden)

    Roqueline A. G. M. F. Aversi-Ferreira

    2014-01-01

    Full Text Available The palmaris longus is considered a phylogenetic degenerate metacarpophalangeal joint flexor muscle in humans, a small vestigial forearm muscle; it is the most variable muscle in humans, showing variation in position, duplication, slips and could be reverted. It is frequently studied in papers about human anatomical variations in cadavers and in vivo, its variation has importance in medical clinic, surgery, radiological analysis, in studies about high-performance athletes, in genetics and anthropologic studies. Most studies about palmaris longus in humans are associated to frequency or case studies, but comparative anatomy in primates and comparative morphometry were not found in scientific literature. Comparative anatomy associated to morphometry of palmaris longus could explain the degeneration observed in this muscle in two of three of the great apes. Hypothetically, the comparison of the relative length of tendons and belly could indicate the pathway of the degeneration of this muscle, that is, the degeneration could be associated to increased tendon length and decreased belly from more primitive primates to those most derivate, that is, great apes to modern humans. In conclusion, in primates, the tendon of the palmaris longus increase from Lemuriformes to modern humans, that is, from arboreal to terrestrial primates and the muscle became weaker and tending to be missing.

  16. Morphometric and Statistical Analysis of the Palmaris Longus Muscle in Human and Non-Human Primates

    Science.gov (United States)

    Aversi-Ferreira, Roqueline A. G. M. F.; Bretas, Rafael Vieira; Maior, Rafael Souto; Davaasuren, Munkhzul; Paraguassú-Chaves, Carlos Alberto; Nishijo, Hisao; Aversi-Ferreira, Tales Alexandre

    2014-01-01

    The palmaris longus is considered a phylogenetic degenerate metacarpophalangeal joint flexor muscle in humans, a small vestigial forearm muscle; it is the most variable muscle in humans, showing variation in position, duplication, slips and could be reverted. It is frequently studied in papers about human anatomical variations in cadavers and in vivo, its variation has importance in medical clinic, surgery, radiological analysis, in studies about high-performance athletes, in genetics and anthropologic studies. Most studies about palmaris longus in humans are associated to frequency or case studies, but comparative anatomy in primates and comparative morphometry were not found in scientific literature. Comparative anatomy associated to morphometry of palmaris longus could explain the degeneration observed in this muscle in two of three of the great apes. Hypothetically, the comparison of the relative length of tendons and belly could indicate the pathway of the degeneration of this muscle, that is, the degeneration could be associated to increased tendon length and decreased belly from more primitive primates to those most derivate, that is, great apes to modern humans. In conclusion, in primates, the tendon of the palmaris longus increase from Lemuriformes to modern humans, that is, from arboreal to terrestrial primates and the muscle became weaker and tending to be missing. PMID:24860810

  17. Interval training by normobaric hypoxia accelerates the reinnervation of musculus extensor digitorum longus in mice

    DEFF Research Database (Denmark)

    Vardya, Irina; (Vard'ya); Mospanova, Svetlana V.

    2000-01-01

    Dokl Biol Sci. 2000 Mar-Apr;371:112-4. Interval training by normobaric hypoxia accelerates the reinnervation of musculus extensor digitorum longus in mice. Vard'ya IV , Mospanova SV , Portnov VV , Balezina OP , Koshelev VB . Department of Human and Animal Physiology, Faculty of Biology, Moscow...

  18. Magnetic resonance imaging of hereditary hernias of the peroneus longus muscle

    Energy Technology Data Exchange (ETDEWEB)

    Braunstein, J.T. [Department of Imaging, Cedars-Sinai Center, UCLA School of Medicine, Los Angeles CA (United States); Crues, J.V. III [Department of Imaging, Cedars-Sinai Center, UCLA School of Medicine, Los Angeles CA (United States)

    1995-11-01

    In this report, we describe three patients in a single family who exhibited muscle hernias of the peroneus longus associated with fascial defects arising from the area where vessels and nerves penetrate the fascia, and show the MR findings which established the diagnosis and allowed us to formulate a pathophysiologic explanation for the lesions found in these individuals. (orig./MG)

  19. Anatomical variations of the deep head of Cruveilhier of the flexor pollicis brevis and its significance for the evolution of the precision grip.

    Science.gov (United States)

    Dunlap, Samuel S; Aziz, M Ashraf; Ziermann, Janine M

    2017-01-01

    Cruveilhier described in 1834 the human flexor pollicis brevis (FPB), a muscle of the thenar compartment, as having a superficial and a deep head, respectively, inserted onto the radial and ulnar sesamoids of the thumb. Since then, Cruveilhier's deep head has been controversially discussed. Often this deep head is confused with Henle's "interosseous palmaris volaris" or said to be a slip of the oblique adductor pollicis. In the 1960s, Day and Napier described anatomical variations of the insertions of Cruveilhier's deep head, including its absence, and hypothesized, that the shift of the deep head's insertion from ulnar to radial facilitated "true opposability" in anthropoids. Their general thesis for muscular arrangements underlying the power and precision grip is sound, but they did not delineate their deep head from Henle's muscle or the adductor pollicis, and their description of the attachments of Cruveilhier's deep head were too vague and not supported by a significant portion of the anatomical literature. Here, we reinvestigated Cruveilhier's deep head to resolve the controversy about it and because many newer anatomy textbooks do not describe this muscle, while it is often an obvious functionally (writing, texting, precision grip) and clinically significant thenar muscle. For the first time, we empirically delineated Cruveilhier's deep head from neighboring muscles with which it was previously confused. We observed 100% occurrence of the uncontested deep head in 80 human hands, displaying a similar variability of insertions as Day and Napier, but in significantly different numbers. Furthermore, we found variability in the origin and included as important landmarks the trapezoid and the ligamentum carpi radiatum. We tested the assertion regarding the evolutionary morphology and its role in the improvements in thumb movements during various precision grips. Our overall conclusions differ with respect to the developmental and evolutionary origin of the FPB

  20. Acute neck pain in the ED: Consider longus colli calcific tendinitis vs meningitis.

    Science.gov (United States)

    Patel, Tyag K; Weis, James C

    2017-06-01

    Presented here is a rare cause of severe neck pain - acute longus colli calcific tendinitis - in a 54year old man who presented to the emergency department. The neck pain is due to inflammation caused by calcium hydroxyapatite crystal deposition in the tendons on the longus colli muscles. This is non-infectious. The gold standard for diagnosis is a CT neck which best shows the calcifications in the anterior vertebral column of C1-C4, where the tendons of these muscles insert bilaterally. Longus colli calcific tendinitis is not life-threatening and patients will make a full recovery after treatment with NSAIDs. However, this condition is often confused with life-threatening conditions such as infection (meningitis or retropharyngeal abscess), intracranial hemorrhage, trauma, herniation of cervical discs, or malignancy (Estimable et al. (2015) [1]). Symptoms associated with calcific tendinitis of the longus colli muscle are non-specific and include mild fever, moderate-severe headache, neck pain, and drastically reduced range of motion of the neck. More specific symptoms are the presence of dysphagia and odynophagia. Lab findings usually are significant for mild leukocytosis, and elevated ESR and CRP. Awareness of this condition by E.D. physicians can avoid unnecessary invasive interventions, increased costs, and delays that result from incorrect diagnosis and treatment. This is a unique case in which a patient who was afebrile with a normal ESR was worked up for meningitis and an intracranial process, and also empirically treated for meningitis before finally being diagnosed with acute calcific tendinitis of the longus colli muscle in the E.D. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Characteristic MRI Findings of upper Limb Muscle Involvement in Myotonic Dystrophy Type 1.

    Directory of Open Access Journals (Sweden)

    Kazuma Sugie

    Full Text Available The objective of our study was to evaluate the relation between muscle MRI findings and upper limb weakness with grip myotonia in patients with myotonic dystrophy type 1 (DM1. Seventeen patients with DM1 were evaluated by manual muscle strength testing and muscle MRI of the upper limbs. Many DM1 patients presenting with decreased grasping power frequently showed high intensity signals in the flexor digitorum profundus (FDP muscles on T1-weighted imaging. Patients presenting with upper limb weakness frequently also showed high intensity signals in the flexor pollicis longus, abductor pollicis longus, and extensor pollicis muscles. Disturbances of the distal muscles of the upper limbs were predominant in all DM1 patients. Some DM1 patients with a prolonged disease duration showed involvement of not only distal muscles but also proximal muscles in the upper limbs. Muscle involvement of the upper limbs on MRI strongly correlated positively with the disease duration or the numbers of CTG repeats. To our knowledge, this is the first study to provide a detailed description of the distribution and severity of affected muscles of the upper limbs on MRI in patients with DM1. We conclude that muscle MRI findings are very useful for identifying affected muscles and predicting the risk of muscle weakness in the upper limbs of DM1 patients.

  2. Role of muscles in the stabilization of ligament-deficient wrists.

    Science.gov (United States)

    Esplugas, Mireia; Garcia-Elias, Marc; Lluch, Alex; Llusá Pérez, Manuel

    2016-01-01

    This article reviews the results of a series of cadaver investigations aimed at clarifying the role of muscles in the stabilization of ligament-deficient wrists. According to these studies, isometric contraction of some forearm muscles induces midcarpal (MC) supination (ie, the abductor pollicis longus, extensor carpi radialis longus, and flexor carpi ulnaris), whereas other muscles induce MC pronation (ie, the extensor carpi ulnaris). Because MC supination implies tightening of the volar scaphoid-distal row ligaments, the MC supination muscles are likely to prevent scaphoid collapse of wrists with scapholunate ligament insufficiency. MC pronator muscles, by contrast, would be beneficial in stabilizing wrists with ulnar-sided ligament deficiencies owing to their ability to tighten the triquetrum-distal row ligaments. Should these laboratory findings be validated by additional clinical research, proprioceptive reeducation of selected muscles could become an important tool for the treatment of dynamic carpal instabilities. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  3. Association between hip abductor function, rear-foot dynamic alignment, and dynamic knee valgus during single-leg squats and drop landings

    Directory of Open Access Journals (Sweden)

    Yoshinori Kagaya

    2015-06-01

    Conclusion: Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.

  4. Hip resurfacing using a modified lateral approach with limited splitting of the gluteus medius muscle results in significant impairment of hip abductor strength.

    Science.gov (United States)

    Moussazadeh, A J; Kohlhof, H; Wirtz, D C; Wimmer, M D; Randau, T M; Wölk, T; Gravius, S

    2013-01-01

    A lateral, transgluteal approach for hip resurfacing carries the risk of approach-related weakening of the hip abductors due to unsuccessful re-adaptation of the gluteal muscles to the greater trochanter or to injury to the inferior nerve branch of the superior gluteal nerve. We investigated whether hip resurfacing using a soft tissue-sparing, modified transgluteal approach with limited cranial splitting of the gluteus medius muscle reduces hip abductor strength and the risk of approach-related injury to the superior gluteal nerve. Thirty-one patients (14 female, 17 male; mean age 53.5 ± 5.2 years) underwent hip resurfacing using a modified transgluteal approach with limited cranial splitting of the gluteus medius muscle. Nerve conduction signals were measured by surface electromyography (EMG), hip abductor strength by isokinetic testing a mean 36.2 months (± 11 mos) after surgery. The unoperated side was used as control. Surface EMG disclosed no neural lesions of the inferior branch of the superior gluteal nerve. Isokinetics revealed a significant reduction in muscle strength on the operated versus the contralateral side. Even a limited incision of the gluteus medius muscle resulted in significant impairment of hip abductor strength 2.5 years after surgery.

  5. Intra- and Inter-Rater Reliability of the Rate of Force Development of Hip Abductor Muscles Measured by Hand-Held Dynamometer

    Science.gov (United States)

    Takeda, Kazuya; Tanabe, Shigeo; Koyama, Soichiro; Nagai, Tomoko; Sakurai, Hiroaki; Kanada, Yoshikiyo; Shomoto, Koji

    2018-01-01

    The aim of this study was to clarify the intra- and inter-rater reliability of the rate of force development in hip abductor muscle force measurements using a hand-held dynamometer. Thirty healthy adults were separately assessed by two independent raters on two separate days. Rate of force development was calculated from the slope of the…

  6. [Obese woman presenting as vocal cord abductor paralysis and floppy arytenoid associated with early signs of multiple system atrophy].

    Science.gov (United States)

    Sakuta, Hideki; Miyamoto, Masayuki; Suzuki, Keisuke; Miyamoto, Tomoyuki; Nakajima, Itsuo; Nakamura, Toshiki; Hirata, Koichi

    2012-01-01

    In multiple system atrophy (MSA), sleep-related breathing disorders are commonly observed, including vocal cord abductor paralysis (VCAP), which can cause sudden death. In its early stage, VCAP occurs only during sleep, but as the disease progresses, it appears when both awake and asleep. We encountered a 59-year-old obese woman who had been under continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea syndrome (OSAS) for approximately one year but later developed acute respiratory failure because of VCAP. VCAP was the predominant finding that led to the diagnosis of MSA in our patient. On laryngoscopic examination, the movement of the patient's larynx was normal during wakefulness, but VCAP, paradoxical movements of the vocal cord and a floppy arytenoid were observed during drug-induced sleep. We suggest that detection of VCAP and laryngopharyngeal abnormalities such as floppy arytenoid in the early stage of MSA is important for determining treatment options.

  7. Acute neck pain due to tendonitis of the longus colli: CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Artenian, D.J.; Lipman, J.K.; Scidmore, G.K.; Brant-Zawadzki, M.

    1989-05-01

    Calcific retropharyngeal tendonitis is an under-recognized cause of acute cervical pain produced by inflammation of the longus colli muscle. Although the clinical presentation may mimic more serious disorders, the diagnosis can be established radiographically by identification of prevertebral soft tissue calcification and swelling. Six patients with typical signs and symptoms of retropharyngeal tendonitis are presented. All were evaluated with plain films, four with CT and one with MRI. The pathognomonic finding of amorphous calcification anterior to C1-2 with associated asymmetric soft tissue swelling was clearly demonstrated by CT. Diffuse swelling of the longus colli muscle was shown as prominent high signal in the prevertebral region by T2 weighted MRI.

  8. A variation of the extensor hallucis longus muscle (accessory extensor digiti secundus muscle).

    Science.gov (United States)

    Tezer, Murat; Cicekcibasi, Aynur Emine

    2012-06-01

    An accessory muscle adjacent to the extensor hallucis longus muscle (EHL) was observed between the EHL and the extensor digitorum longus muscle (EDL) in the anterior side of both legs of the cadaver of a 72-year-old male, during educational dissection, and it was observed that the tendon of this muscle extended to the second toe. The tendon of this muscle united with the second toe tendon of the EDL. These common tendons appeared before reaching the toe media phalanxes and extended to the related media phalanxes of toe. However, an additional tendon separating from this accessory muscle tendon united with the EHL tendon at the left foot. This accessory muscle, unlike the variations identified to date, is considered to extend to the second toe, and the name "accessory extensor digiti secundus muscle" is offered.

  9. Acute neck pain due to tendonitis of the longus colli: CT and MRI findings

    International Nuclear Information System (INIS)

    Artenian, D.J.; Lipman, J.K.; Scidmore, G.K.; Brant-Zawadzki, M.

    1989-01-01

    Calcific retropharyngeal tendonitis is an under-recognized cause of acute cervical pain produced by inflammation of the longus colli muscle. Although the clinical presentation may mimic more serious disorders, the diagnosis can be established radiographically by identification of prevertebral soft tissue calcification and swelling. Six patients with typical signs and symptoms of retropharyngeal tendonitis are presented. All were evaluated with plain films, four with CT and one with MRI. The pathognomonic finding of amorphous calcification anterior to C1-2 with associated asymmetric soft tissue swelling was clearly demonstrated by CT. Diffuse swelling of the longus colli muscle was shown as prominent high signal in the prevertebral region by T2 weighted MRI. (orig.)

  10. Inflammation of vertebral bone associated with acute calcific tendinitis of the longus colli muscle

    Energy Technology Data Exchange (ETDEWEB)

    Mihmanli, I.; Kanberoglu, K. [Dept. of Radiology, Istanbul Univ. (Turkey); Karaarslan, E. [Intermed Medical Center, Nisantasi, Istanbul (Turkey)

    2001-12-01

    We present a case of acute retropharyngeal calcific tendinitis with characteristic findings on radiographic, computed tomography, and magnetic resonance imaging (MRI). To our knowledge, this is the first acute retropharyngeal calcific tendinitis report having inflammation of both the vertebra itself and the longus colli muscle diagnosed on MRI. In patients with neck pain, acute retropharyngeal calcific tendinitis should be kept in mind in the differential diagnosis, even if these patients had vertebral pathological signals on MRI. (orig.)

  11. Inflammation of vertebral bone associated with acute calcific tendinitis of the longus colli muscle

    International Nuclear Information System (INIS)

    Mihmanli, I.; Kanberoglu, K.; Karaarslan, E.

    2001-01-01

    We present a case of acute retropharyngeal calcific tendinitis with characteristic findings on radiographic, computed tomography, and magnetic resonance imaging (MRI). To our knowledge, this is the first acute retropharyngeal calcific tendinitis report having inflammation of both the vertebra itself and the longus colli muscle diagnosed on MRI. In patients with neck pain, acute retropharyngeal calcific tendinitis should be kept in mind in the differential diagnosis, even if these patients had vertebral pathological signals on MRI. (orig.)

  12. Evaluation of the neuromuscular compartments in the peroneus longus muscle through electrical stimulation and accelerometry

    Directory of Open Access Journals (Sweden)

    Guillermo A. Mendez

    2013-10-01

    Full Text Available BACKGROUND: Muscles are innervated exclusively by a nerve branch and possess definite actions. However, mammalian skeletal muscles, such as the trapezius, the medial gastrocnemius, and the peroneus longus, are compartmentalized. In the peroneus longus muscle, multiple motor points, which innervate individual neuromuscular compartments (NMC, the superior (S-NMC, anteroinferior (AI-NMC, and posteroinferior (PI-NMC, have been described. The contribution of each neuromuscular compartment to the final action of the muscle is fundamental for the rehabilitation of patients afflicted by neurological and muscle dysfunctions. Interventions are often based on electrical principles that take advantage of the physiological characteristics of muscles and nerves to generate therapeutic effects. OBJECTIVE: To compare the effects of stimulating the different neuromuscular compartments (NMCs of the peroneus longus muscle on the motor threshold (MT and acceleration of the foot. METHOD: This is a cross-sectional study comprising 37 subjects. The three NMCs of the peroneus longus muscle were stimulated, and the acceleration of the foot and the motor threshold of each NMC were evaluated. A repeated measures analysis of variance with Bonferroni corrections of two intra-subjects factors was performed. RESULTS: The stimulation of the different NMCs did not result in any differences in MT (F=2.635, P=0.079. There were significant differences between the axes of acceleration caused by the stimulation of the different NMCs (F=56,233; P=0.000. The stimulation of the posteroinferior compartment resulted in the greatest acceleration in the X-axis (mean 0.614; standard deviation 0.253. CONCLUSIONS: The posteroinferior compartment primarily contributes to the eversion movement of the foot. NMCs have specific functional roles that contribute to the actions of the muscles to which they belong.

  13. Technique tip: EDL-to-EHL double loop transfer for extensor hallucis longus reconstruction.

    Science.gov (United States)

    Bastías, Gonzalo F; Cuchacovich, Natalio; Schiff, Adam; Carcuro, Giovanni; Pellegrini, Manuel J

    2017-12-06

    Extensor hallucis longus (EHL) tendon injuries often occur in the setting of lacerations to the dorsum of the foot. End-to-end repair is advocated in acute lacerations, or in chronic cases when the tendon edges are suitable for tension free repair. Reconstruction with allograft or autograft is advocated for cases not amenable to a primary direct repair. This is often seen in cases with tendon retraction and more commonly in the chronic setting. In many countries the use of allograft is very limited or unavailable making reconstruction with autograft and tendon transfers the primary choice of treatment. Tendon diameter mismatch and diminished resistance are common issues in other previously described tendon transfers. We present the results of a new technique for reconstruction of non-reparable EHL lacerations in three patients using a dynamic double loop transfer of the extensor digitorum longus (EDL) of the second toe that addresses these issues. At one-year follow up, all patients recovered active/passive hallux extension with good functional (AOFAS Score) and satisfaction results. No reruptures or other complications were reported in this group of patients. No second toe deformities or dysfunction were reported. Second EDL-to-EHL Double Loop Transfer for Extensor Hallucis Longus reconstruction is a safe, reproducible and low-cost technique to address EHL ruptures when primary repair is not possible. IV (Case Series). Copyright © 2017. Published by Elsevier Ltd.

  14. Myostatin dysfunction impairs force generation in extensor digitorum longus muscle and increases exercise-induced protein efflux from extensor digitorum longus and soleus muscles.

    Science.gov (United States)

    Baltusnikas, Juozas; Kilikevicius, Audrius; Venckunas, Tomas; Fokin, Andrej; Bünger, Lutz; Lionikas, Arimantas; Ratkevicius, Aivaras

    2015-08-01

    Myostatin dysfunction promotes muscle hypertrophy, which can complicate assessment of muscle properties. We examined force generating capacity and creatine kinase (CK) efflux from skeletal muscles of young mice before they reach adult body and muscle size. Isolated soleus (SOL) and extensor digitorum longus (EDL) muscles of Berlin high (BEH) mice with dysfunctional myostatin, i.e., homozygous for inactivating myostatin mutation, and with a wild-type myostatin (BEH+/+) were studied. The muscles of BEH mice showed faster (P < 0.01) twitch and tetanus contraction times compared with BEH+/+ mice, but only EDL displayed lower (P < 0.05) specific force. SOL and EDL of age-matched but not younger BEH mice showed greater exercise-induced CK efflux compared with BEH+/+ mice. In summary, myostatin dysfunction leads to impairment in muscle force generating capacity in EDL and increases susceptibility of SOL and EDL to protein loss after exercise.

  15. Application of the Goutallier/Fuchs Rotator Cuff Classification to the Evaluation of Hip Abductor Tendon Tears and the Clinical Correlation With Outcome After Repair.

    Science.gov (United States)

    Bogunovic, Ljiljana; Lee, Simon X; Haro, Marc S; Frank, Jonathon M; Mather, Richard C; Bush-Joseph, Charles A; Nho, Shane J

    2015-11-01

    To assess the reliability and reproducibility of the Goutallier/Fuchs classification for the evaluation of abductor tendon tears of the hip, as well as to identify the relation between preoperative tear size, abductor muscle quality, and the success of endoscopic tendon repair. This is a retrospective review of 30 consecutive endoscopic abductor tendon repairs performed by a single surgeon over a 2-year period. Preoperative magnetic resonance imaging scans were reviewed, and the muscle was assigned a grade according to the Goutallier/Fuchs classification. Patient-rated outcome scores--visual analog scale score, Hip Outcome Score (HOS), and modified Harris Hip Score (mHHS)--were collected preoperatively and at a minimum of 2 years postoperatively. Intraobserver and interobserver reliability for muscle grading was calculated. Postoperative outcome measures were compared with preoperative tear size, muscle grade, and repair type to assess for correlations. Of the 30 hips included in the study, over 75% were classified as grade 1 (n = 15) or grade 2 (n = 8). The intraobserver reliability and interobserver reliability of the classification system averaged 0.872 and 0.916, respectively. Two patients (grades 3 and 4) had repair failure and underwent muscle transfer. In the remaining 28 hips, improvement was seen in the visual analog scale score (6.0 v 1.7, P size, or repair type (double v single row) did not affect postoperative outcomes. The Goutallier/Fuchs classification system can be reliably and reproducibly applied to the evaluation of abductor tendon tears of the hip and appears to correlate with patient-rated outcomes after repair. Increasing preoperative muscle fatty atrophy correlates with increased patient pain and decreased patient satisfaction and functional outcomes after repair. Level IV, prognostic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  16. Cuboid oedema due to peroneus longus tendinopathy: a report of four cases

    International Nuclear Information System (INIS)

    O'Donnell, Paul; Saifuddin, Asif

    2005-01-01

    To highlight focal bone abnormality in the cuboid due to tendinopathy of the adjacent peroneus longus. A retrospective review was carried out of the relevant clinical and imaging features. Two male and two female patients were studied, mean age 51.5 years (range 32 - 67 years), referred with foot pain and imaging showing an abnormal cuboid thought to represent either tumour or infection. A long history of foot pain was usual with a maximum of 8 years. Radiographs were normal in two cases and showed erosion in two, one of which exhibited periosteal new bone formation affecting the cuboid. Bone scintigraphy was undertaken in two patients, both of whom showed increased uptake of isotope. MRI, performed in all patients, showed oedema in the cuboid adjacent to the peroneus longus tendon. The tendon and/or paratendinous tissues were abnormal in all cases, but no tendon discontinuity was identified. One patient possessed an os peroneum. Unequivocal evidence of bone erosion was seen using MRI in three patients, but with greater clarity in two cases using CT. Additional findings of tenosynovitis of tibialis posterior, oedema in the adjacent medial malleolus and synovitis of multiple joints in the foot were seen in one patient. Imaging diagnosis was made in all cases avoiding bone biopsy, but surgical exploration of the peroneal tendons was performed in two cases and biopsy of ankle synovium in one. Oedema with erosion of the cuboid bone, simulating a bone lesion (cuboid ''pseudotumour''), may be caused by adjacent tendinopathy of peroneus longus. It is vital to be aware of this entity to avoid unnecessary biopsy of the cuboid. (orig.)

  17. Cuboid oedema due to peroneus longus tendinopathy: a report of four cases

    Energy Technology Data Exchange (ETDEWEB)

    O' Donnell, Paul; Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)

    2005-07-01

    To highlight focal bone abnormality in the cuboid due to tendinopathy of the adjacent peroneus longus. A retrospective review was carried out of the relevant clinical and imaging features. Two male and two female patients were studied, mean age 51.5 years (range 32 - 67 years), referred with foot pain and imaging showing an abnormal cuboid thought to represent either tumour or infection. A long history of foot pain was usual with a maximum of 8 years. Radiographs were normal in two cases and showed erosion in two, one of which exhibited periosteal new bone formation affecting the cuboid. Bone scintigraphy was undertaken in two patients, both of whom showed increased uptake of isotope. MRI, performed in all patients, showed oedema in the cuboid adjacent to the peroneus longus tendon. The tendon and/or paratendinous tissues were abnormal in all cases, but no tendon discontinuity was identified. One patient possessed an os peroneum. Unequivocal evidence of bone erosion was seen using MRI in three patients, but with greater clarity in two cases using CT. Additional findings of tenosynovitis of tibialis posterior, oedema in the adjacent medial malleolus and synovitis of multiple joints in the foot were seen in one patient. Imaging diagnosis was made in all cases avoiding bone biopsy, but surgical exploration of the peroneal tendons was performed in two cases and biopsy of ankle synovium in one. Oedema with erosion of the cuboid bone, simulating a bone lesion (cuboid ''pseudotumour''), may be caused by adjacent tendinopathy of peroneus longus. It is vital to be aware of this entity to avoid unnecessary biopsy of the cuboid. (orig.)

  18. Repair of acute extensor hallucis longus tendon injuries: a retrospective review.

    Science.gov (United States)

    Wong, Justin C; Daniel, Joseph N; Raikin, Steven M

    2014-02-01

    Extensor hallucis longus (EHL) tendon injuries may occur with lacerations sustained over the dorsum of the foot and lead to hallux dysfunction. Primary repair is performed when tendon edges are opposable; however, if a gap exists between tendon edges, then reconstruction with tendon graft or tendon transfer may be necessary to restore hallux alignment and dorsiflexion. We describe the surgical technique and report the results on a large series of patients having undergone primary repair or reconstruction of EHL tendon lacerations. We retrospectively reviewed all patients undergoing EHL tendon repair or reconstruction between January 2005 and May 2012. Information on patient demographics, mechanism of injury, time to surgery, intraoperative findings, surgical repair or reconstruction technique, and postoperative function were collected. Patients were contacted by telephone for administration of the Foot and Ankle Ability Measure (FAAM) and American Orthopaedic Foot and Ankle Society Hallux questionnaires. Twenty of 23 patients undergoing EHL tendon repair or reconstruction were available for review at an average clinical follow-up of 12 months (range 3-89 months) and an average telephone follow-up of 5.1 years (range 1-10.4 years). Primary EHL repair was performed in 80% of cases, with the remaining patients undergoing reconstruction with deep tendon transfer of the extensor digitorum longus tendon from the second toe. At final follow-up, 19 of 20 patients had active hallux dorsiflexion. The average FAAM Activities of Daily Living score was 94.2% (range 58.3% to 100%) and the average FAAM Sports score was 94.2% (range 65.6% to 100%). Primary repair or reconstruction of EHL tendon lacerations is a reliable procedure that restores hallux alignment and function in most patients as measured by the validated FAAM questionnaire. Deep tendon transfer from the extensor digitorum longus may be performed if EHL tendon edges are not opposable thus eliminating the need for

  19. Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli

    Science.gov (United States)

    Yin, Zhaoyang; Yin, Jian; Cai, Jun; Sui, Tao; Cao, Xiaojian

    2015-01-01

    Abstract Anterior cervical surgery is commonly used for cervical vertebral body lesions. However, the structure of blood vessels and nerve tissues along the route of anterior cervical surgery is complex. We aimed to measure the data of the longus colli, the sympathetic trunk and the cervical sympathetic trunk (CST) ganglia in Chinese cadaver specimens. A total of 32 adult cadavers were studied. We delineated the surgical anatomy of the CST. The superior and inferior/cervicothoracic ganglia of the sympathetic trunk consistently appeared. The middle ganglion was observed in 28.1% of the specimens and there were 2 cases of unilateral double middle cervical ganglia. The inferior ganglion was observed in 25.0% of the specimens and the cervicothoracic ganglion was observed in the remaining specimens. The distance between the CST gradually decreased from the top to the bottom, and the distance between the medial edges of the longus colli gradually broadened from the top down. The average angle between the bilateral CST and the midline of the vertebra was 11.2°±1.8° on the left side and 10.3°±1.4° on the right side. The average angle between the medial margins of longus colli of both sides was 11.1°±1.9°. The CST is at high risk when LC muscle is cut transversely or is dragged heavily, especially at the levels of C6 and C7. Awareness of the regional anatomy of the CST could help surgeons to identify and preserve it during anterior cervical surgeries. PMID:26668584

  20. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus

    Science.gov (United States)

    Kim, Moon-Hwan; Yi, Chung-Hwi; Weon, Jong-Hyuck; Cynn, Heon-Seock; Jung, Do-Young; Kwon, Oh-Yun

    2015-01-01

    [Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exercise. The hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction were measured initially and after 8 weeks by radiography and ultrasonography. [Results] While there were no significant changes in the three parameters in the orthosis group, there were significant differences in the orthosis plus toe-spread-out exercise group after 8 weeks. In addition there were significant differences in the three measures between the two groups. [Conclusion] The toe-spread-out exercise reduces the hallux valgus angle and hallux valgus angle during active abduction, and increases the cross-sectional area of the abductor hallucis muscle. The toe-spread-out exercise is recommended for patients with mild to moderate hallux valgus. PMID:25995546

  1. The Comparison of the Effects of Trigger Points Pressure Release and Kinesio Taping on Pain and Hip Abductor Muscles Strength in Patients with Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Vahid Mazloum

    2016-10-01

    Full Text Available Background & objectives: Hip muscles insufficiency plays a significant role in deterioration of patellofemoral pain syndrome (PFPS, which can be manifested as myofascial trigger point (MTrPs in hip muscles. Then, our purpose was to determine the prevalence of MTrPs in the gluteus medius (GMe and quadratus lumborum (QL muscles and to investigate the effect of a therapeutic intervention on pain intensity and hip abductor muscles isometric strength in patients with PFPS. Methods: Forty volunteer subjects (20 patients and 20 healthy participated in the study. Latent MTrPs in GMe and QL were evaluated and a handheld dynamometer was used to measure peak isometric strength test (PIST for hip abductors. Patients with PFPS having MTrPs in GMe were randomly divided into either a treatment group (Mean age±SD: 23.2±4.3 years or control (Mean age±SD: 24.4±4.6 years. The therapeutic intervention included trigger point pressure release (TrPPR and Kinesio Taping® (KT. Pain intensity and PIST for hip abductors were assessed at baseline and after intervention in both groups. Results: There is more significant patients with PFPS having latent MTrPs in GMe and QL than the healthy counterparts (p0.05. Conclusion: Concomitant using of TrPPR therapy and KT method can decrease pain intensity in individuals with PFPS. Further studies are required to understand the underlying mechanisms.

  2. The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain: a prospective study.

    Science.gov (United States)

    Verrelst, Ruth; Willems, Tine Marieke; De Clercq, Dirk; Roosen, Philip; Goossens, Lennert; Witvrouw, Erik

    2014-11-01

    To prospectively identify proximal risk factors contributing to the development of exertional medial tibial pain (EMTP). Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010-2011 and 2011-2012. 95 female students, aged 18.15 ± 0.84, were tested at the beginning of their first academic year. Testing included isokinetic hip strength measurements of the abductors, adductors, internal rotators and external rotators. The follow-up of the individulas was assessed using a weekly online questionnaire and a 3-monthly retrospective control questionnaire. EMTP was diagnosed by an experienced MD (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of EMTP. 21 individuals were diagnosed with EMTP during follow-up. The results of this study identified that decreased hip abductor concentric strength is a predictive parameter for the development of EMTP in females. More specifically, total work (p=0.010) and average power (p=0.045) for concentric abduction strength were found to be significant predictors for this lower leg overuse injury. Hip abductor weakness is a significant predictor for EMTP in women. Preventive screening methods for EMTP should therefore include this proximal contributing factor. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus.

    Science.gov (United States)

    Kim, Moon-Hwan; Yi, Chung-Hwi; Weon, Jong-Hyuck; Cynn, Heon-Seock; Jung, Do-Young; Kwon, Oh-Yun

    2015-04-01

    [Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exercise. The hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction were measured initially and after 8 weeks by radiography and ultrasonography. [Results] While there were no significant changes in the three parameters in the orthosis group, there were significant differences in the orthosis plus toe-spread-out exercise group after 8 weeks. In addition there were significant differences in the three measures between the two groups. [Conclusion] The toe-spread-out exercise reduces the hallux valgus angle and hallux valgus angle during active abduction, and increases the cross-sectional area of the abductor hallucis muscle. The toe-spread-out exercise is recommended for patients with mild to moderate hallux valgus.

  4. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot.

    Science.gov (United States)

    Chundru, Usha; Liebeskind, Amy; Seidelmann, Frank; Fogel, Joshua; Franklin, Peter; Beltran, Javier

    2008-06-01

    To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA. Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, pcalcaneal edema (15.0% vs 3.0%, P=0.005), calcaneal spur (48.0% vs 7.0%, Pcalcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant. Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy.

  5. The study of surface electromyography used for the assessment of abductor hallucis muscle activity in patients with hallux valgus.

    Science.gov (United States)

    Mortka, Kamila; Lisiński, Przemysław; Wiertel-Krawczuk, Agnieszka

    2018-01-26

    Hallux valgus is a common foot disorder. In patients with hallux valgus, the anatomy and biomechanics of foot is subject to alterations. The aim of this clinical and neurophysiological study is to compare the activity of abductor hallucis (AbdH) muscle between the group of patients with hallux valgus and control group of healthy people, with the use of surface electromyography. The study involved 44 feet with diagnosed hallux valgus (research group) and 42 feet without deformation (control group). The X-ray images, measurements of range of motion in the first metatarsophalangeal joint and in hallux interphalangeal joint, and the surface electromyography study recorded from AbdH muscle were performed. Considering the amplitude of motor unit action potential, study participants with hallux valgus demonstrate significantly less activity of AbdH muscle than people without hallux valgus deformity. This activity is not dependent on the severity of valgus, age, or range of motion. It is speculated that the changes of the AbdH function may occur in the period before clinical appearance of hallux valgus deformity, or at the onset of distortion development. Further studies are needed for a comprehensive assessment of AbdH muscle in patients with hallux valgus.

  6. A further observation of muscle spindles in the extensor digitorum longus muscle of the aged rat.

    Science.gov (United States)

    Desaki, Junzo; Nishida, Naoya

    2010-01-01

    We observed three novel muscle spindles in the extensor digitorum longus muscle of the aged (20 months) rat. Two muscle spindles of the three contained thin muscle fibers lacking sensory innervation between the layers of the spindle capsule and within the periaxial space, respectively. The other one contained sensory-innervated thin muscle fibers with an indistinct equatorial nucleation between the layers of the spindle capsule. These findings suggest that the occurrence of thin muscle fibers may be intimately related to the degeneration and regeneration of extrafusal muscle fibers during aging and that these newly formed thin muscle fibers may often fail to receive sensory innervation.

  7. Myofascial force transmission causes interaction between adjacent muscles and connective tissue: Effects of blunt dissection and compartmental fasciotomy on length force characteristics of rat extensor digitorum longus muscle

    NARCIS (Netherlands)

    Huijing, P.A.J.B.M.; Baan, G.C.

    2001-01-01

    Muscles within the anterior tibial compartment (extensor digitorum longus: EDL. tibialis anterior: TA, and extensor hallucis longus muscles: EHL) and within the peroneal compartment were excited simultaneously and maximally. The ankle joint was fixed kept at 90°. For EDL length force characteristics

  8. Denervated muscle fibers explain the deficit in specific force following reinnervation of the rat extensor digitorum longus muscle.

    Science.gov (United States)

    van der Meulen, Jack H; Urbanchek, Melanie G; Cederna, Paul S; Eguchi, Tomoaki; Kuzon, William M

    2003-10-01

    The authors tested the hypothesis that, after denervation and reinnervation of skeletal muscle, observed deficits in specific force can be completely attributed to the presence of denervated muscle fibers. The peroneal nerve innervating the extensor digitorum longus muscle in rats was sectioned and the distal stump was coapted to the proximal stump, allowing either a large number of motor axons (nonreduced, n = 12) or a drastically reduced number of axons access to the distal nerve stump (drastically reduced, n = 18). A control group of rats underwent exposure of the peroneal nerve, without transection, followed by wound closure (control, n = 9). Four months after the operation, the maximum tetanic isometric force (Fo) of the extensor digitorum longus muscle was measured in situ and the specific force (sFo) was calculated. Cross-sections of the muscles were labeled for neural cell adhesion molecule (NCAM) protein to distinguish between innervated and denervated muscle fibers. Compared with extensor digitorum longus muscles from rats in the control (295 +/- 11 kN/m2) and nonreduced (276 +/- 12 kN/m2) groups, sFo of the extensor digitorum longus muscles from animals in the drastically reduced group was decreased (227 +/- 15 kN/m2, p extensor digitorum longus muscles from animals in the drastically reduced group (18 +/- 3 percent) was significantly higher than in the control (3 +/- 1 percent) group, but not compared with the nonreduced (9 +/- 2 percent) group. After exclusion of the denervated fibers, sFo did not differ between extensor digitorum longus muscles from animals in the drastically reduced (270 +/- 20 kN/m2), nonreduced (301 +/- 13 kN/m2), or control (303 +/- 10 kN/m2) groups. The authors conclude that, under circumstances of denervation and rapid reinnervation, the decrease in sFo of muscle can be attributed to the presence of denervated muscle fibers.

  9. Results of Long-Term Follow-Up Observations of Blepharoptosis Correction Using the Palmaris Longus Tendon

    Science.gov (United States)

    Shin, YongHo

    2008-01-01

    Background The frontalis sling procedure is a useful approach for correcting severe blepharoptosis. However, blepharoptosis often recurs after corrective surgery using the tensor fascia lata. Good results without recurrence after a modified Fox method were obtained using the palmaris longus tendon. This study examined the safety and validity of the surgical method using the palmaris longus tendon through long-term follow-up observations. Methods To reduce the rate of recurrence, the highest point on the pentagon of the Fox method was fixed to the frontalis fascia and frontalis muscle. It was fixed once again to the area 1 cm above the highest point. This approach remarkably reduces the incidence of recurrence by fixing the pentagon of the Fox method not only to the palmaris longus tendon but also to the frontalis fascia and again to the frontalis muscle. A modified Fox method using the palmaris longus tendon was used to treat 16 eyelids of 10 patients. A senior surgeon performed the procedure in all cases under local anesthesia. Results The mean follow-up period was 51 months (range = 18–86 months). There was no case of blepharoptosis recurrence and a good field of view was secured after surgery. Long-term follow-up revealed that the visual field had been well secured with a mean MRD1 of 3.1 mm. The eyelids were well maintained without any postoperative adverse reaction such as exposure keratitis. Conclusion The palmaris longus tendon as useful donor material does not lead to recurrence of blepharoptosis, which is often encountered when the tensor fascia lata is used. The modified Fox method using the palmaris longus tendon can be an effective and valid surgical approach that produces both immediate and long-term results. PMID:18446402

  10. The pyramidalis-anterior pubic ligament-adductor longus complex (PLAC) and its role with adductor injuries

    DEFF Research Database (Denmark)

    Schilders, Ernest; Bharam, Srino; Golan, Elan

    2017-01-01

    crest and anterior pubic ligament and attaches to the linea alba on the medial border. The proximal adductor longus attaches to the pubic crest and anterior pubic ligament. The anterior pubic ligament is also a fascial anchor point connecting the lower anterior abdominal aponeurosis and fascia lata....... The rectus abdominis, however, is not attached to the adductor longus; its lateral tendon attaches to the cranial border of the pubis; and its slender internal tendon attaches inferiorly to the symphysis with fascia lata and gracilis. CONCLUSION: The study demonstrates a strong direct connection between...

  11. The relationship between hip-abductor strength and the magnitude of pelvic drop in patients with low back pain.

    Science.gov (United States)

    Kendall, Karen D; Schmidt, Christie; Ferber, Reed

    2010-11-01

    It has been theorized that a positive Trendelenburg test (TT) indicates weakness of the stance hip-abductor (HABD) musculature, results in contralateral pelvic drop, and represents impaired load transfer, which may contribute to low back pain. Few studies have tested whether weakness of the HABDs is directly related to the magnitude of pelvic drop (MPD). To examine the relationship between HABD strength and MPD during the static TT and during walking for patients with nonspecific low back pain (NSLBP) and healthy controls (CON). A secondary purpose was to examine this relationship in NSLBP after a 3-wk HABD-strengthening program. Quasi-experimental. Clinical research laboratory. 20 (10 NSLBP and 10 CON). HABD strengthening. Normalized HABD strength, MPD during TT, and maximal pelvic frontal-plane excursion during walking. At baseline, the NSLBP subjects were significantly weaker (31%; P = .03) than CON. No differences in maximal pelvic frontal-plane excursion (P = .72), right MPD (P = 1.00), or left MPD (P = .40) were measured between groups. During the static TT, nonsignificant correlations were found between left HABD strength and right MPD for NSLBP (r = -.32, P = .36) and CON (r = -.24, P = .48) and between right HABD strength and left MPD for NSLBP (r = -.24, P = .50) and CON (r = -.41, P = .22). Nonsignificant correlations were found between HABD strength and maximal pelvic frontal-plane excursion for NSLBP (r = -.04, P = .90) and CON (r = -.14, P = .68). After strengthening, NSLBP demonstrated significant increases in HABD strength (12%; P = .02), 48% reduction in pain, and no differences in MPD during static TT and maximal pelvic frontal-plane excursion compared with baseline. HABD strength was poorly correlated to MPD during the static TT and during walking in CON and NSLBP. The results suggest that HABD strength may not be the only contributing factor in controlling pelvic stability, and the static TT has limited use as a measure of HABD function.

  12. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Chundru, Usha [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Liebeskind, Amy; Beltran, Javier [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Seidelmann, Frank; Franklin, Peter [Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Fogel, Joshua [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Brooklyn College, Department of Economics, Brooklyn, NY (United States)

    2008-06-15

    To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA. Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, p < 0.001), presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), calcaneal edema (15.0% vs 3.0%, P = 0.005), calcaneal spur (48.0% vs 7.0%, P < 0.001), plantar fasciitis (52.5% vs 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001). After multivariate logistic regression analysis, only age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03, 1.09], calcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant. Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy. (orig.)

  13. Effects of button position on a soft keyboard: Muscle activity, touch time, and discomfort in two-thumb text entry.

    Science.gov (United States)

    Chang, Joonho; Choi, Bori; Tjolleng, Amir; Jung, Kihyo

    2017-04-01

    Intensive use of the thumbs for text entry on smartphones may contribute to discomfort, pain, or musculoskeletal disorders. This study investigated the effect of twenty-five button positions (5 rows × 5 columns) on a soft keyboard for two-thumb entry. Two experiments measured muscle activity, touch time, and discomfort as a function of the button positions. In Phase I, the muscle activities of two intrinsic (abductor pollicis brevis and first dorsal interossei) and two extrinsic (abductor pollicis longus and extensor digitorum communis) muscles associated with thumb motions were observed for ten college students (age: 24.2). In Phase II, touch time and discomfort were measured for 40 college students (age: 23.6). The results demonstrated that the %MVCs of the intrinsic muscles significantly increased when the thumbs flexed and abducted. Also, the button positions near the rest positions of the thumbs resulted in significantly shorter touch times (0.66 s) and lower discomfort ratings (0.70 pt) than their peripheral buttons (0.76 s; 2.29 pt). Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Flexor hallucis longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus

    NARCIS (Netherlands)

    Baan, H.; Baan, Henriette; Drossaers-Bakker, K.W.; Dubbeldam, Rosemary; Dubbeldam, Rosemary; Buurke, Jaap J.; Nene, A.V.; van de Laar, Mart A F J

    2007-01-01

    Background: To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL) tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints. Methods: Thirty RA patients with painful feet were analysed, their

  15. Flexor accessorius longus: A rare variation of the deep extrinsic digital flexors of the leg and its phylogenetic significance

    Directory of Open Access Journals (Sweden)

    Jaijesh P

    2006-01-01

    Full Text Available Anomalies of the calf muscles are rare. One such anomalous muscle, known as the Muscle Flexor accessorius longus (also named accessorius ad accessorium, accessorius secondus, accessory flexor digitorum longus or pronator pedis is of morphological significance. When present, this originates in the deep fascia of the tibia or fibula and inserts in the foot either into the flexor digitorum accessorius or into the tendons of the flexor digitorum longus. In this report we present a discussion of the morphological significance and phylogenetic history of one such muscle observed. In this case report we describe an anomalous calf muscle which extends from the popliteal region, runs along the posterior compartment of the leg, reaches the sole and is inserted to the flexor digitorum longus muscle. This kind of muscle variations are considered to be the higher origin of the flexor digitorum accessorius muscle of the sole. Here we discuss the phylogenetic history of this muscle as this muscle variant is present in some primitive mammals, absent in apes and in this particular case appeared as one of the muscles of the flexor compartment of the leg.

  16. Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Vince W Lands

    2016-01-01

    Full Text Available The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.

  17. Foot posture is associated with morphometry of the peroneus longus muscle, tibialis anterior tendon, and Achilles tendon.

    Science.gov (United States)

    Murley, G S; Tan, J M; Edwards, R M; De Luca, J; Munteanu, S E; Cook, J L

    2014-06-01

    The aim of this study was to investigate the association between foot type and the morphometry of selected muscles and tendons of the lower limb. Sixty-one healthy participants (31 male, 30 female; aged 27.1 ± 8.8 years) underwent gray-scale musculoskeletal ultrasound examination to determine the anterior-posterior (AP) thickness of tibialis anterior, tibialis posterior, and peroneus longus muscles and tendons as well as the Achilles tendon. Foot type was classified based on arch height and footprint measurements. Potentially confounding variables (height, weight, hip and waist circumference, rearfoot and ankle joint range of motion, and levels of physical activity) were also measured. Multiple linear regression models were used to determine the association between foot type with muscle and tendon morphometry accounting for potentially confounding variables. Foot type was significantly and independently associated with AP thickness of the tibialis anterior tendon, peroneus longus muscle, and Achilles tendon, accounting for approximately 7% to 16% of the variation. Flat-arched feet were associated with a thicker tibialis anterior tendon, a thicker peroneus longus muscle, and a thinner Achilles tendon. Foot type is associated with morphometry of tendons that control sagittal plane motion of the rearfoot; and the peroneus longus muscle that controls frontal plane motion of the rearfoot. These findings may be related to differences in tendon loading during gait. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Effects of β2-agonists on force during and following anoxia in rat extensor digitorum longus muscle

    DEFF Research Database (Denmark)

    Fredsted, Anne; Gissel, Hanne; Ortenblad, Niels

    2012-01-01

    )-agonists affect force and ion homeostasis in anoxic muscles. In the present study isolated rat extensor digitorum longus (EDL) muscles exposed to anoxia showed a considerable loss of force, which was markedly reduced by the β(2)-agonists salbutamol (10(-6) M) and terbutaline (10(-6) M). Intermittent...

  19. A Biomechanical Analysis of Interference Screw Versus Bone Tunnel Fixation of Flexor Hallucis Longus Tendon Transfers to the Calcaneus.

    Science.gov (United States)

    Liu, George T; Balldin, B Christian; Zide, Jacob R; Chen, Christopher T

    The flexor hallucis longus tendon transfer is commonly used to restore function in chronic Achilles tendon ruptures and chronic Achilles tendinopathy. The tendon is often secured to the calcaneus either through a bone tunnel or by an interference screw. We hypothesized that tenodesis using the bone tunnel method would be mechanically superior to interference screw fixation for flexor hallucis longus transfers. Eight matched pairs of cadaveric specimens were assigned randomly to the bone tunnel or interference screw technique and were loaded to failure. Biomechanical analysis was performed to evaluate the ultimate strength, peak stress, Young's modulus, failure strain, and strain energy. Unpaired comparison, paired comparison, and linear regression analyses were used to determine statistical significance. A slight 22% ± 9% decrease in Young's modulus and a 52% ± 18% increase of strain energy were found in the interference screw group. However, no differences in ultimate strength, peak stress, or failure strain were seen between the 2 groups on paired comparison. Our findings suggest that interference screw fixation provides similar spontaneous biomechanical properties to the use of a bone tunnel for flexor hallucis longus transfer to the calcaneus. The interference screw is a practical option for fixation of the flexor hallucis longus tendon to the calcaneus and can be performed through a single incision approach. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Return to sport activities after medial displacement calcaneal osteotomy and flexor digitorum longus transfer.

    Science.gov (United States)

    Usuelli, F G; Di Silvestri, C A; D'Ambrosi, R; Maccario, C; Tan, E W

    2018-03-01

    Medial displacement calcaneal osteotomy with flexor digitorum longus transfer is a common treatment for the management of the adult flatfoot associated with posterior tibial tendon dysfunction. In the literature, there is a paucity of information regarding the ability of patients to return to sport and recreational activities after this surgical procedure. The purpose of this retrospective clinical study was to assess the rate and type of athletic activities that patients participated in before and after medial displacement calcaneal osteotomy with flexor digitorum longus transfer. A consecutive series of 42 patients with a mean age at surgery of 41 years (range 19-74 years) was evaluated with a minimum follow-up of 24 months (range 18-31 months). Pre- and post-operative sporting activities were assessed. At final follow-up, patients were asked to complete a Sports Athlete Foot and Ankle Score (SAFAS). Each patient was also evaluated with weight-bearing radiographs of the foot before surgery and at final follow-up. Preoperatively, 27 of 42 (64.3 %) patients were engaged in athletic activities, participating in an average of 1.4 h/week (range 0-6 h/week); post-operatively, 36/42 (85.7 %) participated in sport and recreational activities for an average of 3.5 h/week (range 0-15 h/week). Meary's angle improved significantly from 11.5 ± 6.2 degrees preoperatively to 7.0 ± 5.7 degrees at final follow-up (p < 0.01); calcaneal pitch improved significantly from 16.5 ± 4.6 degrees to 19.0 ± 5.0 degrees (p < 0.01). At final follow-up, patients demonstrated good SAFASs in symptom tolerance (86.4 %), pain tolerance (89.0 %), daily living performance (96.1 %), and sports performance (86.7 %). The majority of patients returned to sports and recreational activity after medial displacement calcaneal osteotomy and flexor digitorum longus for the treatment of adult flatfoot associated with posterior tibial tendon dysfunction. III.

  1. Isolated Tuberculous Tenosynovitis of the Anterior Tibial and Extensor Digitorum Longus Tendons

    Directory of Open Access Journals (Sweden)

    Berhan Genç

    2013-01-01

    Full Text Available Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.

  2. Catalase-positive microperoxisomes in rat soleus and extensor digitorum longus muscle fiber types

    Science.gov (United States)

    Riley, Danny A.; Bain, James L. W.; Ellis, Stanley

    1988-01-01

    The size, distribution, and content of catalase-reactive microperoxisomes were investigated cytochemically in three types of muscle fibers from the soleus and the extensor digitorum longus (EDL) of male rats. Muscle fibers were classified on the basis of the mitochondrial content and distribution, the Z-band widths, and the size and shape of myofibrils as the slow-twitch oxidative (SO), the fast-twitch oxidative glycolytic (FOG), and the fast-twitch glycolytic (FG) fibers. It was found that both the EDL and soleus SO fibers possessed the largest microperoxisomes. A comparison of microperoxisome number per muscle fiber area or the microperoxisome area per fiber area revealed following ranking, starting from the largest number and the area-ratio values: soleus SO, EDL SO, EDL FOG, and EDL FG.

  3. Stretch-induced force deficits in murine extensor digitorum longus muscles after cardiotoxin injection.

    Science.gov (United States)

    Markert, Chad; Petroski, Gregory F; Childers, Charles K; McDonald, Kerry S; Childers, Martin K

    2006-10-01

    A leftward shift in a muscle's length-tension relationship is thought to impair myofilament overlap. We hypothesized that left-shifted muscles would incur greater eccentric contraction-induced damage compared to controls. We evaluated contractile properties and force deficits in regenerating murine extensor digitorum longus (EDL) muscles 7, 14, and 21 days after cardiotoxin (CTX) injection. Specific tension recovered to control values by 21 days. CTX-injected muscles demonstrated left-shifted length-tension curves and incurred greater contraction-induced force deficits than controls (P < 0.001) on day 7. We speculate that increased contraction-induced damage in 7-day CTX-injected muscles results from changes in myofilament overlap that occurs during early regeneration.

  4. Gender differences in contractile and passive properties of mdx extensor digitorum longus muscle.

    Science.gov (United States)

    Hakim, Chady H; Duan, Dongsheng

    2012-02-01

    Duchenne muscular dystrophy (DMD) is a severe, muscle-wasting disease caused by mutations in the dystrophin gene. The mdx mouse is the first and perhaps the most commonly used animal model for study of DMD. Both male and female mdx mice are used. However, it is not completely clear whether gender influences contraction and the passive mechanical properties of mdx skeletal muscle. We compared isometric tetanic forces and passive forces of the extensor digitorum longus muscle between male and female mdx mice. At age 6 months, female mdx mice showed better-preserved specific tetanic force. Interestingly, at 20 months of age, female mdx muscle appeared stiffer. Our results suggest that gender may profoundly influence physiological measurement outcomes in mdx mice. Copyright © 2011 Wiley Periodicals, Inc.

  5. Isolated tuberculous tenosynovitis of the anterior tibial and extensor digitorum longus tendons.

    Science.gov (United States)

    Genç, Berhan; Solak, Aynur; Mayda, Aslan; Sen, Nazime

    2013-01-01

    Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.

  6. Lipoma arborescens of the suprapatellar bursa and extensor digitorum longus tendon sheath: report of 2 cases.

    Science.gov (United States)

    Senocak, Efsun; Gurel, Kamil; Gurel, Safiye; Ozturan, Kutay Engin; Cakici, Husamettin; Yilmaz, Fahri; Boran, Cetin

    2007-10-01

    Lipoma arborescens (diffuse articular lipomatosis) is a rare intra-articular lesion consisting of subsynovial villous proliferation of mature fat cells. The usual clinical presentation is painless swelling. The aim of this series was to emphasize the importance of gray scale and color Doppler sonography through the investigation of chronic joint swelling. Lipoma arborescens of the knee and extensor digitorum longus tendon sheath at the ankle region are described. The latter is extremely rare. We examined 2 patients with sonography before using cross-sectional modalities. Gray scale sonography revealed hyperechoic irregular villous and frondlike projections within prominent joint effusion. A wavelike motion of the projections was shown by dynamic compression and manipulation of the effusion. We observed moderate vascularity on color Doppler sonography. Spectral analysis revealed a low-resistance arterial waveform. Gray scale sonography is a useful diagnostic modality that can be performed to evaluate chronic joint swelling before the use of cross-sectional and more expensive modalities.

  7. Hypogravity-induced atrophy of rat soleus and extensor digitorum longus muscles

    Science.gov (United States)

    Riley, D. A.; Ellis, S.; Slocum, G. R.; Satyanarayana, T.; Bain, J. L.; Sedlak, F. R.

    1987-01-01

    Prolonged exposure of humans to hypogravity causes weakening of their skeletal muscles. This problem was studied in rats exposed to hypogravity for 7 days aboard Spacelab 3. Hindlimb muscles were harvested 12-16 hours postflight for histochemical, biochemical, and ultrastructural analyses. The majority of the soleus and extensor digitorum longus fibers exhibited simple cell shrinkage. However, approximately 1% of the fibers in flight soleus muscles appeared necrotic. Flight muscle fibers showed increased glycogen, lower subsarcolemmal staining for mitochondrial enzymes, and fewer subsarcolemmal mitochondria. During atrophy, myofibrils were eroded by multiple focal losses of myofilaments; lysosomal autophagy was not evident. Tripeptidylaminopeptidase and calcium-activated protease activities of flight soleus fibers were significantly increased, implying a role in myofibril breakdown. Simple fiber atrophy appears to account for muscle weakening during spaceflight, but fiber necrosis is also a contributing factor.

  8. Catalase overexpression does not impair extensor digitorum longus muscle function in normal mice.

    Science.gov (United States)

    Liu, Mingju; Yue, Yongping; Li, Dejia; Duan, Dongsheng

    2007-12-01

    Catalase is a major antioxidant enzyme. Increasing catalase expression represents a promising avenue to improve muscle function in certain physiological conditions and in some muscle diseases. We hypothesized that catalase overexpression should not impair normal muscle contraction. We delivered a hemagglutinin (HA)-tagged human catalase gene to normal mouse muscle by an adeno-associated viral vector (AAV). Western blot and immunostaining revealed efficient expression of HA-tagged catalase. Enzymatic assay demonstrated an approximately threefold increase in catalase activity in AAV-infected muscles. Catalase overexpression impaired neither twitch nor tetanic tension in the extensor digitorum longus (EDL) muscle. Furthermore, EDL fatigue response was not altered. Taken together, we have developed a novel AAV vector to enhance catalase expression. Lack of apparent toxicity in normal muscle strongly supports further exploration of this vector to reduce oxidative stress-induced muscle damage.

  9. Using a double-layered palmaris longus tendon for suspension of facial paralysis

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Bakholdt, Vivi; Sørensen, Jens Ahm

    2015-01-01

    INTRODUCTION: Facial palsy is a debilitating condition entailing both cosmetic and functional limitations. Static suspension procedures can be performed when more advanced dynamic techniques are not indicated. Since 2006, we have used a double-layered palmaris longus tendon graft through an ovular...... electronic patient records were retrieved, patients were invited for a follow-up visit and results were measured using the Lip Reanimation Outcomes Questionnaire. Furthermore, standardised photographs were taken and evaluated by multiple surgeons. RESULTS: A total of 13 patients were included with a mean...... at follow-up. Photographic evaluation revealed an acceptable symmetry at rest with an increasing asymmetry with increasing smile intensity. No post-operative complications or donor site morbidity was noted in any of our patients. CONCLUSION: Our technique is easy to perform with no noteworthy complications...

  10. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus

    OpenAIRE

    Kim, Moon-Hwan; Yi, Chung-Hwi; Weon, Jong-Hyuck; Cynn, Heon-Seock; Jung, Do-Young; Kwon, Oh-Yun

    2015-01-01

    [Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exerci...

  11. Repair and rehabilitation of extensor hallucis longus and brevis tendon lacerations in a professional dancer.

    Science.gov (United States)

    Bronner, Shaw; Ojofeitimi, Sheyi; Rose, Donald

    2008-06-01

    Case report. Tendon lacerations of the hallux are potentially devastating to a dancer. Strength of the hallux musculature is necessary to attain and maintain balance, push-off in multiple turns, and decelerate in jumps and hops. The purpose of this paper is to report on the repair and rehabilitation of extensor hallucis longus and extensor hallucis brevis tendon lacerations in a professional dancer. A 30-year-old dancer sustained complete laceration of her extensor hallucis longus and extensor hallucis brevis tendons, and partial laceration of the dorsal aspect of the hallux metatarsophalangeal (MTP) joint capsule. Following primary repair, at 9 weeks postsurgery, hallux MTP joint active dorsiflexion was limited to 5 degrees and passive dorsiflexion to 70 degrees . First toe dorsiflexion and plantar flexion strength was 4/5 at the MTP and 3+/5 at the interphalangeal joint. Rehabilitation included functional electrical stimulation to address considerable calf atrophy, strengthening exercises, functional retraining, and progressive return to dance. The dancer returned to her previous level of dancing in 18 weeks, with 73 degrees and 85 degrees of hallux MTP joint active and passive dorsiflexion, and 30 degrees and 35 degrees of active and passive plantar flexion, respectively. Hallux MTP and interphalangeal joint muscle strength were 5/5 and 4+/5, respectively. Improvement, manifested in her SF-36 and Dance Functional Outcome System scores, accompanied her full functional recovery. Hallux stability provided by coactivation of the great toe extensors and flexors is crucial to accomplish the demands of bipedal and unipedal balances and activities in dance. This report demonstrates the success of primary surgical repair and rehabilitation in a dancer/athlete experiencing this injury.

  12. Structural characterization of CFA/III and Longus type IVb pili from enterotoxigenic Escherichia coli.

    Science.gov (United States)

    Kolappan, Subramaniapillai; Roos, Justin; Yuen, Alex S W; Pierce, Owen M; Craig, Lisa

    2012-05-01

    The type IV pili are helical filaments found on many Gram-negative pathogenic bacteria, with multiple diverse roles in pathogenesis, including microcolony formation, adhesion, and twitching motility. Many pathogenic enterotoxigenic Escherichia coli (ETEC) isolates express one of two type IV pili belonging to the type IVb subclass: CFA/III or Longus. Here we show a direct correlation between CFA/III expression and ETEC aggregation, suggesting that these pili, like the Vibrio cholerae toxin-coregulated pili (TCP), mediate microcolony formation. We report a 1.26-Å resolution crystal structure of CofA, the major pilin subunit from CFA/III. CofA is very similar in structure to V. cholerae TcpA but possesses a 10-amino-acid insertion that replaces part of the α2-helix with an irregular loop containing a 3(10)-helix. Homology modeling suggests a very similar structure for the Longus LngA pilin. A model for the CFA/III pilus filament was generated using the TCP electron microscopy reconstruction as a template. The unique 3(10)-helix insert fits perfectly within the gap between CofA globular domains. This insert, together with differences in surface-exposed residues, produces a filament that is smoother and more negatively charged than TCP. To explore the specificity of the type IV pilus assembly apparatus, CofA was expressed heterologously in V. cholerae by replacing the tcpA gene with that of cofA within the tcp operon. Although CofA was synthesized and processed by V. cholerae, no CFA/III filaments were detected, suggesting that the components of the type IVb pilus assembly system are highly specific to their pilin substrates.

  13. Femoral anteversion influences vastus medialis and gluteus medius EMG amplitude: composite hip abductor EMG amplitude ratios during isometric combined hip abduction-external rotation.

    Science.gov (United States)

    Nyland, J; Kuzemchek, S; Parks, M; Caborn, D N M

    2004-04-01

    This prospective study evaluated differences in vastus medialis (VM) and gluteus medius (GM) EMG amplitude:composite hip abductor (gluteus maximus, gluteus medius, tensor fascia lata) EMG amplitude ratios among subjects with low or high relative femoral anteversion. Data were collected during the performance of a non-weight bearing, non-sagittal plane maximal volitional effort isometric combined hip abduction-external rotation maneuver. Eighteen nonimpaired athletically active females participated in this surface EMG study. Medial hip rotation (relative femoral anteversion estimate) was measured with a handheld goniometer. Subjects were grouped by medial hip rotation displacement (group 1 42 degrees =52.7+/-7 degrees ) for statistical analysis (Mann Whitney U-tests, p < 0.05). Group 2 had decreased VM (42+/-23% vs. 69+/-30%, U=19, p=0.034) and GM (62+/-25% vs. 96+/-39%, U=19, p=0.034) normalized mean peak EMG amplitude:composite mean peak hip abductor EMG amplitude ratios compared to group 1. Decreased normalized VM (-27%) and GM (-34%) EMG amplitudes among subjects with increased relative femoral anteversion suggest reduced dynamic frontal and transverse plane femoral control from these muscles, possibly contributing to the increased incidence of non-contact knee injury observed among athletic females.

  14. Assessment of isokinetic peak torque reliability of the hip flexor, extensor, adductors and abductors muscles in female soccer players from 14 to 25 years old.

    Science.gov (United States)

    Santos Andrade, Marilia; Mascarin, Naryana C; Benedito-Silva, Ana A; Carderelli Minozzo, Fabio; Vancini, Rodrigo L; Barbosa DE Lira, Claudio A

    2016-01-01

    The aim of this study was to evaluate test-retest reliability of concentric flexor, extensor, abductor and adductor muscular isokinetic hip torques in female soccer players. Sixteen highly-trained female soccer players were evaluated. Isokinetic dynamometer assessment was performed at 30°/s and 150°/s concentrically. The muscles tested were hip flexor (Fl), extensor (Ext), adductor (Add) and abductor (Abd). The reproducibility of the measured peak torque (PT) was analyzed by using the intraclass correlation coefficient (ICC). The difference in PT between the first and second tests was tested using Student's t-test. The ICC for the observed PT values revealed moderate to high reproducibility (ranging from 0.55 to 0.76) for the hip Fl and Ext measurements at 150º/s and for Add and Abd measurements at 30 and 150º/s. For the hip Fl and Ext measurements at 30º/s the ICC was poor. The isokinetic assessment of the concentric PT values generated by the hip Fl and Ext and Add and Abd is moderate to highly reproducible, when assessed at the highest test velocity (150º/s). The test-retest reliability of hip isokinetic strength measures seems to be affected by the type muscle and test velocity.

  15. MRI features in de Quervain`s tenosynovitis of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Glajchen, N. [Mount Sinai Hospital, New York, NY (United States). Dept. of Radiology; Schweitzer, M. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology

    1996-01-01

    De Quervain`s stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain`s synovitis was suggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain`s disease. De Quervain`s tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings. (orig.)

  16. MRI features in de Quervain's tenosynovitis of the wrist

    International Nuclear Information System (INIS)

    Glajchen, N.; Schweitzer, M.

    1996-01-01

    De Quervain's stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain's synovitis was suggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain's disease. De Quervain's tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings. (orig.)

  17. Hip abductors and thigh muscles strength ratios and their relation to electromyography amplitude during split squat and walking lunge exercises

    Directory of Open Access Journals (Sweden)

    Petr Stastny

    2015-06-01

    Full Text Available Background: The hip abductors (HAB, quadriceps (Q and hamstrings (H reciprocal strength ratios are predictors of electromyography (EMG amplitude during load carrying walking at moderate intensity. Therefore, these strength ratios might predict also the EMG during the exercises as walking lunge (WL or split squat (SSq at submaximal intensity. Objective: To determine whether the EMG amplitude of vastus mediali (VM, vastus laterali (VL, biceps femoris (BF and gluteus medius (Gmed is associated with muscle strength ratio during SSqs and WLs. To determine whether the EMG amplitude differs between individuals with HAB/H ratio above and below one and between individuals with H/Q or HAB/Q ratio above and below 0.5 during SSqs and WLs. Methods: 17 resistance-trained men (age 29.6 ± 4.6 years with at least 3 years of strength training performed in cross-sectional design 5 s maximal voluntary isometric contractions (MVIC on an isokinetic dynamometer for knee extension, knee flexion, and hip abduction. The MVIC was used to normalize the EMG signal and estimate the individual strength ratios. Than participants performed WL and SSq for a 5 repetition maximum, to find out muscle activity at submaximal intensity of exercise. Results: The H/Q ratio was associated by Kendall's tau (τ with VM (τ = .33 and BF (τ = -.71 amplitude, HAB/Q ratio was associated with BF (τ = -.43 and Gmed (τ = .38 amplitude, as well as HAB/H was associated with VM (τ = -.41 and Gmed (τ = .74 amplitude. ANOVA results showed significant differences between SSq and WL (F(4, 79 = 10, p < .001, ηp2 = .34 in Gmed amplitude, where WL resulted in higher Gmed amplitude compared to SSq. Other significant differences were found between H/Q groups (F(4, 29 = 3, p = .04, ηp2 = .28 in VM and Gmed amplitude, where group with H/Q > 0.5 showed higher VMO amplitude and lower Gmed amplitude. Furthermore, significant difference was found

  18. The influence of passive stretch on the growth and protein turnover of the denervated extensor digitorum longus muscle

    Science.gov (United States)

    Goldspink, David F.

    1978-01-01

    At 7 days after cutting the sciatic nerve, the extensor digitorum longus muscle was smaller and contained less protein than its innervated control. Correlating with these changes was the finding of elevated rates of protein degradation (measured in vitro) in the denervated tissue. However, at this time, rates of protein synthesis (measured in vitro) and nucleic acid concentrations were also higher in the denervated tissue, changes more usually associated with an active muscle rather than a disused one. These anabolic trends have, at least in part, been explained by the possible greater exposure of the denervated extensor digitorum longus to passive stretch. When immobilized under a maintained influence of stretch the denervated muscle grew to a greater extent. Although this stretch-induced growth appeared to occur predominantly through a stimulation of protein synthesis, it was opposed by smaller increases in degradative rates. Nucleic acids increased at a similar rate to the increase in muscle mass when a continuous influence of stretch was imposed on the denervated tissue. In contrast, immobilization of the denervated extensor digitorum longus in a shortened unstretched state reversed most of the stretch-induced changes; that is, the muscle became even smaller, with protein synthesis decreasing to a greater extent than breakdown after the removal of passive stretch. The present investigation suggests that stretch will promote protein synthesis and hence growth of the extensor digitorum longus even in the absence of an intact nerve supply. However, some factor(s), in addition to passive stretch, must contribute to the anabolic trends in this denervated muscle. PMID:708412

  19. Recovery of muscle function after deep neuromuscular block by means of diaphragm ultrasonography and adductor of pollicis acceleromyography with comparison of neostigmine vs. sugammadex as reversal drugs: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Cappellini, Iacopo; Picciafuochi, Fabio; Ostento, Daniele; Danti, Ginevra; De Gaudio, Angelo Raffaele; Adembri, Chiara

    2018-02-21

    The extensive use of neuromuscular blocking agents (NMBAs) during surgical procedures still leads to potential residual paralyzing effects in the postoperative period. Indeed, neuromuscular monitoring in an intra-operative setting is strongly advocated. Acetylcholinesterase inhibitors can reverse muscle block, but their short half-life may lead to residual curarization in the ward, especially when intermediate or long-acting NMBAs have been administered. Sugammadex is the first selective reversal drug for steroidal NMBAs; it has been shown to give full and rapid recovery of muscle strength, thus minimizing the occurrence of residual curarization. Acceleromyography of the adductor pollicis is the gold standard for detecting residual curarization, but it cannot be carried out on conscious patients. Ultrasonography of diaphragm thickness may reveal residual effects of NMBAs in conscious patients. This prospective, double-blind, single-center randomized controlled study will enroll patients (of American Society of Anesthesiologists physical status I-II, aged 18-80 years) who will be scheduled to undergo deep neuromuscular block with rocuronium for ear, nose, or throat surgery. The study's primary objective will be to compare the effects of neostigmine and sugammadex on postoperative residual curarization using two different tools: diaphragm ultrasonography and acceleromyography of the adductor pollicis. Patients will be extubated when the train-of-four ratio is > 0.9. Diaphragm ultrasonography will be used to evaluate the thickening fraction, which is the difference between the end expiratory thickness and the end inspiratory thickness, normalized to the end expiratory thickness. Ultrasonography will be performed before the initiation of general anesthesia, before extubation, and 10 and 30 min after discharging patients from the operating room. The secondary objective will be to compare the incidence of postoperative complications due to residual neuromuscular

  20. PERONEUS LONGUS ACTIVITY IN DIFFERENT TYPES OF TAPING: ATHLETES WITH ANKLE INSTABILITY

    Directory of Open Access Journals (Sweden)

    Muhammad Rahmani Jaffar

    Full Text Available ABSTRACT Introduction: Participation in sport among university athletes in Malaysia has progressed right up to Olympic level. However, some of these athletes are prevented from competing due to injuries. Ankle injuries, in particular, are among the common types of injury. Even so, there is still lack of local data and research describing the incidence of ankle injuries. Objectives: To determine peroneus longus muscle activity in different taped ankles and positions among subjects with functional ankle instability (FAI. Methods: Twenty-three subjects with ankle instability (AJFAT score > 26 volunteered to take part in the study. The subjects were tested under three conditions; 1 no tape (NT, 2 Kinesio(r tape (KT, and 3 rigid tape (RT. The subjects completed two postural stability tests, followed by a sudden inversion perturbation test with EMG, recording throughout the procedures. The EMG data were analyzed, filtered, full-wave rectified and normalized. The data were analyzed by analysis of variance (Independent T-test and ANOVA to evaluate differences in peak muscle activation (mV and peroneal latency (ms. Results: Peak muscle activation of the peroneus was activated more in the RT group during both the Static and Dynamic Stability Tests. Apart from that, there were no statistically significant differences. During sudden inversion perturbation, the RT group was the one that was most activated (p=0.001. Peroneal latency was even delayed in KT and RT during the three tests, and shorter in the NT group. There were significant differences during the Dynamic Stability Test, between the NT and KT groups (p=0.001 and between the NT, RT and KT groups (p=0.001. Conclusion: RT tape may enhance the peroneus longus response by maintaining a higher level of muscle activation, especially during dynamic movements and sudden inversion of the ankle, and may selectively benefit individuals with FAI. The KT ankle did not show superior effect to the NT ankle, and

  1. Reconstruction of a Total Soft Palatal Defect Using a Folded Radial Forearm Free Flap and Palmaris Longus Tendon Sling

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    Myung Chul Lee

    2012-01-01

    Full Text Available BackgroundThe soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate.MethodsSix patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation.ResultsMean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%. The mean score of the speech acuity test was 5.84 (range, 5 to 6. These mean ratings represent a satisfactory level of speech function.ConclusionsThe large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.

  2. [The acquired flatfoot: mid-term results of the medial displacement calcaneal-osteotomy with flexor digitorum longus transfer].

    Science.gov (United States)

    Ivanic, G M; Hofstaetter, S G; Trnka, H J

    2006-01-01

    The present retrospective study investigates the mid-term results after medial displacement calcaneal osteotomy combined with flexor digitorum longus transfer for the treatment of acquired flatfoot deformity due to posterior tibial tendon insufficiency at stage II (Johnson and Strom Classification). 30 feet in 29 patients (6 male, 23 female) with an average age of 58 years (from 43 to 68 years) had surgery between 1995 and 2001. All feet were examined at an average follow-up of 58.5 months (range 35-97 months) and were evaluated with the American-Orthopaedic-Foot and Ankle Society (AOFAS) Hindfoot-Score. The average AOFAS-Score was 88.8+/-10.7 points (range 48 to 100) at final follow-up. The AOFAS-pain-subscale score was 34+/-6.2 points. At the latest follow-up were 14 feet (47%) painfree, 14 feet (47%) noted mild pain and 2 feet (6%) had daily pain. One foot (3%) had pain due to subluxation of the musculus flexor digitorum longus tendon, in another one pain was caused by a contract Chopart joint (3%). Further complications were painful prominent hardware (17%) and neuralgia of the sural nerve (7%). The authors conclude that the combination of the medial calcaneal displacement osteotomy with flexor digitorum longus transfer may provide optimal results in patients with adult acquired flatfoot deformity and posterior tibialis tendon dysfunction.

  3. The frondiform ligament and pseudotenosynovitis of the extensor digitorum longus tendon: MRI evaluation with cadaveric correlation

    International Nuclear Information System (INIS)

    Zember, Jonathan; Rosenberg, Zehava; Mba-Jones, Chimere; Bencardino, Jenny; Rossi, Ignacio

    2016-01-01

    Fluid along the frondiform ligament, the sinus tarsi stem of the inferior extensor retinaculum (IER), can approximate the extensor digitorum longus (EDL), at times simulating tenosynovitis. Our purpose, based on MRI and cadaveric studies, was to further evaluate this scantly described phenomenon, to identify associated findings and to alert the radiologists to the potential pitfall of over diagnosing EDL tenosynovitis. Two musculoskeletal radiologists retrospectively reviewed the radiology reports and MRI studies of 258 ankle MRI exams, performed at our institution, for fluid along the frondiform ligament extending toward the EDL. No patient had EDL pathology clinically. MRI was performed in two cadaveric ankles following injection of the sinus tarsi and EDL tendon sheath, under ultrasound guidance. Altogether, 31 MRIs demonstrated fluid extending from the sinus tarsi along the frondiform ligament toward the EDL. In 30 cases (97 %), the fluid partially surrounded the tendon, without tendon sheath distension. Based on the radiology reports, in 11 of the 31 cases (35 %), the fluid was misinterpreted as abnormal. Most common associated findings included ligamentous injury, posterior tibial tendon (PTT) tear, flat-foot, and osteoarthrosis. In the cadavers, fluid extended along the frondiform ligament toward the EDL after sinus tarsi injection; there was no communication between EDL tendon sheath and the sinus tarsi. Fluid within the sinus tarsi can extend along the frondiform ligament and partially surround the EDL, manifesting as pseudotenosynovitis. This phenomenon, often seen with ligamentous tears or PTT dysfunction, should not be misdiagnosed as true pathology of the EDL. (orig.)

  4. Origin attachments of the caudofemoralis longus muscle in the Jurassic dinosaur Allosaurus

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    Andrea Cau

    2017-06-01

    Full Text Available The caudofemoralis longus muscle (CFL is the primary limb retractor among non-avian sauropsids, and underwent a dramatic reduction along the dinosaur lineage leading to birds. The osteological correlates of the CFL among fossil reptiles have been controversial, because, contrary to traditional interpretations, the extent of the muscle is not necessarily related to the distribution of the caudal ribs. In some Cretaceous dinosaurs, the extent of the CFL has been inferred based on the preserved bony septa between the CFL and other tail muscles. Here, we describe a series of tail vertebrae of the Jurassic dinosaur Allosaurus, each showing a previously-unreported feature: a sulcus, formed by a regular pattern of tightly packed horizontal slits, that runs vertically along the lateral surfaces of the centra and neural arches. These sulci are interpreted as the origin attachment sites of the CFL, allowing for direct determination of the muscle extent along the tail of this dinosaur. Anteriorly to the 18th caudal vertebra, the sulcus runs along most of the centrum and neural arch, then it progressively reduces its vertical extent, and disappears between caudals 24 and 32, a pattern consistent with previous CFL reconstructions in other theropods.

  5. The effect of kinesio tape on neuromuscular activity of peroneus longus.

    Science.gov (United States)

    Juchler, Isabelle; Blasimann, Angela; Baur, Heiner; Radlinger, Lorenz

    2016-01-01

    Functional ankle instability is the result of sensorimotor or structural deficits. The commonly used kinesio tape (KT) is supposed to have a positive influence on sensorimotor functions. Eight women and two men (mean ± SD, age 24.4 ± 3.3 years) with functional ankle instability with recurrent ankle sprains ran downhill on a treadmill (3.3 m/s and a negative slope of 5°). The first trial was without KT, the second with KT on the peroneus longus (PL) muscle. Neuromuscular activity was measured using surface electromyography for 15 seconds. Sensation of giving way was assessed with a visual analog scale (VAS). Comparisons were made between measurements with and without KT using the Wilcoxon rank sum test. The level of significance was set at P ≤ 0.05. None of the chosen parameters for preactivation, reflex activation, or total activation showed statistically significant differences between the two trials (P > 0.05). The mean values for the sensation of giving way were lower with KT (VAS, median 1.2, range 0-2.8) than without (VAS, median 1.8, range 0-3.9), but did not reach statistical significance (P = 0.102) or clinical relevance. KT in participants with functional ankle instability (FAI) seems to have no effect on the neuromuscular activity of PL and sensation of giving way during downhill running.

  6. Effects of methylmercury on the motor and sensory innervation of the rat extensor digitorum longus muscle

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    Yip, R.K.; Riley, D.A.

    1987-06-01

    The histochemical study examined the effects of chronic methylmercury (MeHg) intoxication on the motor and sensory innervation of extensor digitorum longus muscles. Light microscopic examination of silver-stained axons in the intramuscular nerve bundles of MeHg-treated rats showed Wallerian-like degeneration and a reduction in the number of nerve fibers. Disrupted axons were predominantly sensory because 22.2% of spindle afferents (I/sub a/) and 90.0% of Golgi tendon organ (I/sub b/) sensory fibers were completely degenerated whereas less than 1% of motor ending were totally destroyed. Partial disruption occurred in the cholinesterase and motor terminals of 13.7% of endplates. Their results demonstrated greater vulnerability of sensory nerves than of motor nerves to MeHg-induced degeneration. Thus, the abnormal reflexes, ataxia, and muscle weakness following MeHg poisoning appear related to reduction of proprioceptive feedback from muscles and tendons irradiation to the documented lesions in the central nervous system.

  7. Heat stress attenuates skeletal muscle atrophy of extensor digitorum longus in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Nonaka, K; Une, S; Akiyama, J

    2015-09-01

    To investigate whether heat stress attenuates skeletal muscle atrophy of the extensor digitorum longus (EDL) muscle in streptozotocin-induced diabetic rats, 12-week-old male Wistar rats were randomly assigned to four groups (n = 6 per group): control (Con), heat stress (HS), diabetes mellitus (DM), and diabetes mellitus/heat stress (DM + HS). Diabetes was induced by intraperitoneal injection of streptozotocin (50 mg/kg). Heat stress was induced in the HS and DM + HS groups by immersion of the lower half of the body in hot water at 42 °C for 30 min; it was initiated 7 days after injection of streptozotocin, and was performed once a day, five times a week for 3 weeks. The muscle fiber cross-sectional area of EDL muscles from diabetic and non-diabetic rats was determined; heat stress protein (HSP) 72 and HSP25 expression levels were also analyzed by western blotting. Diabetes-induced muscle fiber atrophy was attenuated upon heat stress treatment in diabetic rats. HSP72 and HSP25 expression was upregulated in the DM + HS group compared with the DM group. Our findings suggest that heat stress attenuates atrophy of the EDL muscle by upregulating HSP72 and HSP25 expression.

  8. The frondiform ligament and pseudotenosynovitis of the extensor digitorum longus tendon: MRI evaluation with cadaveric correlation.

    Science.gov (United States)

    Zember, Jonathan; Rosenberg, Zehava; Rossi, Ignacio; Mba-Jones, Chimere; Bencardino, Jenny

    2016-08-01

    Fluid along the frondiform ligament, the sinus tarsi stem of the inferior extensor retinaculum (IER), can approximate the extensor digitorum longus (EDL), at times simulating tenosynovitis. Our purpose, based on MRI and cadaveric studies, was to further evaluate this scantly described phenomenon, to identify associated findings and to alert the radiologists to the potential pitfall of over diagnosing EDL tenosynovitis. Two musculoskeletal radiologists retrospectively reviewed the radiology reports and MRI studies of 258 ankle MRI exams, performed at our institution, for fluid along the frondiform ligament extending toward the EDL. No patient had EDL pathology clinically. MRI was performed in two cadaveric ankles following injection of the sinus tarsi and EDL tendon sheath, under ultrasound guidance. Altogether, 31 MRIs demonstrated fluid extending from the sinus tarsi along the frondiform ligament toward the EDL. In 30 cases (97 %), the fluid partially surrounded the tendon, without tendon sheath distension. Based on the radiology reports, in 11 of the 31 cases (35 %), the fluid was misinterpreted as abnormal. Most common associated findings included ligamentous injury, posterior tibial tendon (PTT) tear, flat-foot, and osteoarthrosis. In the cadavers, fluid extended along the frondiform ligament toward the EDL after sinus tarsi injection; there was no communication between EDL tendon sheath and the sinus tarsi. Fluid within the sinus tarsi can extend along the frondiform ligament and partially surround the EDL, manifesting as pseudotenosynovitis. This phenomenon, often seen with ligamentous tears or PTT dysfunction, should not be misdiagnosed as true pathology of the EDL.

  9. Truncated dystrophins reduce muscle stiffness in the extensor digitorum longus muscle of mdx mice.

    Science.gov (United States)

    Hakim, Chady H; Duan, Dongsheng

    2013-02-15

    Muscle stiffness is a major clinical feature in Duchenne muscular dystrophy (DMD). DMD is the most common lethal inherited muscle-wasting disease in boys, and it is caused by the lack of the dystrophin protein. We recently showed that the extensor digitorum longus (EDL) muscle of mdx mice (a DMD mouse model) exhibits disease-associated muscle stiffness. Truncated micro- and mini-dystrophins are the leading candidates for DMD gene therapy. Unfortunately, it has never been clear whether these truncated genes can mitigate muscle stiffness. To address this question, we examined the passive properties of the EDL muscle in transgenic mdx mice that expressed a representative mini- or micro-gene (ΔH2-R15, ΔR2-15/ΔR18-23/ΔC, or ΔR4-23/ΔC). The passive properties were measured at the ages of 6 and 20 mo and compared with those of age-matched wild-type and mdx mice. Despite significant truncation of the gene, surprisingly, the elastic and viscous properties were completely restored to the wild-type level in every transgenic strain we examined. Our results demonstrated for the first time that truncated dystrophin genes may effectively treat muscle stiffness in DMD.

  10. Properties of regenerated mouse extensor digitorum longus muscle following notexin injury.

    Science.gov (United States)

    Head, S I; Houweling, P J; Chan, S; Chen, G; Hardeman, E C

    2014-04-01

    Muscles of mdx mice are known to be more susceptible to contraction-induced damage than wild-type muscle. However, it is not clear whether this is because of dystrophin deficiency or because of the abnormal branching morphology of dystrophic muscle fibres. This distinction has an important bearing on our traditional understanding of the function of dystrophin as a mechanical stabilizer of the sarcolemma. In this study, we address the question: 'Does dystrophin-positive, regenerated muscle containing branched fibres also show an increased susceptibility to contraction-induced damage?' We produced a model of fibre branching by injecting dystrophin-positive extensor digitorum longus muscles with notexin. The regenerated muscle was examined at 21 days postinjection. Notexin-injected muscle contained 29% branched fibres and was not more susceptible to damage from mild eccentric contractions than contralateral saline-injected control muscle. Regenerated muscles also had greater mass, greater cross-sectional area and lower specific force than control muscles. We conclude that the number of branched fibres in this regenerated muscle is below the threshold needed to increase susceptibility to damage. However, it would serve as an ideal control for muscles of young mdx mice, allowing for clearer differentiation of the effects of dystrophin deficiency from the effects of fibre regeneration and morphology.

  11. Regeneration of muscle fibers in the extensor digitorum longus muscle of the aged rat.

    Science.gov (United States)

    Desaki, Junzo

    2008-04-01

    Regeneration of muscle fibers was observed in the extensor digitorum longus (EDL) muscle of aged (24 and 27 months) Wistar rats. The aged muscles consisted almost exclusively of medium-sized muscle fibers. In addition to degenerating and/or atrophied muscle fibers, very small muscle fibers <10 mum in diameter were observed in some muscle bundles which sporadically distributed in the muscle. In the degenerating muscle fibers, satellite cells mostly appeared to be normal, possibly surviving within the scaffold of basal lamina to form new (regenerating) muscle fibers. However, some of the satellite cells were degenerated and destroyed, suggesting the decrease in number of muscle fibers. On the other hand, very small muscle fibers existed between small and/or medium-sized muscle fibers or in the wide interstitial spaces between them solitarily or in small groups. In addition, immature muscle cells having a centrally located nucleus and sporadically distributed myofilaments were observed among the small and/or medium-sized muscle fibers and partially lacked a layer of basal lamina. These immature muscle cells were often closely apposed to fibroblasts with some slender cytoplasmic processes and/or to each other without an interposing basal lamina. These findings suggest that in addition to satellite cells within the basal lamina tubes, some of the regenerating muscle fibers in the aged EDL muscle may be originated from mesenchymal cells such as fibroblasts in the interstitial spaces.

  12. Intratendinous ganglion cyst of the extensor digitorum longus tendon: A case report.

    Science.gov (United States)

    Robinson, Cal; Kocialkowski, Cezary; Bhosale, Abhijit; Pillai, Anand

    2016-06-01

    Ganglion cysts are benign lesions, common in the hand and wrist. Intratendinous ganglion, however, are rare. We present the first reported case of an intratendinous ganglion cyst in an extensor digitorum longus (EDL) tendon of the foot. A 35-year old presented with a left-sided painful dorsolateral foot swelling. Ultrasound suggested a ganglion cyst in proximity to the EDL tendon of the 5th toe. Two distinct swellings were identified on surgical exploration, including a 6×1cm ganglion lying within the EDL tendon substance that had resulted in tendon splitting. The lesions were excised and EDL tendon repaired. Histological analysis confirmed that both lesions were ganglion cysts. Post-operative recovery was uneventful. Intratendinous ganglion cysts are rare lesions that pose a unique set of diagnostic and treatment challenges. Unlike conventional ganglion, their diagnosis may not be possible until surgical exploration. They have been reported to increase the risk of spontaneous tendon rupture. As such, a lower operative threshold should be applied to prevent their progression. A high index of suspicion should be applied to any ganglion reported radiologically to be in close contact with tendons. If diagnosed upon surgical exploration, it is essential that the operating surgeon is prepared to appropriately modify the procedure to involve primary tendon repair, tendon transfer or tenodesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Structural changes of microvessels in the extensor digitorum longus muscle of the aged rat.

    Science.gov (United States)

    Desaki, Junzo; Nishida, Naoya

    2007-08-01

    We examined the structural changes of microvessels (arterioles, capillaries, and venules) in the extensor digitorum longus muscle of the aged (27 months) rat. Muscle bundles in the aged muscle almost consisted of medium-sized muscle fibers which were peculiar in the aged EDL muscle. However, microvessels in and around these muscle bundles varied in shape. Degenerating capillaries and scaffolds of basal laminae remaining after necrosis of preexisting capillaries were frequently observed around these medium-sized muscle fibers. In addition, the vascular lumen was often very narrow or irregular slit-like. In terminal and precapillary arterioles, the endothelium and smooth muscle cells showed a constricted appearance and their vascular lumen was often irregular slit-like, probably playing an important role in intercepting the blood flow into the disrupted capillaries. Moreover, some venules had the slit-like vascular lumen, sawtooth-like endothelium and thick or multilayered basal laminae, and occasional erythrocytes were found outside the endothelium, probably indicating that these venules are in the course of regeneration. These findings suggest that in addition to the frequent destruction of capillaries, the structural changes of arterioles and venules may be involved in remodeling the microvasculature of the muscle bundles after maturation of regenerating muscle fibers.

  14. Different pattern of aquaporin-4 expression in extensor digitorum longus and soleus during early development.

    Science.gov (United States)

    Nicchia, Grazia P; Mola, Maria G; Pisoni, Michela; Frigeri, Antonio; Svelto, Maria

    2007-05-01

    Aquaporin-4 (AQP4) is the neuromuscular water channel expressed at the sarcolemma of mammalian fast-twitch fibers that mediates a high water transport rate, which is important during muscle activity. Clinical interest in the neuromuscular expression of AQP4 has increased as it is associated with the protein complex formed by dystrophin, the product of the gene affected in Duchenne muscular dystrophy. The expression of AQP4 during development has not been characterized. In this study, we analyzed the expression of AQP4 in extensor digitorum longus (EDL) and soleus, a fast- and slow-twitch muscle, respectively, during the first weeks after birth. The results show that AQP4 expression in both types of skeletal muscle occurs postnatally. The time course of expression of AQP4 in the two types of muscles was also different. Whereas the expression of AQP4 protein levels in the EDL showed a progressive increase during the first month after birth, reaching levels found in adults by day 24, the levels of the protein in the soleus showed a transient peak between day 12 and day 24 and declined thereafter, an effect that may be related to the transient high number of fast motor units innervating the soleus muscle during this time. The results suggest that AQP4 expression in skeletal muscle is under neuronal influence and contribute to the understanding of the molecular events of fiber differentiation during development.

  15. Passive mechanical properties of maturing extensor digitorum longus are not affected by lack of dystrophin.

    Science.gov (United States)

    Wolff, Andrew V; Niday, Ashley K; Voelker, Kevin A; Call, Jarrod A; Evans, Nicholas P; Granata, Kevin P; Grange, Robert W

    2006-09-01

    Mechanical weakness of skeletal muscle is thought to contribute to onset and early progression of Duchenne muscular dystrophy, but this has not been systematically assessed. The purpose of this study was to determine in mice: (1) whether the passive mechanical properties of maturing dystrophic (mdx) muscles were different from control; and (2) if different, the time during maturation when these properties change. Prior to and following the overt onset of the dystrophic process (14-35 days), control and dystrophic extensor digitorum longus (EDL) muscles were subjected to two passive stretch protocols in vitro (5% strain at instantaneous and 1.5 L(0)/s strain rates). Force profiles were fit to a viscoelastic muscle model to determine stiffness and damping. The mdx and control EDL muscles exhibited similar passive mechanical properties at each age, suggesting a functional threshold for dystrophic muscle below which damage may be minimized. Determining this threshold may have important clinical implications for treatments of muscular dystrophy involving physical activity.

  16. Aging impairs regulation of ryanodine receptors from extensor digitorum longus but not soleus muscles.

    Science.gov (United States)

    Gaboardi, Angela J; Kressler, Jochen; Snow, Teresa K; Balog, Edward M

    2018-01-09

    Because impaired excitation-contraction coupling and reduced sarcoplasmic reticulum (SR) Ca 2+ release may contribute to the age-associated decline in skeletal muscle strength, we investigated the effect of aging on regulation of the skeletal muscle isoform of the ryanodine receptor (RyR1) by physiological channel ligands. [ 3 H]Ryanodine binding to membranes from 8- and 26-month-old Fischer 344 extensor digitorum longus (EDL) and soleus muscles was used to investigate the effects of age on RyR1 modulation by Ca 2+ and calmodulin (CaM). Aging reduced maximal Ca 2+ -stimulated binding to EDL membranes. In 0.3 μM Ca 2+ , age reduced binding and CaM increased binding to EDL membranes. In 300 μM Ca 2+ , CaM reduced binding, but the age effect was not significant. Aging did not affect Ca 2+ or CaM regulation of soleus RyR1. In aged fast-twitch muscle, impaired RyR1 Ca 2+ regulation may contribute to lower SR Ca 2+ release and reduced muscle function. Muscle Nerve, 2018. © 2018 Wiley Periodicals, Inc.

  17. The innervation of extensor hallucis longus muscle: an anatomical study for selective neurotomy.

    Science.gov (United States)

    Vittoria, Nazzi; Giuseppe, Messina; Ivano, Dones; Giovanni, Broggi

    2009-10-01

    This study is aimed to describe the observable anatomical variants of the innervation of extensor hallucis longus muscle (EHLM) in order to have the surgical coordinates to perform neurotomy on the targeted branches of its innervation and to give a valuable alternative to the commonly used technique of fascicular subepineurial neurotomy in patients affected by toe hyperextension dystonia. In 15 fresh cadavers of adults, 29 lower limbs (14 right and 15 left) were studied. Anatomical dissections to isolate the innervating branches of EHLM were performed. Each branch from EHLM was analyzed by microscopical opening of the epineurium to observe the number of nerve fascicles. Various measurements were made to obtain anatomical coordinates for surgery. The distance between the most prominent point of the head of the fibula and the origin of the nervous branches innervating the EHLM is not proportional to the length of the leg. In 72.4% of the studied legs, the distance between the origin of the first branch innervating the EHLM and the origin of the deep peroneal nerve is 7 +/- 2 cm. In 80% of legs, the distance between the origin of the second branch and the origin of the deep peroneal nerve is 10 +/- 1.1 cm. In only one limb with double innervation, two fascicles were found, while in six limbs (25%) only one fascicle was found. This anatomical study traced some valuable surgical coordinates useful for the execution of a selective peripheral neurotomy on the nerve branch innervating the EHLM.

  18. Classification system for flexor digitorum accessorius longus muscle variants within the leg: clinical correlations.

    Science.gov (United States)

    Hur, Mi-Sun; Won, Hyung-Sun; Oh, Chang-Seok; Chung, In-Hyuk; Lee, Woo-Chun; Yoon, Young Cheol

    2014-10-01

    The flexor digitorum accessorius longus (FDAL), a variant leg muscle, can cause tarsal tunnel syndrome. This study was performed to classify the variants of the FDAL by dissection and to correlate the dissection results with clinical cases of tarsal tunnel syndrome caused by this muscle. Eighty lower limbs of embalmed Korean cadavers were dissected. MR images of two clinical cases of tarsal tunnel syndrome caused by the FDAL were correlated with the dissection results. The FDAL was observed in nine out of 80 specimens (11.3%) and it was classified into three types depending on its site of origin and its relationship to the posterior tibial neurovascular bundle (PTNV) in the leg. In Type I (6.3%), the FDAL originated in the leg and ran superficially along the PTNV, either not crossing (Type Ia, 3.8%) or crossing (Type Ib, 2.5%) the neurovascular bundle. In Type II (6.3%), it originated in the tarsal tunnel. Most FDALs followed a similar course in the tarsal tunnel and the plantar pedis. On correlating the MR images of the clinical cases with this classification, the FDAL corresponded to Types Ia and II. All three types of FDAL can compress the tibial nerve in the tarsal tunnel or the distal leg. Clarification of the topographical relationship between this muscle and the PTNV would help to improve the results of surgery for tarsal tunnel syndrome caused by the FDAL. © 2014 Wiley Periodicals, Inc.

  19. Assessment of the presence/absence of the palmaris longus muscle in different sports, and elite and non-elite sport populations.

    Science.gov (United States)

    Fowlie, Craig; Fuller, Colin; Pratten, Margaret K

    2012-06-01

    To investigate whether higher presence of the palmaris longus muscle is associated with sports that require hand grip. Cross-sectional study. Six hundred and forty-two medical students, members of sports clubs and national athletes. Participants were invited to complete a questionnaire that assessed their main sport, elite or non-elite level of participation, and level of activity. The presence of the palmaris longus was assessed visually using a standardised test. Presence of the palmaris longus, type of hand grip required for the sport and the level of participation. The presence of the palmaris longus was higher in elite athletes (21/22, 96%) than non-elite athletes (66/84, 79%; P=0.066) for sports that require a dominant-handed or two-handed cylindrical grip (18/22, 82% and 19/35, 54%, respectively; P=0.034). For both elite and non-elite athletes, the presence of the palmaris longus was higher in those participating in sustained grip sports (325/387, 84%) compared with sports that do not require a sustained grip (150/197, 76%; P=0.012). The palmaris longus may provide an advantage in certain types of sport that require hand grip, and for elite athletes participating in sports that require a dominant-handed or two-handed cylindrical hand grip. Orthopaedic specialists considering the use of the palmaris longus for a grafting procedure on an athlete should consider the level of participation and the type of hand grip required in the athlete's sport. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  20. Clinical outcomes and frontal plane two-dimensional biomechanics during the 30-second single leg stance test in patients before and after hip abductor tendon reconstructive surgery.

    Science.gov (United States)

    Huxtable, Rose E; Ackland, Timothy R; Janes, Gregory C; Ebert, Jay R

    2017-07-01

    Hip abductor tendon tears are a common cause of Greater Trochanteric Pain Syndrome. Conservative treatments are often ineffective and surgical reconstruction may be recommended. This study investigated the improvement in clinical outcomes and frontal plane two-dimensional biomechanics during a 30-second single leg stance test, in patients undergoing reconstruction. We hypothesized that clinical scores and pertinent biomechanical variables would significantly improve post-surgery, and these outcomes would be significantly correlated. Twenty-one patients with symptomatic tendon tears underwent reconstruction. Patients were evaluated pre-surgery, and at 6 and 12months post-surgery, using patient-reported outcome measures, assessment of hip abductor strength and six-minute walk capacity. Frontal plane, two-dimensional, biomechanical variables including pelvis-on-femur angle, pelvic drop, trunk lean and lateral pelvic shift, were evaluated throughout a 30-second single leg stance test. ANOVA evaluated outcomes over time, while Pearson's correlations investigated associations between clinical scores, pain, functional and biomechanical outcome variables. While clinical and functional measures significantly improved (P0.05) were observed in biomechanical variables from pre- to post-surgery. While five patients displayed a positive Trendelenburg sign pre-surgery, only one was positive post-surgery. Clinical outcomes and biomechanical variables during the single leg stance test were not correlated. Despite improvements in clinical and functional measures over time, biomechanical changes during a weight bearing single leg stance test were not significantly different following tendon repair. Follow up beyond 12months may be required, whereby symptomatic relief may precede functional and biomechanical improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Incidence of agenesis of palmaris longus in the Andhra population of India

    Directory of Open Access Journals (Sweden)

    K Devi Sankar

    2011-01-01

    Full Text Available Background : The knowledge of Palmaris longus (PL is a growing interest for its wide role in reconstructive plastic surgeries as a donor tendon for transfer or transplant. The prevalence of the PL agenesis has been well-documented by many authors in different ethnic groups or populations. Many conventional tests for determining the presence of the PL has been described, but lamentably there are many discrepancies in confirming its presence or absence. Slight modifications of the prevailing methods can still give authenticate results. Aim : This prospective study was conducted to determine the incidence of unilateral and bilateral agenesis of PL and its association with sex and side of the limb in the Andhra population of India. Materials and Methods : A total of 942 subjects of both sexes belonging to 18-23 years were used to access the PL using various tendon examination techniques including our modified Schaeffer′s test. The data collected were analyzed by Pearsons χ2 test using SPSS software. Results : Overall agenesis of muscle in both sexes was 264 (28.0%, out of which 40.2% was seen in females and 14.7% in males with the ratio of 3:1. The unilateral agenesis was seen in 70.5% and bilateral agenesis in 29.5% subjects. The left side agenesis was seen in 51.6% and right side in 48.4% subjects. Conclusions : The prevalence of bilateral and unilateral agenesis was more common on left side with a greater likelihood in the female subjects. The proposed technique could bring better results in all subjects and can be implemented in manual examination of PL.

  2. RNA-seq transcriptome analysis of extensor digitorum longus and soleus muscles in large white pigs.

    Science.gov (United States)

    Zhu, Jiayu; Shi, Xin'e; Lu, Hongzhao; Xia, Bo; Li, Yuefeng; Li, Xiao; Zhang, Qiangling; Yang, Gongshe

    2016-04-01

    Skeletal muscle fibers are mainly categorized into red and white fiber types, and the ratio of red/white fibers within muscle mass plays a crucial role in meat quality such as tenderness and flavor. To better understand the molecular difference between the two muscle fibers, this study takes advantage of RNA-seq to compare differences in the transcriptome between extensor digitorum longus (EDL; white fiber) and soleus (Sol; red fiber) muscles of large white pigs. In total, 89,658,562 and 46,723,568 raw reads from EDL and Sol were generated, respectively. Comparison between the two transcriptomes revealed 561 differentially expressed genes, with 408 displaying higher and 153 lower levels of expression in Sol. Quantitative real-time polymerase chain reaction validated the differential expression of nine genes. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis discovered several differentially enriched biological functions and processes of the two muscles. Moreover, transcriptome comparison between EDL and Sol identified many muscle-related genes (CSRP3, ACTN2, MYL1, and MYH6) and pathways related to myofiber formation, such as focal adhesion, tight junction formation, extracellular matrix (ECM)-receptor pathway, calcium signaling, and Wnt signaling. In addition, 58,362 and 58,359 single nucleotide polymorphisms were identified in EDL and Sol, respectively, and the sequence of 9069 genes was refined at the 5', 3' or both ends. Numerous novel transcripts and alternatively spliced RNAs were also identified. Our transcriptome analysis constitutes valuable sequence resource for uncovering important genes and pathways involved in muscle fiber type determination, and might help further our understanding of the molecular mechanisms in different types of muscle.

  3. Treadmill but not wheel running improves fatigue resistance of isolated extensor digitorum longus muscle in mice.

    Science.gov (United States)

    Jeneson, J A L; de Snoo, M W; Verlinden, N A T; Joosten, B J L J; Doornenbal, A; Schot, A; Everts, M E

    2007-06-01

    The present study is the first to compare the physiological impact of either forced treadmill or voluntary wheel running exercise on hindlimb muscle in mice. Male C57BL/6 mice were subjected to either 6 weeks of forced treadmill or voluntary wheel running exercise. Mice in the treadmill running exercise group (TRE; n = 8) ran 1.9 km day(-1) at a speed of 16 m min(-1) against an uphill incline of 11 degrees. In the running wheel exercise group (RWE; n = 8) animals ran 8.8 +/- 0.2 km per day (average speed 42 +/- 2 m min(-1)). After the experimental period, animals were killed and mechanical performance and oxygen consumption of isolated extensor digitorum longus (EDL) muscle were determined during serial electrical stimulation at 0.5, 1 and 2 Hz. Steady-state half-width time (HWT) of twitch contraction at 0.5 Hz was significantly shorter in TRE and RWE than controls (CON) (41.3 +/- 0.2, 41.3 +/- 0.1 and 44.3 +/- 0.1 s respectively; P < 0.05). The rate of fatigue development and HWT lengthening at 2 Hz was the same in RWE and CON but lower in TRE (1.2-fold and twofold respectively; P < 0.05). EDL oxygen consumption, mitochondrial content and myosin heavy chain (MyHC) composition were not different between the groups. These results indicate that both exercise modalities have an effect on a hindlimb fast-twitch muscle in mice, with the greatest impact seen with forced treadmill running.

  4. Capsaicin delays regeneration of the neuromuscular junction of rat extensor digitorum longus muscle after ischemia.

    Science.gov (United States)

    Turchányi, Béla; Hamar, János; Tömböl, Teréz; Siklós, László

    2006-04-01

    Trauma or the tourniquet used in orthopedic surgery is often associated with ischemia-reperfusion (I/R) injury with a consequent decrease of muscle power. To explore whether components of the neuromuscular junction (NMJ) are involved in this muscle dysfunction, NMJs were ultrastructurally characterized in the extensor digitorum longus muscle of rats at reperfusion times of 1, 24, 72, and 168 h after a 120-min arterial occlusion. Disorganization of the presynaptic membrane and mitochondrial injury was noted at 1 h, followed by fragmentation and partial engulfment of nerve terminals by Schwann cells at 24 and 72 h. The magnitude of degenerative changes declined at 168 h, suggesting the commencement of regeneration. The postsynaptic membrane remained intact throughout the whole period. In our previous study, deafferentation with pretreatment of the sciatic nerve with capsaicin, which reduces neurogenic inflammation and has a selective effect on nociceptive fibers, improved functional recovery of the muscle after I/R. The present results document a significantly delayed structural regeneration of the motor nerve terminals after combined capsaicin and I/R treatment. Since capsaicin treatment alone had no discernible effect on the structure of NMJs, the findings point to a possibly indirect effect of capsaicin on the motor nerves, which may predispose them to increased susceptibility unmasked only by a subsequent injury. The mismatch between the enhanced functional improvement of the muscle and delayed regeneration of the nerve after capsaicin pretreatment questions the efficient use of such deafferentation to protect the integrity of neuromuscular junctions in I/R injury.

  5. A hind limb disuse model inducing extensor digitorum longus atrophy in rats: tail suspension-immobilization.

    Science.gov (United States)

    Du, Fangying; Wang, Jun; Gao, Yunfang; Wang, Huiping; Wang, Qi; Jiang, Shanfeng; Goswami, Nandu

    2011-07-01

    This study aimed to examine the effects of a new hind limb disuse model on the morphology and fiber type distribution of the extensor digitorum longus (EDL) of rats. Quicker onset of disuse atrophy would reduce the amount of time the animals have to be subjected to tail suspension. The new hind limb disuse mode was achieved by tail suspension (TS) and one hind limb fixed by plaster-casting (tail suspension-immobilization, TS+Im). There were 42 female Sprague-Dawley rats randomly divided into 7 groups (6 rats in each group) and exposed to the conditions for 0-6 wk, respectively. The cross-sectional area (CSA) and the types of muscle fiber of the rats' EDL were measured and classified by histochemical staining. The decrease of EDL's CSA caused by TS+Im was more obvious (significant change was observed after 4 wk and Type I fiber's CSA decreased 27.3% after 6 wk) than that caused by TS only (significant change occurred after 6 wk and Type I fiber's CSA diminished 18.01% at that time). TS lead to the transition of Type IIB fibers to Type I and IIA fibers while TS+Im led to Type I and IIA fibers getting converted to Type IIB fibers. When compared to TS only, TS+Im caused faster and greater reduction of the EDL's CSA in rats. TS+Im can also lead to a shift from oxidative to glycolytic metabolism of the EDL muscle fiber. Tail suspension-immobilization is a new hind limb disuse model for the EDL and may be more effective.

  6. Sphingosine 1-phosphate protects mouse extensor digitorum longus skeletal muscle during fatigue.

    Science.gov (United States)

    Danieli-Betto, Daniela; Germinario, Elena; Esposito, Alessandra; Megighian, Aram; Midrio, Menotti; Ravara, Barbara; Damiani, Ernesto; Libera, Luciano Dalla; Sabbadini, Roger A; Betto, Romeo

    2005-06-01

    Sphingomyelin derivatives exert various second messenger actions in numerous tissues. Sphingosine (SPH) and sphingosine 1-phosphate (S1P) are two major sphingomyelin derivatives present at high levels in blood. The aim of the present work was to investigate whether S1P and SPH exert relevant actions in mouse skeletal muscle contractility and fatigue. Exogenous S1P and SPH administration caused a significant reduction of tension decline during fatigue of extensor digitorum longus muscle. Final tension after the fatiguing protocol was 40% higher than in untreated muscle. Interestingly, N,N-dimethylsphingosine, an inhibitor of SPH kinase (SK), abolished the effect of supplemented SPH but not that of S1P, suggesting that SPH acts through its conversion to S1P. Moreover, SPH was not effective in Ca(2+)-free solutions, in agreement with the hypothesis that SPH action is dependent on its conversion to S1P by the Ca(2+)-requiring enzyme SK. In contrast to SPH, S1P produced its positive effects on fatigue in Ca(2+)-free conditions, indicating that S1P action does not require Ca(2+) entry and most likely is receptor mediated. The effects of S1P could be ascribed in part to its ability to prevent the reduction (-20 mV) of action potential amplitude caused by fatigue. In conclusion, these results indicate that extracellular S1P has protective effects during the development of muscle fatigue and that the extracellular conversion of SPH to S1P may represent a rheostat mechanism to protect skeletal muscle from possible cytotoxic actions of SPH.

  7. [Correction of flexible lesser toe deformity : Transfer of the flexor digitorum longus tendon].

    Science.gov (United States)

    Arbab, D; Frank, D; Bouillon, B; Lüring, C

    2017-07-04

    Realignment and pain relief of toes 2-5 by flexor-to-extensor tendon transfer of the flexor digitorum longus (FDL) muscle. As an isolated procedure in flexible proximal interphalangeal (PIP) joint flexion and/or flexible metatarsophalangeal (MTP) joint extension (hammer toe). In combination with a metatarsal osteotomy or PIP joint arthrodesis in case of flexible MTP joint extension. General medical contraindications to surgical interventions. Stiffness of the PIP or MTP joint. Plantar stab incision in the distal interphalangeal (DIP) flexion crease and tenotomy of the FDL tendon. More proximally transverse incision on the plantar aspect of the proximal phalanx and isolation of the FDL tendon. The tendon is split longitudinally along the raphe and the two limbs are transferred from plantar to the dorsal aspect of the proximal phalanx adjacent to the bone. The crossed limbs are sutured to each other under appropriate tension and corrected position of the toe. Postoperative dressings for 3 weeks in corrected position. Subsequently tape dressing in plantar position for 6-12 weeks. Full weight bearing. A total of 24 toes with flexible PIP and/or MTP joint deformity were treated with a FDL tendon transfer. In 14 toes an isolated procedure was performed, in 10 cases an additional metatarsal osteotomy. Patients with operative treatment of the first ray, revision or reoperation were excluded. Mean follow-up was 8.4 (4-14) months. After 6 weeks 22 toes (92%) showed physiological alignment of the PIP and MTP joint. At the last follow-up, 4 (16%) toes had recurrent or persistent extension deformity of the MTP joint. There were no infections, overcorrections, impaired wound healing or transversal malalignment.

  8. Pseudotear of the peroneus longus tendon on MRI, secondary to a fibrocartilaginous node

    International Nuclear Information System (INIS)

    Didolkar, Manjiri M.; Malone, Alfred L.; Nunley, James A.; Dodd, Leslie G.; Helms, Clyde A.

    2012-01-01

    The purpose of this study was to identify the presence of a fibrocartilaginous node within the distal peroneus longus tendon (PLT) just proximal to the cubital tunnel and correlate this with MRI signal characteristics of the distal PLT, which could result in a pseudotear appearance on MRI. We correlated imaging characteristics with pathologic specimens. Institutional review board approval was obtained. Retrospectively, 91 ankle MRIs utilizing a standard ankle protocol were reviewed by two musculoskeletal radiologists. Four cadaver ankles were imaged using a standard ankle MRI protocol and reviewed by the same radiologists. All the MRIs were examined for signal changes in the PLT. The cadaver ankles then underwent PLT dissection by an orthopaedic surgeon, and a pathologic review was undertaken by a pathologist with orthopaedic specialization, who looked for an os peroneum or proposed fibrocartilaginous node relating to the signal change found on the MRIs. In the 91 ankle MRI studies, the PLT demonstrated normal low and increased signals. On the fat-saturated T2-weighted sequence, 76 (83.5%) ankles demonstrated low signal and 15 (16.5%) demonstrated increased signal. Of the cadaver ankle MRIs, all four demonstrated increased signal within the PLT; three contained a fibrocartilaginous node and one contained an os peroneum in that same region. The MRI signal of the PLT can change with the presence of a fibrocartilaginous node, which may be due to the molecular and chemical content of the fibrocartilage. This node increases the MRI signal in the distal PLT and gives the appearance of a pseudotear. (orig.)

  9. [Oxidative stress in soleus and extensor digitorum longus (EDL) muscles of spontaneously hypertensive rats].

    Science.gov (United States)

    Hernández, Noelina; De Sanctis, Juan B; Losada, Mercedes; Torres, Sonia H; Sosa, Amparo; Rivas, Miriam

    2011-09-01

    Systemic diseases affect skeletal muscle, and inflammation and oxidative stress are some of the involved mechanisms. There is scarce information about the effects of essential hypertension on skeletal muscle. The soleus and extensor digitorum longus (EDL) muscles of spontaneously hypertensive rats (SHR) were studied compared to control Wistar Kyoto (WKY) rats. The levels of nitrite and nitrate in micromol/mg-protein; endothelial (eNOS), neuronal (nNOS), and inducible (iNOS) nitric oxide synthases, nitrotyrosine and tumour necrosis factor alpha (TNF-alpha) in ng/mg-protein were determined. Compared with controls, the SHR showed increased levels of nitrotyrosine (soleus 24.4 +/- 5.0 vs. 3.3 +/- 0.3, p<0.001; EDL 20.2 +/- 4.3 vs. 4.5 +/- 0.4, p<0.0037), iNOS (soleus 26.6 +/- 3.7 vs. 8.3 +/- 0.9; EDL 21.3 +/- 3.7 vs. 11.0 +/- 0.8, both p<0.0001) and TNF-alpha (soleus 2.2 +/- 0.5 vs. 0.6 +/- 0.1, p<0.05; EDL 1.9 +/- 0.2 vs. 0.6 +/- 0.1, p<0.02). A decrease of eNOS was found in soleus muscle (20.6 +/- 1.4 vs. 30.3 +/- 1.2, p<0.00001); of nNOS (soleus 16.8 +/- 1.4 vs. 20.7 +/- 1.8, p< 0.05; EDL 13.6 +/- 1.3 vs. 21.9 +/- 1.8, p<.005) and nitrite in EDL (5.8 +/- 0.3 vs. 7.1 +/- 0.5, p<0.026).There was a positive correlation between TNF-alpha vs. nitrotyrosine in soleus (r=0.798; p<0.031) and a tendency in EDL (r=0.739; p=0.059); iNOS vs. nitrotyrosine (soleus: r=0.908; p<0.0001; EDL: r=0.707; p<0.01), a tendency between TNF-alpha and iNOS (EDL: r=0.736; p<0.059); and a negative correlation between eNOS vs. nitrotyrosine in soleus muscle (r=-0.816; p<0.0012). In conclusion, in skeletal muscles of SHR an inflammatory process was found evidenced by the increase in TNF-alpha, nitrotyrosine and iNOS. The decreased levels of constitutive synthases, together with the higher level of iNOS, are indicative of endothelial dysfunction.

  10. Proximal phalanx and flexor digitorum longus tendon biomechanics in flexor to extensor tendon transfer.

    Science.gov (United States)

    DiPaolo, Zachary J; Ross, Matthew S; Laughlin, Richard T; Gould, Greg; Flower, Katie; Kiger, Lorrie; Markert, Ronald J

    2015-05-01

    The flexor to extensor transfer of the flexor digitorum longus (FDL) tendon has been a relatively common operative procedure for the treatment of a flexible hammer toe deformity and chronic metatarsophalangeal (MTP) joint dislocation. A possible complication of using the tunnel technique rather than the tendon splitting technique is iatrogenic fracture through the drilled tunnel site. The purpose of this investigation was to study the FDL tendon and proximal phalanx dimensions in the area of the transfer procedure in order to improve preoperative planning and minimize postoperative complications. Additionally, this study investigated the force necessary to create a fracture in a predrilled proximal phalanx and attempted to elucidate a relationship between that force and the percentage of bone remaining after the drilling process. The proximal phalanx and FDL tendon of the second, third, and fourth toes from both the right and the left foot of 14 fresh frozen cadavers were dissected, and the digit was amputated at the MTP joint. A total of 84 toes (42 right, 42 left) were obtained from 14 cadavers. The diameter of the FDL tendon was measured, and the circumference and volume were calculated. Fourteen proximal phalanges of either the right or the left foot were then drilled with a 3.5-mm drill, as is often done in a tendon transfer procedure. The 14 nondrilled bones from the contralateral foot were used as matched controls. Radiographs were then taken of the proximal phalanges, and the dimensions of the drill tunnel and remaining bone were calculated. These measurements were used to calculate the volume of the bone, the volume of the drill tunnel, and the percentage of bone remaining after the drilling process. The bones were then tested for load-to-failure using a biomechanical loading apparatus. The average bone and tendon diameter measurements showed a gradual decrease in size from the second to the fourth digits. The bone removed by drilling the tunnel accounted

  11. Flexor Hallucis Longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus

    Directory of Open Access Journals (Sweden)

    Buurke Jaap J

    2007-11-01

    Full Text Available Abstract Background To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints. Methods Thirty RA patients with painful feet were analysed, their feet were examined clinically for the presence of pes planus and range of motion (ROM, radiographs were scored looking for the presence of forefoot damage, and ultrasound examination was performed, examining the presence of tenosyovitis or rupture of the FHL at the level of the medial malleolus. The correlation between the presence or absence of the FHL and ROM, forefoot damage and pes planus was calculated. Results In 11/60(18% of the feet, a rupture of the FHL was found. This was associated with a limited motion of the MTP1-joint, measured on the JAM (χ2 = 10.4, p = 0.034, a higher prevalence of pes planus (χ2 = 5.77, p = 0.016 and a higher prevalence of erosions proximal at the MTP-1 joint (χ2 = 12.3, p = 0.016, and joint space narrowing of the MTP1 joint (χ2 = 12.7, p = 0.013. Conclusion Rupture of the flexor hallucis longus tendon in RA-patients is associated with limited range of hallux motion, more erosions and joint space narrowing of the MTP-1-joint, as well as with pes planus.

  12. The Variation in the Absence of the Palmaris Longus in a Multiethnic Population of the United States: An Epidemiological Study

    Directory of Open Access Journals (Sweden)

    Ali M. Soltani

    2012-01-01

    Full Text Available The absence of the palmaris longus (PL has been shown to vary based on body side, gender, and ethnicity. In prior studies, homogenous ethnic populations have been shown to have differences in rates of absence. However, no study thus far has analyzed the differences in palmaris longus prevalence in a multiethnic population. We prospectively collected data on 516 patients visiting the outpatient hand clinics at LAC+USC Medical Center and Keck Medical Center. Analysis of the data was then performed for variables including ethnicity, laterality, and gender. There were no differences in the absence of the PL based on laterality or gender. Ethnically, there was no difference between white (non-Hispanic and white (Hispanic patients, with prevalence of 14.9% and 13.1%, respectively. However, African American (4.5% and Asian (2.9% patients had significantly fewer absences of the PL than the Caucasian, Hispanic reference group ( and , resp.. African Americans and Asians have a decreased prevalence of an absent PL. The Caucasian population has a relatively greater prevalence of an absence of the PL. This epidemiological study demonstrates the anatomic variation in this tendon and may be taken into account when planning an operation using tendon grafts.

  13. The relation between maximal voluntary force in m. palmaris longus and the temporal and spatial summation of muscle fiber recruitment in human subjects

    DEFF Research Database (Denmark)

    Claudel, Cécyl G.; Ahmed, Waqas; Elbrønd, Vibeke S.

    2018-01-01

    This study aimed at looking at the frequency (T-score) and the amplitude (S-score) of fiber use during contraction of a forearm muscle, m. palmaris longus, as measured by acoustic myography (AMG). An additional aim was to relate the T- and S-scores to the recorded force obtained from a hand...

  14. Myofascial force transmission is increasingly important at lower forces: firing frequency-related length-force characteristics of rat extensor digitorum longus

    NARCIS (Netherlands)

    Meijer, H.J.M.; Baan, G.C.; Huijing, P.A.J.B.M.

    2006-01-01

    Aim: Effects of submaximal stimulation frequencies on myofascial force transmission were investigated for rat anterior crural muscles with all motor units activated. Methods: Tibialis anterior and extensor hallucis longus (TAEHL) muscles were kept at constant muscle-tendon complex length, but

  15. Myofascial force transmission in dynamic muscle conditions: effects of dynamic shortening of a single head of multi-tendoned rat extensor digitorum longus muscle

    NARCIS (Netherlands)

    Maas, H.; Huijing, P.A.J.B.M.

    2005-01-01

    This study investigated the effects of myofascial force transmission during dynamic shortening of head III of rat extensor digitorum longus muscle (EDL III). The anterior crural compartment was left intact. Force was measured simultaneously at the distal EDL III tendon, the proximal EDL tendon and

  16. De Qeurvian Tenosynovitis: Clinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

    Directory of Open Access Journals (Sweden)

    Arefah Dehghani Tafti

    2011-03-01

    Full Text Available AbstractObjectives: De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease.Methods: This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes.Results: During a three month follow-up, a significant difference was shown between the two methods (p=0.03. Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars, but there were 13 postoperative complaints with transverse incision.Conclusion: According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision.

  17. Regional variation in the mechanical properties and fibre-type composition of the rat extensor digitorum longus muscle.

    Science.gov (United States)

    Kissane, Roger W P; Egginton, Stuart; Askew, Graham N

    2018-01-01

    What is the central question of this study? Mammalian muscle is typically heterogeneous in fibre-type distribution, with distinct regional variation in composition. The effects this might have on mechanical performance are largely unknown. What is the main finding and its importance? Contractile properties vary regionally within a heterogeneous muscle. The mixed extensor digitorum longus muscle has phenotypically distinct compartments that differ in their isometric twitch kinetics, the optimal cycle frequency for maximal power generation and fatigue resistance. The mechanisms underpinning the decline in performance during fatigue differ between compartments. Regional variation in mechanical performance suggests that regions of the extensor digitorum longus muscle might be differentially recruited during locomotion, depending upon functional demand. Fibre-type composition is heterogeneous, and distribution varies spatially in many muscles, indicating that there might be regional variation in recruitment and mechanical output. The rat extensor digitorum longus muscle is composed of predominantly fast-twitch fibres and exhibits a gradient in phenotype, resulting in oxidative medial (areal composition 24.3% type I/IIa) and glycolytic lateral (92.4% type IIx/IIb) compartments. Here, we investigated the variation in mechanical performance between the medial and lateral compartments during isometric, isotonic and cyclical contractions. Isometric tetanic stress and force-velocity relationships were similar in both compartments, but isometric twitch kinetics were slower in the medial compared with the lateral compartment. The medial compartment also had a lower optimal cycle frequency for maximal net power generation (11 versus 15 Hz; P < 0.05) attributable to slower isometric kinetics, resulting in a lower level of activation and reduced net work generation at higher cycle frequencies, compared with the lateral compartment. The more oxidative, medial compartment had

  18. Effect of thyroid hormones on acetylcholinesterase mRNA levels in the slow soleus and fast extensor digitorum longus muscles of the rat.

    Science.gov (United States)

    Pregelj, P; Crne-Finderle, N; Sketelj, J

    2003-01-01

    In the rat, the level of acetylcholinesterase messenger RNA in the typical slow soleus muscles is only about 20-30% of that in the fast extensor digitorum longus muscles. The expression of contractile proteins in muscles is influenced by thyroid hormones and hyperthyroidism makes the slow soleus muscle faster. The influence of thyroid hormones on the levels of acetylcholinesterase messenger RNA level in the slow soleus and fast extensor digitorum longus muscle of the rat was studied in order to examine the effect of thyroid hormones on muscle acetylcholinesterase expression. Hyperthyroidism was induced in rats by daily thyroid hormone injection or thyroid hormone releasing tablet implantation. Hind-limb suspension was applied to produce muscle unloading. Muscle denervation or reinnervation was achieved by sciatic nerve transection or crush. Acetylcholinesterase messenger RNA levels were analyzed by Northern blots and evaluated densitometrically. Hyperthyroidism increased the levels of acetylcholinesterase messenger RNA in the slow soleus muscles close to the levels in the fast extensor digitorum longus. The effect was the same in the unloaded soleus muscles. Acetylcholinesterase expression increased also in the absence of innervation (denervation), in the presence of changed nerve activation pattern (reinnervation), and under enhanced tonic neural activation of the soleus muscle (electrical stimulation). However, the changes were substantially smaller than those observed in the control soleus muscles. Enhancement of acetylcholinesterase expression in the soleus muscles by the thyroid hormones is, therefore, at last in part due to hormonal effect on the muscle itself. On the contrary, increased level of the thyroid hormones had no influence on acetylcholinesterase expression in the normal fast extensor digitorum longus muscles. However, some enhancing influence was apparent whenever the total number of nerve-induced muscle activations per day in the extensor

  19. Morphological and biochemical changes in soleus and extensor digitorum longus muscles of rats orbited in Spacelab 3

    Science.gov (United States)

    Riley, D. A.; Slocum, T.; Bain, J. L. W.; Sedlak, F. R.; Elis, S.; Satyanarayana, T.

    1985-01-01

    Muscle atrophy in rats exposed to hypogravity for seven days aboard Spacelab 3 is examined. Hindlimb muscles were harvested 12-16 days postflight, and prepared for enzyme studies and electron microscopy. Simple cell shrinkage was found, with a mean fiber area decrease of 35.8 percent for soleus and 24.9 percent for extensor digitorum longus (EDL) flight muscle fibers, as compared with control muscle fibers. EDL and soleus muscles showed increases in alkaline myofibrillar ATPase, alpha glycerophosphate dehydrogenase, and glycogen, and a decrease in NADH dehydrogenase staining. The 26 percent increase in calcium activated protease suggests that the focal degradation of myofibrils is the key process of myofibril breakdown. The presence in the flight soleus muscles of one percent necrotic fibers is unexplained. The observed shift towards histochemical fast-muscle type properties is consistent with previous findings.

  20. Electrical stimulation attenuates denervation and age-related atrophy in extensor digitorum longus muscles of old rats.

    Science.gov (United States)

    Dow, Douglas E; Dennis, Robert G; Faulkner, John A

    2005-04-01

    Skeletal muscles of old rats and elderly humans lose muscle mass and maximum force. Denervation is a major cause of age-related muscle atrophy and weakness, because denervated fibers do not contract, and undergo atrophy. At any age, surgical denervation causes even more dramatic muscle atrophy and loss in force than aging does. Electrical stimulation that generates tetanic contractions of denervated muscles reduces the denervation-induced declines. We investigated whether a stimulation protocol that maintains mass and force of denervated extensor digitorum longus muscles of adult rats would also maintain these properties in denervated muscles of old rats during a 2-month period of age-induced declines in these properties. Contractile activity generated by the electrical stimulation eliminated age-related losses in muscle mass and reduced the deficit in force by 50%. These data provide support for the hypothesis that during aging, lack of contractile activity in fibers contributes to muscle atrophy and weakness.

  1. Ischemia Increases the Twitch Latent Period in the Soleus and Extensor Carpi Radialis Longus Muscles from Adult Rats.

    Science.gov (United States)

    Morales, Camilo; Fierro, Leonardo

    2017-10-01

    Complete ischemia and reperfusion effects on twitch force (∫(F·t)), twitch latent period (TLP), maximal rate of rise of twitch tension (δF/δt) max , and twitch maximum relaxation rate (TMRR) were assessed. We divided 36 adult rats into four groups; two control groups (n = 9), a group undergoing 1 hour of ischemia followed by 1 hour of reperfusion (n = 9), and one group exposed to 2 hours of ischemia followed by 1 hour of reperfusion (n = 9). We have induced twitch contractions every 10 minutes in the soleus and the extensor carpi radialis longus (ECRL). Twitch contractions were recorded and then analyzed for ∫(F·t), TLP, (δF/δt) max , and TMRR. During 1 hour and 40 minutes of ischemia, TLP increased to 179 ± 24% (p values.

  2. Delayed rupture of the extensor hallucis longus and extensor digitorum communis tendons after breaching the anterior capsule with a radiofrequency probe during ankle arthroscopy: a case report.

    Science.gov (United States)

    Tuncer, Serdar; Aksu, Neslihan; Isiklar, Ugur

    2010-01-01

    A 40-year-old man with early arthritis, loose bodies, and anterolateral joint impingement symptoms in his left ankle, which was refractory to noninvasive therapeutic modalities for 1 year, underwent ankle arthroscopy and radiofrequency thermal ablation. The anterior capsule of the ankle joint was breached by the radiofrequency probe while the loose bodies were removed from the anterior recess, exposing the extensor tendons and resulting in a delayed spontaneous rupture of the extensor hallucis longus tendon and extensor tendons to the second and third toes. The extensor hallucis longus tendon was repaired with a semitendinosus tendon graft, and extensor digitorum tendons underwent primary repair. The patient regained full function and was symptom free 1 year after surgery. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Stenosing Tenosynovitis of the Flexor Hallucis Longus Tendon Associated with the Plantar Capsular Accessory Ossicle at the Interphalangeal Joint of the Great Toe

    Directory of Open Access Journals (Sweden)

    Song Ho Chang

    2017-01-01

    Full Text Available This report presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon associated with the plantar capsular accessory ossicle at the interphalangeal joint of the great toe, which was confirmed by intraoperative observation and was successfully treated with surgical resection of the ossicle. As the plantar capsular accessory ossicle was not visible radiographically due to the lack of ossification, ultrasonography was helpful for diagnosing this disorder.

  4. Avulsion Fractures at the Base of the 2nd Metacarpal Due to the Extensor Carpi Radialis Longus Tendon: A Case Report and Review of the Literature

    OpenAIRE

    Najefi, Ali; Jeyaseelan, Lucksmana; Patel, Anand; Kapoor, Akhil; Auplish, Sunil

    2016-01-01

    Introduction Simultaneous contraction of the extensor carpi radialis longus (ECRL) with forced hyperflexion of the wrist can result in avulsion of the tendon and its bony attachment at its insertion at the dorsum of the base of the second metacarpal. This is a rare and often unreported fracture pattern. Case Presentation We present a 31- year- old male who sustained a hyperflexion injury. He was managed surgically and had good pos...

  5. Successful return to play following adductor longus proximal tendon rupture in professional soccer without re-injury at 12 months: A case report.

    Science.gov (United States)

    Gözübüyük, Ömer B; Moen, Maarten H; Akman, Mehmet; Ipseftel, Ioakim; Karakuzu, Agah

    2017-09-08

    Treatment of total ruptures of adductor longus is challenging in professional sports. Time for return to pre-injury level as well as re-injury rates are of concern and surgical and conservative treatment approaches are debated; yet no consensus approach described for professional athletes. We present a case of a professional soccer player who experienced a rupture in his left adductor longus proximal tendon during a game and was treated conservatively. This case was followed-up during clinical assessment, imaging and strength testing until and after return to play. Primary outcome measure was the return to standard play condition at his pre-injury level without any functional deficits, measured by isokinetic testing. Second outcome measure was the recurrence. No recurrence was observed during the first year of follow-up. Total ruptures are very challenging for both the physician and the player to make a quick decision due to minimal or lack of pain. Functional outcomes are almost identical although operative treatments need longer time to return to play. This case report adds another example to the literature of a successful return to play after non-operative treatment of adductor longus rupture at elite level soccer.

  6. Changes in Systolic Blood Pressure during Isometric Contractions of Different Size Muscle Groups.

    Science.gov (United States)

    1979-05-01

    extensor carpi radialis, flexor digitorum sublimis, and the flexor digitorum profundus. There was no electromyograp ic evidence of activity from the...stabilizers of tais activity are the flexor digitorium I superficialis and profundus, extensor carpi radialis, opponens pollicis, flexor pollicis longus and...radialis) , wrist extensors ( extensor carpi ulnaris) , and the biceps and triceps during index finger adductior. and the biceps, triceps, anterior

  7. Anatomy and vascularization of the flexor hallucis longus muscle and its implication in free fibula flap transfer: an anatomical study.

    Science.gov (United States)

    Sassu, Paolo; Acland, Robert D; Salgado, Christopher John; Mardini, Samir; Ozyurekoglu, Tuna

    2010-02-01

    Contracture as well as weakness of the flexor hallucis longus (FHL) are possible complications following free fibula flap harvest. Possible causes have been related to fibrotic change of the muscle either due to devascularization or compartment-like syndrome after a tight wound closure. This study elucidates the vascularization and nerve supply of the FHL muscle after fibula flap harvest in a fresh cadaver model.A fibula bone flap was harvested through a lateral approach in 20 fresh limbs. The popliteal artery was isolated and injected with a silicone compound, the muscle isolated, and its neurovascular supply visualized.The distal third and fourth portion of the FHL muscle was always found to be located in a more compressed and deeper compartment. The peroneal artery was entirely filled by the silicone compound in 17 fresh cadaver limbs with at least one branch supplying the distal fourth of the FHL. The posterior tibialis artery was filled in all limbs and an average of 2 branches was found to supply the muscle. In all dissections, the nerve supplying the FHL originated from the tibialis nerve with an average of three branches perforating the muscle.Following fibula harvest, the FHL muscle will maintain vascular supply through the distal portion of the peroneal artery and the posterior tibialis artery. Nerve injury to the FHL muscle is unlikely during flap harvest.

  8. Alpha 7 integrin preserves the function of the extensor digitorum longus muscle in dystrophin-null mice.

    Science.gov (United States)

    Hakim, Chady H; Burkin, Dean J; Duan, Dongsheng

    2013-11-01

    The dystrophin-associated glycoprotein complex (DGC) and the α7β1-integrin complex are two independent protein complexes that link the extracellular matrix with the cytoskeleton in muscle cells. These associations stabilize the sarcolemma during force transmission. Loss of either one of these complexes leads to muscular dystrophy. Dystrophin is a major component of the DGC. Its absence results in Duchenne muscular dystrophy (DMD). Because α7-integrin overexpression has been shown to ameliorate muscle histopathology in mouse models of DMD, we hypothesize that the α7β1-integrin complex can help preserve muscle function. To test this hypothesis, we evaluated muscle force, elasticity, and the viscous property of the extensor digitorum longus muscle in 19-day-old normal BL6, dystrophin-null mdx4cv, α7-integrin-null, and dystrophin/α7-integrin double knockout mice. While nominal changes were found in single knockout mice, contractility and passive properties were significantly compromised in α7-integrin double knockout mice. Our results suggest that DGC and α7β1-integrin complexes may compensate each other to maintain normal skeletal muscle function. α7β1-Integrin upregulation may hold promise to treat not only histological, but also physiological, defects in DMD.

  9. Heat stress prevents the decrease in succinate dehydrogenase activity in the extensor digitorum longus of streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Nonaka, K; Une, S; Komatsu, M; Yamaji, R; Akiyama, J

    2018-03-16

    This study aimed to investigate whether heat stress (HS) prevents a decrease in succinate dehydrogenase (SDH) activity and heat shock protein 60 (HSP60) and superoxide dismutase 2 (SOD2) contents in the extensor digitorum longus of streptozotocin (STZ)-induced diabetic rats. Twelve-week-old male Wistar rats were assigned to one of the four groups (n=6/group): control (Con), HS, diabetes mellitus (DM), and diabetes mellitus and heat stress (DM+HS). Diabetes was induced by the administration of STZ (50 mg/kg). HS was initiated 7 days after STZ treatment and performed at 42 °C for 30 min 5 times a week for 3 weeks. SDH activity was decreased in the DM and DM+HS groups. However, SDH activity was greater in the DM+HS group than in the DM group. Although HSP60 content was lower in the DM group than in the Con group, it was maintained in the DM+HS groups and was higher than that in the DM group. SOD2 content was decreased only in the DM group. These findings suggest that HS prevents the decrease in SDH activity in the skeletal muscle induced by DM. According to this mechanism, the maintenance of SOD2 and HSP60 by HS may suppress the increase in oxidative stress.

  10. Effect of Age on Skeletal Muscle Proteolysis in Extensor Digitorum Longus Muscles of B6C3F1 Mice

    Science.gov (United States)

    Reynolds, Thomas H.; Krajewski, Katherine M.; Larkin, Lisa M.; Reid, Pamela; Halter, Jeffrey B.; Supiano, Mark A.; Dengel, Donald R.

    2009-01-01

    The purpose of this study was to determine if age-related muscle atrophy is associated with an increased rate of protein degradation in extensor digitorum longus (EDL) muscles from young (YG; 2–4 months), middle-aged (MA; 12–17 months), and aged (AG; 22–24 months) B6C3F1 mice. EDL muscles from AG mice weighed less than EDL muscles from MA mice (p = .01). EDL muscles from MA mice weighed more than EDL muscles from YG mice (p = .02). The rate of protein degradation, as assessed by tyrosine release during in vitro incubations, was higher in EDL muscles from AG mice than it was in those from MA mice (p = .03). The rate of protein degradation was higher in EDL muscles from YG mice than it was in those from MA mice (p = .04). An inverse relationship existed between muscle mass and protein degradation (r = −.67; p = .0001). We conclude that skeletal muscle protein degradation rates decrease with maturation and increase with advancing age. PMID:11983717

  11. Electron microscopic study of capillary network remodeling in the extensor digitorum longus muscle of normal adult rat.

    Science.gov (United States)

    Kitahara, Shuji; Desaki, Junzo; Yoshii, Asuka; Matsui, Aya; Morikawa, Shunichi; Ezaki, Taichi

    2016-12-01

    Capillary networks demonstrate structural changes during maturation, aging, vascular disease, and cancer. Their morphological structure and function have an important influence on each other. Understanding the process of morphological vascular changes in the capillary network with advancing age may help overcome fatal vascular diseases. Aging-related structural changes of the capillary segments may accompany degeneration and regeneration of muscle fibers and serve to remodel the capillary network as a means of adapting to the changing environment. However, difficulty in obtaining human samples has hampered clarification of these microstructural changes. Herein, we examined serial ultrathin sections of capillary segments in the extensor digitorum longus muscle of normal mature (12 months old) rats in an attempt to analyze their structural changes. After bifurcation, a minimum of one capillary segment was filled with erythrocytes and was found to have fenestrations and plural endothelial disruptions, or pores, at the fenestrated portions. Some of the stagnated erythrocytes demonstrated extended protrusions, and their processes appeared to penetrate the basal lamina through the pores. These findings can also show that capillary segments are involved in partial remodeling of the capillary network. A better understanding of age-related structural changes of the capillary networks will help in fine-tuning novel vascular therapy for not only several fatal vascular diseases but also malignant tumors. © The Author 2016. Published by Oxford University Press on behalf of The Japanese Society of Microscopy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Comparative proteomic analysis of the aging soleus and extensor digitorum longus rat muscles using TMT labeling and mass spectrometry.

    Science.gov (United States)

    Chaves, Daniela F S; Carvalho, Paulo C; Lima, Diogo B; Nicastro, Humberto; Lorenzeti, Fábio M; Siqueira-Filho, Mário; Hirabara, Sandro M; Alves, Paulo H M; Moresco, James J; Yates, John R; Lancha, Antonio H

    2013-10-04

    Sarcopenia describes an age-related decline in skeletal muscle mass, strength, and function that ultimately impairs metabolism and leads to poor balance, frequent falling, limited mobility, and a reduction in quality of life. Here we investigate the pathogenesis of sarcopenia through a proteomic shotgun approach. In brief, we employed tandem mass tags to quantitate and compare the protein profiles obtained from young versus old rat slow-twitch type of muscle (soleus) and a fast-twitch type of muscle (extensor digitorum longus, EDL). Our results disclose 3452 and 1848 proteins identified from soleus and EDL muscles samples, of which 78 and 174 were found to be differentially expressed, respectively. In general, most of the proteins were structural related and involved in energy metabolism, oxidative stress, detoxification, or transport. Aging affected soleus and EDL muscles differently, and several proteins were regulated in opposite ways. For example, pyruvate kinase had its expression and activity different in both soleus and EDL muscles. We were able to verify with existing literature many of our differentially expressed proteins as candidate aging biomarkers and, most importantly, disclose several new candidate biomarkers such as the glioblastoma amplified sequence, zero β-globin, and prolargin.

  13. Inotropic effects of the K+ channel blocker 3,4-diaminopyridine: differential responses of rat soleus and extensor digitorum longus.

    Science.gov (United States)

    van Lunteren, Erik; Pollarine, Jennifer; Moyer, Michelle

    2006-12-01

    The K+ channel blocker 3,4-diaminopyrindine (DAP) increases diaphragm force, use of which could potentially improve muscle performance during functional neuromuscular stimulation. To determine the extent of hindlimb muscle force augmentation, and delineate whether DAP effects vary in muscles comprised of mainly slow versus fast fibers, rat soleus, extensor digitorum longus (EDL) and diaphragm muscle samples were studied in vitro. DAP increased force of all three muscles, but at high concentrations the force increases were transient and were followed by declines in force below baseline. The maximum DAP-induced twitch force increase was smaller for soleus (38 +/-7%) than both EDL (94+/-12%) (P < 0.05) and diaphragm (93+/-13%) (P < 0.01). During fatigue-inducing 20 Hz stimulation (tested at an intermediate DAP concentration), force of soleus muscle remained significantly elevated by DAP for the entire testing period, force of DAP-treated EDL muscle rapidly declined to values in untreated muscle, and force of DAP-treated diaphragm had an intermediate force-time profile. Muscles varied in extent to which isometric contractile kinetics were altered by DAP. Thus, the K+ channel blocker DAP improves contractile performance of limb muscles, but the profile of improvement is distinct between the soleus and EDL muscles.

  14. Low dose simvastatin induces compositional, structural and dynamic changes in rat skeletal extensor digitorum longus muscle tissue.

    Science.gov (United States)

    Simsek Ozek, Nihal; Sara, Yildirim; Onur, Rustu; Severcan, Feride

    2009-10-06

    Statins are commonly used drugs in the treatment of hypercholesterolaemia. There are many adverse effects of statins on skeletal muscle, but the underlying mechanisms remain unclear. In the present study, the effects of low dose (20 mg/kg) simvastatin, a lipophilic statin, on rat EDL muscle (extensor digitorum longus muscle) were investigated at the molecular level using FTIR (Fourier-transform infrared) spectroscopy. FTIR spectroscopy allows us rapid and sensitive determination of functional groups belonging to proteins, lipids, carbohydrates and nucleic acids simultaneously. The results revealed that simvastatin treatment induces a significant decrease in lipid, nucleic acid, protein and glycogen content. A significant increase in the lipid/protein and nucleic acid/protein ratios was also obtained with simvastatin treatment. Furthermore, an increase in lipid order and membrane fluidity was detected. A decrease in the bandwidth of the amide I band and shifting of the position of this band to higher frequency values in treated muscle indicates structural changes in proteins. Detailed secondary structure analysis of the amide I band revealed a significant increase in antiparallel and aggregated beta-sheet, random coil structure and a significant decrease in beta-sheet structure, which indicates protein denaturation.

  15. Properties of extensor digitorum longus muscle and skinned fibers from adult and aged male and female Actn3 knockout mice.

    Science.gov (United States)

    Chan, Stephen; Seto, Jane T; Houweling, Peter J; Yang, Nan; North, Kathryn N; Head, Stewart I

    2011-01-01

    Absence of α-actinin-3, encoded by the ACTN3 "speed gene," is associated with poorer sprinting performance in athletes and a slowing of relaxation in fast-twitch muscles of Actn3 knockout (KO) mice. Our first aim was to investigate, at the individual-fiber level, possible mechanisms for this slowed relaxation. Our second aim was to characterize the contractile properties of whole extensor digitorum longus (EDL) muscles from KO mice by age and gender. We examined caffeine-induced Ca(2+) release in mechanically skinned EDL fibers from KO mice, and measured isolated whole EDL contractile properties. The sarcoplasmic reticulum of KO muscle fibers loaded Ca(2+) more slowly than that of wild-types (WTs). Whole KO EDL muscles had longer twitch and tetanus relaxation times than WTs, and reduced mass and cross-sectional area. These effects occurred in both male and female mice, but they diminished with age. These changes in KO muscles and fibers help to explain the effects of α-actinin-3 deficiency observed in athletes. Copyright © 2010 Wiley Periodicals, Inc.

  16. Effects of chronic administration of clenbuterol on contractile properties and calcium homeostasis in rat extensor digitorum longus muscle.

    Science.gov (United States)

    Sirvent, Pascal; Douillard, Aymerick; Galbes, Olivier; Ramonatxo, Christelle; Py, Guillaume; Candau, Robin; Lacampagne, Alain

    2014-01-01

    Clenbuterol, a β2-agonist, induces skeletal muscle hypertrophy and a shift from slow-oxidative to fast-glycolytic muscle fiber type profile. However, the cellular mechanisms of the effects of chronic clenbuterol administration on skeletal muscle are not completely understood. As the intracellular Ca2+ concentration must be finely regulated in many cellular processes, the aim of this study was to investigate the effects of chronic clenbuterol treatment on force, fatigue, intracellular calcium (Ca2+) homeostasis and Ca2+-dependent proteolysis in fast-twitch skeletal muscles (the extensor digitorum longus, EDL, muscle), as they are more sensitive to clenbuterol-induced hypertrophy. Male Wistar rats were chronically treated with 4 mg.kg-1 clenbuterol or saline vehicle (controls) for 21 days. Confocal microscopy was used to evaluate sarcoplasmic reticulum Ca2+ load, Ca2+-transient amplitude and Ca2+ spark properties. EDL muscles from clenbuterol-treated animals displayed hypertrophy, a shift from slow to fast fiber type profile and increased absolute force, while the relative force remained unchanged and resistance to fatigue decreased compared to control muscles from rats treated with saline vehicle. Compared to control animals, clenbuterol treatment decreased Ca2+-transient amplitude, Ca2+ spark amplitude and frequency and the sarcoplasmic reticulum Ca2+ load was markedly reduced. Conversely, calpain activity was increased by clenbuterol chronic treatment. These results indicate that chronic treatment with clenbuterol impairs Ca2+ homeostasis and this could contribute to the remodeling and functional impairment of fast-twitch skeletal muscle.

  17. Novel muscle spindles containing muscle fibers devoid of sensory innervation in the extensor digitorum longus muscle of aged rats.

    Science.gov (United States)

    Desaki, Junzo; Nishida, Naoya

    2008-04-01

    We examined the structural features of muscle spindles at the equatorial and juxtaequatorial regions in the extensor digitorum longus muscle of adult (12 months) and aged (25 months) rats. In aged muscle spindles, the lamellated layers of the spindle capsule were a little increased in number compared to those in the adult ones. Two novel muscle spindles were observed in the aged muscle. In one muscle spindle, the spindle capsule contained four thin intrafusal muscle fibers invested by the inner capsule and two muscle fibers between the layers of the spindle capsule. Serial semithin sections revealed that the latter lacked the investment of the spindle capsule at the polar region. The other muscle spindle contained four intrafusal muscle fibers: two thin sensory-innervated muscle fibers invested by the inner capsule and two thick muscle fibers similar in structural features to neighboring extrafusal muscle fibers and lacking sensory innervation within the wide periaxial space. These findings suggest that two muscle fibers between the layers of the spindle capsule may be invested by the newly formed capsular cells during aging, while two thick fibers within the periaxial space may fail to receive the sensory innervation during the early development and follow the course of extrafusal fiber differentiation.

  18. Effects of chronic administration of clenbuterol on contractile properties and calcium homeostasis in rat extensor digitorum longus muscle.

    Directory of Open Access Journals (Sweden)

    Pascal Sirvent

    Full Text Available Clenbuterol, a β2-agonist, induces skeletal muscle hypertrophy and a shift from slow-oxidative to fast-glycolytic muscle fiber type profile. However, the cellular mechanisms of the effects of chronic clenbuterol administration on skeletal muscle are not completely understood. As the intracellular Ca2+ concentration must be finely regulated in many cellular processes, the aim of this study was to investigate the effects of chronic clenbuterol treatment on force, fatigue, intracellular calcium (Ca2+ homeostasis and Ca2+-dependent proteolysis in fast-twitch skeletal muscles (the extensor digitorum longus, EDL, muscle, as they are more sensitive to clenbuterol-induced hypertrophy. Male Wistar rats were chronically treated with 4 mg.kg-1 clenbuterol or saline vehicle (controls for 21 days. Confocal microscopy was used to evaluate sarcoplasmic reticulum Ca2+ load, Ca2+-transient amplitude and Ca2+ spark properties. EDL muscles from clenbuterol-treated animals displayed hypertrophy, a shift from slow to fast fiber type profile and increased absolute force, while the relative force remained unchanged and resistance to fatigue decreased compared to control muscles from rats treated with saline vehicle. Compared to control animals, clenbuterol treatment decreased Ca2+-transient amplitude, Ca2+ spark amplitude and frequency and the sarcoplasmic reticulum Ca2+ load was markedly reduced. Conversely, calpain activity was increased by clenbuterol chronic treatment. These results indicate that chronic treatment with clenbuterol impairs Ca2+ homeostasis and this could contribute to the remodeling and functional impairment of fast-twitch skeletal muscle.

  19. Age-related dystrophin-glycoprotein complex structure and function in the rat extensor digitorum longus and soleus muscle.

    Science.gov (United States)

    Rice, Kevin M; Preston, Deborah L; Neff, David; Norton, Michael; Blough, Eric R

    2006-11-01

    This study tested the hypothesis that age-related changes in the dystrophin-glycoprotein complex (DGC) may precede age-associated alterations in muscle morphology and function. Compared to those in adult (6 month) rats, extensor digitorum longus (EDL) and soleus muscle mass was decreased in old (30 month) and very old (36 month) Fischer 344/NNiaHSD x Brown Norway/BiNia rats. The amount of dystrophin, beta-dystroglycan, and alpha-sarcoglycan increased with aging in the EDL and decreased with aging in the soleus. alpha-Dystroglycan levels were increased with aging in both muscles and displayed evidence of altered glycosylation. Immunostaining for the presence of antibody infiltration and dystrophin following increased muscle stretch suggested that the aging in the soleus was characterized by diminished membrane integrity. Together, these data suggest that aging is associated with alterations in EDL and soleus DGC protein content and localization. These results may implicate the DGC as playing a role in age-associated skeletal muscle remodeling.

  20. Repercusión de la variabilidad anatómica del primer compartimento extensor de la mano en la enfermedad de De Quervain The impact of anatomical variability of the first extensor compartment of the hand in the De Quervain's disease

    Directory of Open Access Journals (Sweden)

    F.J. López Mendoza

    2011-09-01

    Full Text Available En la enfermedad de De Quervain, la cirugía es la indicación estándar como procedimiento terapéutico y consiste en la liberación de los tendones abductor pollicis longus (APL y extensor pollicis brevis (EPB del primer compartimento de la mano. Está documentada la presencia de un septum dentro del compartimento entre los tendones del extensor corto y del abductor largo del pulgar. La importancia que tiene describir y hallar este subcompartimento radica en que la falta de conocimiento del mismo provoca el fallo en su liberación completa en los pacientes con enfermedad de De Quervain, por lo que los síntomas pueden persistir en el postoperatorio inmediato y tardío. El objetivo de este trabajo es determinar la presencia de un subcompartimento en el primer compartimento extensor de la mano en la población mexicana. Realizamos en el Hospital General Dr. Manuel Gea González de México DF un total de 32 liberaciones del primer compartimento extensor en 30 pacientes, todas secundarias a enfermedad de De Quervain con seguimiento promedio postoperatorio de 7,5 meses. La presencia de este subcompartimento se encontró en 21 pacientes (65,6 % de los casos, conteniendo en el 100 % el tendón EPB. El APL presentó 3 fascículos en el 31,25 % de casos, 2 fascículos en el 53,12 % y 1 fascículo en el 15,6 %. El EPB presentó 2 fascículos en el 6,25 % de los casos y 1 fascículo en el 93,75 % del total. En el seguimiento, ningún paciente presentó recidiva de la enfermedad. Proponemos la falta de identificación de un subcompartimento en el primer compartimento extensor de la mano como la principal causa de recidiva de enfermedad de De Quervain en nuestro medio.Surgical release of the first compartment of the hand containing abductor pollicis longus tendon (APL and extensor pollicis brevis (EPB is the gold standard treatment for De Quervain's disease. It´s well known that a septum commonly exists between these two tendons. The importance of this

  1. Flexor digitorum accessorius longus muscle in resistant clubfoot patients: introduction of a new sign predicting its presence.

    Science.gov (United States)

    Shaheen, Samir; Mursal, Haitham; Rabih, Mohamed; Johari, Ashok

    2015-03-01

    Clubfoot, talipes equino varus (TEV), is a common congenital foot anomaly. Some cases are resistant to conservative treatment. Many causes of resistance have been reported, among these, the presence of anomalous muscles; however, the effect of the presence of anomalous muscles on the outcome of conservative management is not well studied. These aberrant muscles are discovered during the extensive surgical release as an abnormal finding. The aim of this work is to study the demographic characteristics of patients with resistant TEV that necessitated extensive soft tissue release at Sudan Clubfoot Clinic and to document the prevalence of flexor digitorum accessorius longus (FDAL) muscle in a large series of clubfoot patients treated by extensive surgery: posteromedial release. Also, we introduce a new observation as an indication by which the surgeon can predict the presence of FDAL. On the basis of an observation that there is a special posture of the big toe in extension in relation to other flexed toes associated with the presence of FDAL, records of patients of clubfoot treated by extensive surgery between 2007 and 2012 at the Sudan Clubfoot Project were reviewed. Demographic characteristics were studied. Only patients with idiopathic TEV were included. Resistant clubfeet necessitated extensive release in 261 patients, 197 males and 64 females. Their ages ranged between 1 day and 15 years at presentation. FDAL muscle was found in 48 patients (54 feet) out of 261 patients (411 feet, 13.14%). In 46 of the 48 patients (95.8%), the presence of the FDAL could be predicted by a sign. FDAL is prevalent in 13% of resistant TEV cases requiring extensive soft tissue release, and the surgeon can expect resistant clubfoot and predict the presence of the FDAL in over 95% before he operates by observing the Samir-Adam sign.

  2. Anoxia induces Ca2+ influx and loss of cell membrane integrity in rat extensor digitorum longus muscle.

    Science.gov (United States)

    Fredsted, Anne; Mikkelsen, Ulla Ramer; Gissel, Hanne; Clausen, Torben

    2005-09-01

    Anoxia can lead to skeletal muscle damage. In this study we have investigated whether an increased influx of Ca2+, which is known to cause damage during electrical stimulation, is a causative factor in anoxia-induced muscle damage. Isolated extensor digitorum longus (EDL) muscles from 4-week-old Wistar rats were mounted at resting length and were either resting or stimulated (30 min, 40 Hz, 10 s on, 30 s off) in the presence of standard oxygenation (95% O2, 5% CO2), anoxia (95% N2, 5% CO2) or varying degrees of reduced oxygenation. At varying extracellular Ca2+ concentrations ([Ca2+]o), 45Ca influx and total cellular Ca2+ content were measured and the release of lactic acid dehydrogenase (LDH) was determined as an indicator of cell membrane leakage. In resting muscles, incubated at 1.3 mM Ca2+, 15-75 min of exposure to anoxia increased 45Ca influx by 46-129% (P<0.001) and Ca2+ content by 20-50% (P<0.001). Mg2+ (11.2 mM) reduced the anoxia-induced increase in 45Ca influx by 43% (P<0.001). In muscles incubated at 20 and 5% O2, 45Ca influx was also stimulated (P<0.001). Increasing [Ca2+]o to 5 mM induced a progressive increase in both 45Ca uptake and LDH release in resting anoxic muscles. When electrical stimulation was applied during anoxia, Ca2+ content and LDH release increased markedly and showed a significant correlation (r2=0.55, P<0.001). In conclusion, anoxia or incubation at 20 or 5% O2 leads to an increased influx of 45Ca. This is associated with a loss of cell membrane integrity, possibly initiated by Ca2+. The loss of cell membrane integrity further increases Ca2+ influx, which may elicit a self-amplifying process of cell membrane leakage.

  3. Effects of β₂-agonists on force during and following anoxia in rat extensor digitorum longus muscle.

    Science.gov (United States)

    Fredsted, A; Gissel, H; Ortenblad, N; Clausen, T

    2012-06-01

    Electrical stimulation of isolated muscles may lead to membrane depolarization, gain of Na(+), loss of K(+) and fatigue. These effects can be counteracted with β(2)-agonists possibly via activation of the Na(+)-K(+) pumps. Anoxia induces loss of force; however, it is not known whether β(2)-agonists affect force and ion homeostasis in anoxic muscles. In the present study isolated rat extensor digitorum longus (EDL) muscles exposed to anoxia showed a considerable loss of force, which was markedly reduced by the β(2)-agonists salbutamol (10(-6) M) and terbutaline (10(-6) M). Intermittent stimulation (15-30 min) clearly increased loss of force during anoxia and reduced force recovery during reoxygenation. The β(2)-agonists salbutamol (10(-7)-10(-5) M) and salmeterol (10(-6) M) improved force development during anoxia (25%) and force recovery during reoxygenation (55-262%). The effects of salbutamol on force recovery were prevented by blocking the Na(+)-K(+) pumps with ouabain or by blocking glycolysis with 2-deoxyglucose. Dibutyryl cAMP (1 mM) or theophylline (1 mM) also improved force recovery remarkably. In anoxic muscles, salbutamol decreased intracellular Na(+) and increased (86)Rb uptake and K(+) content, indicating stimulation of the Na(+)-K(+) pumps. In fatigued muscles salbutamol induced recovery of excitability. Thus β(2)-agonists reduce the anoxia-induced loss of force, leading to partial force recovery. These data strongly suggest that this effect is mediated by cAMP stimulation of the Na(+)-K(+) pumps and that it is not related to recovery of energy status (PCr, ATP, lactate).

  4. Common phenotype of resting mouse extensor digitorum longus and soleus muscles: equal ATPase and glycolytic flux during transient anoxia.

    Science.gov (United States)

    Vinnakota, Kalyan C; Rusk, Joshua; Palmer, Lauren; Shankland, Eric; Kushmerick, Martin J

    2010-06-01

    Rates of ATPase and glycolysis are several times faster in actively contracting mouse extensor digitorum longus muscle (EDL) than soleus (SOL), but we find these rates are not distinguishable at rest. We used a transient anoxic perturbation of steady state energy balance to decrease phosphocreatine (PCr) reversibly and to measure the rates of ATPase and of lactate production without muscle activation or contraction. The rate of glycolytic ATP synthesis is less than the ATPase rate, accounting for the continual PCr decrease during anoxia in both muscles. We fitted a mathematical model validated with properties of enzymes and solutes measured in vitro and appropriate for the transient perturbation of these muscles to experimental data to test whether the model accounts for the results. Simulations showed equal rates of ATPase and lactate production in both muscles. ATPase controls glycolytic flux by feedback from its products. Adenylate kinase function is critical because a rise in [AMP] is necessary to activate glycogen phosphorylase. ATPase is the primary source of H+ production. The sum of contributions of the 13 reactions of the glycogenolytic and glycolytic network to total proton load is negligible. The stoichiometry of lactate and H+ production is near unity. These results identify a default state of energy metabolism for resting muscle in which there is no difference in the metabolic phenotype of EDL and SOL. Therefore, additional control mechanisms, involving higher ATPase flux and [Ca2+], must exist to explain the well-known difference in glycolytic rates in fast-twitch and slow-twitch muscles in actively contracting muscle.

  5. The histochemical profile of the rat extensor digitorum longus muscle differentiates after birth and dedifferentiates in senescence

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    M Lehnert

    2009-08-01

    Full Text Available Age dependent motor unit dedifferentiation is a key component of impaired muscle function in advanced age. Here, we tested the hypothesis that rat muscle histochemical profile during the lifespan of an individual has an age-specific pattern since comprehensive longitudinal studies of muscle differentiation after birth and dedifferentiation in advanced age are scarce. Our results show that extensor digitorum longus muscle (EDL is comprised only of two fiber types after birth, type slow-oxidative (SO and type SDH-intermediate (SDHINT, the latter being indicative for the presence of polyneuronal innervation. In contrast to the constantly growing crosssectional area of the muscle fibers, a dramatic decrease in SDH-INT proportion occurs between day 14 and 21 after birth resulting in a complete loss of fiber type SDH-INT at the age of 90 days (p<0.05. At the age of 270 days, the fiber type composition of rat EDL dedifferentiates as shown by the reappearance of the SDH-INT type with a further increase at the age of 540 days (p<0.05. These changes in histochemical fiber type spectra are brought about by fiber type conversion within the fast twich fibers. The findings of the present study provide further evidence that fiber type conversion is a basic mechanism leading to motor unit differentiation and dedifferentiation during ontogenesis. Fiber type conversion shows a distinct time specific pattern and is also characteristic for motor unit regeneration after peripheral nerve repair. Factors that influence fiber type conversion and thereby motor unit organization may provide a future therapeutic option to enhance the regenerative capacity of motor units.

  6. The histochemical profile of the rat extensor digitorum longus muscle differentiates after birth and dedifferentiates in senescence.

    Science.gov (United States)

    Lehnert, M; Laurer, H; Maier, B; Frank, J; Marzi, I; Steudel, W-I; Mautes, A

    2007-01-01

    Age dependent motor unit dedifferentiation is a key component of impaired muscle function in advanced age. Here, we tested the hypothesis that rat muscle histochemical profile during the lifespan of an individual has an age-specific pattern since comprehensive longitudinal studies of muscle differentiation after birth and dedifferentiation in advanced age are scarce. Our results show that extensor digitorum longus muscle (EDL) is comprised only of two fiber types after birth, type slow-oxidative (SO) and type SDH-intermediate (SDH-INT), the latter being indicative for the presence of polyneuronal innervation. In contrast to the constantly growing cross-sectional area of the muscle fibers, a dramatic decrease in SDH-INT proportion occurs between day 14 and 21 after birth resulting in a complete loss of fiber type SDH-INT at the age of 90 days (p<0.05). At the age of 270 days, the fiber type composition of rat EDL dedifferentiates as shown by the reappearance of the SDH-INT type with a further increase at the age of 540 days (p<0.05). These changes in histochemical fiber type spectra are brought about by fiber type conversion within the fast twich fibers. The findings of the present study provide further evidence that fiber type conversion is a basic mechanism leading to motor unit differentiation and dedifferentiation during ontogenesis. Fiber type conversion shows a distinct time specific pattern and is also characteristic for motor unit regeneration after peripheral nerve repair. Factors that influence fiber type conversion and thereby motor unit organization may provide a future therapeutic option to enhance the regenerative capacity of motor units.

  7. A further observation of the structural changes of microvessels in the extensor digitorum longus muscle of the aged rat.

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    Desaki, Junzo; Nishida, Naoya

    2007-12-01

    We further examined the structural changes of microvessels in the extensor digitorum longus muscle of the aged (18 months) rat. Muscle bundles in this aged muscle constantly consisted of numerous large muscle fibers 50-60 mum in diameter and a few small muscle fibers <30 mum in diameter. Neuromuscular junctions (NMJs) in large muscle fibers often showed degenerative figures, thus degenerating muscle fibers. On the other hand, NMJs in small muscle fibers were mainly characterized by sparse and short junctional folds, being possibly in the course of regeneration. In some muscle bundles, the extracellular matrix was a little widened. Microvascular networks from arterioles to venules via capillaries seemed to vary in structural features between muscle bundles. In addition to the normal microvascular network consisting of microvessels with a round or oval vascular lumen during their course, two different types of microvascular networks were found. One type was characterized by the constriction of arterioles, capillaries and venules, probably representing a degenerative process of the microvascular network. In fact, uneven and compressed scaffolds of basal laminae of capillaries were often observed around these constricted microvessels. The other type consisted of arterioles and capillaries with an irregular slit-like vascular lumen and venules with a round or oval vascular lumen, and these capillaries had thick or two-layered basal laminae, being probably in the course of remodeling of the microvascular network. From these findings, it is suggested that the constriction and/or contraction of microvessels by smooth muscle cells and pericytes may be involved in the degeneration and remodeling of the microvascular network in the muscle bundles following degeneration and regeneration of the muscle fibers.

  8. Guanidine affects differentially the twitch response of diaphragm, extensor digitorum longus and soleus nerve-muscle preparations of mice.

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    Ferrari, Rosana; Rodrigues-Simioni, Léa; da Cruz Höfling, Maria Alice

    2012-06-15

    Guanidine has been used with some success to treat myasthenia gravis and myasthenic syndrome because it increases acetylcholine release at nerve terminals through K⁺, Na⁺ and Ca²⁺ channels-involving mechanisms. Currently, guanidine derivatives have been proposed for treatment of several diseases. Studies aimed at providing new insights to the drug are relevant. Experimentally, guanidine (10 mM) induces on mouse phrenic nerve-diaphragm (PND) preparations neurotransmission facilitation followed by blockade and a greatest secondary facilitation after its removal from bath. Herein, we hypothesized that this peculiar triphasic response may differ in muscles with distinct twitch/metabolic characteristics. Morphological alterations and contractile response of PND, extensor digitorum longus (EDL) and soleus (SOL) preparations incubated with guanidine (10 mM) for 15, 30, 60 min were analyzed. Guanidine concentrations of 5 mM (for PND and EDL) and 1 mM (for EDL) were also tested. Guanidine triphasic effect was only observed on PND regardless the concentration. The morphological alterations in muscle tissue varied along time but did not impede the PND post-wash facilitation. Higher doses (20-25 mM) did not increase EDL or SOL neurotransmission. The data suggest a complex mechanism likely dependent on the metabolic/contractile muscle phenotype; muscle fiber types and density/type of ion channels, sarcoplasmic reticulum and mitochondria organization may have profound impact on the levels and isoform expression pattern of Ca²⁺ regulatory membrane proteins so reflecting regulation of calcium handling and contractile response in different types of muscle.

  9. Guanidine Affects Differentially the Twitch Response of Diaphragm, Extensor Digitorum Longus and Soleus Nerve-Muscle Preparations of Mice

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    Maria Alice da Cruz Höfling

    2012-06-01

    Full Text Available Guanidine has been used with some success to treat myasthenia gravis and myasthenic syndrome because it increases acetylcholine release at nerve terminals through K+, Na+ and Ca2+ channels-involving mechanisms. Currently, guanidine derivatives have been proposed for treatment of several diseases. Studies aimed at providing new insights to the drug are relevant. Experimentally, guanidine (10 mM induces on mouse phrenic nerve-diaphragm (PND preparations neurotransmission facilitation followed by blockade and a greatest secondary facilitation after its removal from bath. Herein, we hypothesized that this peculiar triphasic response may differ in muscles with distinct twitch/metabolic characteristics. Morphological alterations and contractile response of PND, extensor digitorum longus (EDL and soleus (SOL preparations incubated with guanidine (10 mM for 15, 30, 60 min were analyzed. Guanidine concentrations of 5 mM (for PND and EDL and 1 mM (for EDL were also tested. Guanidine triphasic effect was only observed on PND regardless the concentration. The morphological alterations in muscle tissue varied along time but did not impede the PND post-wash facilitation. Higher doses (20–25 mM did not increase EDL or SOL neurotransmission. The data suggest a complex mechanism likely dependent on the metabolic/contractile muscle phenotype; muscle fiber types and density/type of ion channels, sarcoplasmic reticulum and mitochondria organization may have profound impact on the levels and isoform expression pattern of Ca2+ regulatory membrane proteins so reflecting regulation of calcium handling and contractile response in different types of muscle.

  10. S1P3 receptor influences key physiological properties of fast-twitch extensor digitorum longus muscle.

    Science.gov (United States)

    Germinario, Elena; Bondì, Michela; Cencetti, Francesca; Donati, Chiara; Nocella, Marta; Colombini, Barbara; Betto, Romeo; Bruni, Paola; Bagni, Maria Angela; Danieli-Betto, Daniela

    2016-06-01

    To examine the role of sphingosine 1-phosphate (S1P) receptor 3 (S1P3) in modulating muscle properties, we utilized transgenic mice depleted of the receptor. Morphological analyses of extensor digitorum longus (EDL) muscle did not show evident differences between wild-type and S1P3-null mice. The body weight of 3-mo-old S1P3-null mice and the mean cross-sectional area of transgenic EDL muscle fibers were similar to those of wild-type. S1P3 deficiency enhanced the expression level of S1P1 and S1P2 receptors mRNA in S1P3-null EDL muscle. The contractile properties of S1P3-null EDL diverge from those of wild-type, largely more fatigable and less able to recover. The absence of S1P3 appears responsible for a lower availability of calcium during fatigue. S1P supplementation, expected to stimulate residual S1P receptors and signaling, reduced fatigue development of S1P3-null muscle. Moreover, in the absence of S1P3, denervated EDL atrophies less than wild-type. The analysis of atrophy-related proteins in S1P3-null EDL evidences high levels of the endogenous regulator of mitochondria biogenesis peroxisome proliferative-activated receptor-γ coactivator 1α (PGC-1α); preserving mitochondria could protect the muscle from disuse atrophy. In conclusion, the absence of S1P3 makes the muscle more sensitive to fatigue and slows down atrophy development after denervation, indicating that S1P3 is involved in the modulation of key physiological properties of the fast-twitch EDL muscle. Copyright © 2016 the American Physiological Society.

  11. Recombinant Uncarboxylated Osteocalcin Per Se Enhances Mouse Skeletal Muscle Glucose Uptake in both Extensor Digitorum Longus and Soleus Muscles.

    Science.gov (United States)

    Lin, Xuzhu; Parker, Lewan; Mclennan, Emma; Zhang, Xinmei; Hayes, Alan; McConell, Glenn; Brennan-Speranza, Tara C; Levinger, Itamar

    2017-01-01

    Emerging evidence suggests that undercarboxylated osteocalcin (ucOC) improves muscle glucose uptake in rodents. However, whether ucOC can directly increase glucose uptake in both glycolytic and oxidative muscles and the possible mechanisms of action still need further exploration. We tested the hypothesis that ucOC per se stimulates muscle glucose uptake via extracellular signal-regulated kinase (ERK), adenosine monophosphate-activated protein kinase (AMPK), and/or the mechanistic target of rapamycin complex 2 (mTORC2)-protein kinase B (AKT)-AKT substrate of 160 kDa (AS160) signaling cascade. Extensor digitorum longus (EDL) and soleus muscles from male C57BL/6 mice were isolated, divided into halves, and then incubated with ucOC with or without the pretreatment of ERK inhibitor U0126. ucOC increased muscle glucose uptake in both EDL and soleus. It also enhanced phosphorylation of ERK2 (Thr202/Tyr204) and AS160 (Thr642) in both muscle types and increased mTOR phosphorylation (Ser2481) in EDL only. ucOC had no significant effect on the phosphorylation of AMPKα (Thr172). The inhibition of ucOC-induced ERK phosphorylation had limited effect on ucOC-stimulated glucose uptake and AS160 phosphorylation in both muscle types, but appeared to inhibit the elevation in AKT phosphorylation only in EDL. Taken together, ucOC at the physiological range directly increased glucose uptake in both EDL and soleus muscles in mouse. The molecular mechanisms behind this ucOC effect on muscle glucose uptake seem to be muscle type-specific, involving enhanced phosphorylation of AS160 but limitedly modulated by ERK phosphorylation. Our study suggests that, since ucOC increases muscle glucose uptake without insulin, it could be considered as a potential agent to improve muscle glucose uptake in insulin resistant conditions.

  12. Recombinant Uncarboxylated Osteocalcin Per Se Enhances Mouse Skeletal Muscle Glucose Uptake in both Extensor Digitorum Longus and Soleus Muscles

    Directory of Open Access Journals (Sweden)

    Xuzhu Lin

    2017-11-01

    Full Text Available Emerging evidence suggests that undercarboxylated osteocalcin (ucOC improves muscle glucose uptake in rodents. However, whether ucOC can directly increase glucose uptake in both glycolytic and oxidative muscles and the possible mechanisms of action still need further exploration. We tested the hypothesis that ucOC per se stimulates muscle glucose uptake via extracellular signal-regulated kinase (ERK, adenosine monophosphate-activated protein kinase (AMPK, and/or the mechanistic target of rapamycin complex 2 (mTORC2-protein kinase B (AKT-AKT substrate of 160 kDa (AS160 signaling cascade. Extensor digitorum longus (EDL and soleus muscles from male C57BL/6 mice were isolated, divided into halves, and then incubated with ucOC with or without the pretreatment of ERK inhibitor U0126. ucOC increased muscle glucose uptake in both EDL and soleus. It also enhanced phosphorylation of ERK2 (Thr202/Tyr204 and AS160 (Thr642 in both muscle types and increased mTOR phosphorylation (Ser2481 in EDL only. ucOC had no significant effect on the phosphorylation of AMPKα (Thr172. The inhibition of ucOC-induced ERK phosphorylation had limited effect on ucOC-stimulated glucose uptake and AS160 phosphorylation in both muscle types, but appeared to inhibit the elevation in AKT phosphorylation only in EDL. Taken together, ucOC at the physiological range directly increased glucose uptake in both EDL and soleus muscles in mouse. The molecular mechanisms behind this ucOC effect on muscle glucose uptake seem to be muscle type-specific, involving enhanced phosphorylation of AS160 but limitedly modulated by ERK phosphorylation. Our study suggests that, since ucOC increases muscle glucose uptake without insulin, it could be considered as a potential agent to improve muscle glucose uptake in insulin resistant conditions.

  13. Telemetered electromyography of peroneus longus in Varecia variegata and Eulemur rubriventer: implications for the functional significance of a large peroneal process.

    Science.gov (United States)

    Boyer, Doug M; Patel, Biren A; Larson, Susan G; Stern, Jack T

    2007-08-01

    A foot specialized for grasping small branches with a divergent opposable hallux (hallucal grasping) represents a key adaptive complex characterizing almost all arboreal non-human euprimates. Evolution of such grasping extremities probably allowed members of a lineage leading to the common ancestor of modern primates to access resources available in a small-branch niche, including angiosperm products and insects. A better understanding of the mechanisms by which euprimates use their feet to grasp will help clarify the functional significance of morphological differences between the euprimate grasp complex and features representing specialized grasping in other distantly related groups (e.g., marsupials and carnivorans) and in closely related fossil taxa (e.g., plesiadapiforms). In particular, among specialized graspers euprimates are uniquely characterized by a large peroneal process on the base of the first metatarsal, but the functional significance of this trait is poorly understood. We tested the hypothesis that the large size of the peroneal process corresponds to the pull of the attaching peroneus longus muscle recruited to adduct the hallux during grasping. Using telemetered electromyography on three individuals of Varecia variegata and two of Eulemur rubriventer, we found that peroneus longus does not generally exhibit activity consistent with an important function in hallucal grasping. Instead, extrinsic digital flexor muscles and, sometimes, the intrinsic adductor hallucis are active in ways that indicate a function in grasping with the hallux. Peroneus longus helps evert the foot and resists its inversion. We conclude that the large peroneal tuberosity that characterizes the hallucal metatarsal of prosimian euprimates does not correlate to "powerful" grasping with a divergent hallux in general, and cannot specifically be strongly linked to vertical clinging and climbing on small-diameter supports. Thus, the functional significance of this hallmark

  14. Comparative proteomic profiling of soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscles from the mdx mouse model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Carberry, Steven; Brinkmeier, Heinrich; Zhang, Yaxin; Winkler, Claudia K; Ohlendieck, Kay

    2013-09-01

    Duchenne muscular dystrophy is due to genetic abnormalities in the dystrophin gene and represents one of the most frequent genetic childhood diseases. In the X-linked muscular dystrophy (mdx) mouse model of dystrophinopathy, different subtypes of skeletal muscles are affected to a varying degree albeit the same single base substitution within exon 23 of the dystrophin gene. Thus, to determine potential muscle subtype-specific differences in secondary alterations due to a deficiency in dystrophin, in this study, we carried out a comparative histological and proteomic survey of mdx muscles. We intentionally included the skeletal muscles that are often used for studying the pathomechanism of muscular dystrophy. Histological examinations revealed a significantly higher degree of central nucleation in the soleus and extensor digitorum longus muscles compared with the flexor digitorum brevis and interosseus muscles. Muscular hypertrophy of 20-25% was likewise only observed in the soleus and extensor digitorum longus muscles from mdx mice, but not in the flexor digitorum brevis and interosseus muscles. For proteomic analysis, muscle protein extracts were separated by fluorescence two-dimensional (2D) gel electrophoresis. Proteins with a significant change in their expression were identified by mass spectrometry. Proteomic profiling established an altered abundance of 24, 17, 19 and 5 protein species in the dystrophin-deficient soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscle, respectively. The key proteomic findings were verified by immunoblot analysis. The identified proteins are involved in the contraction-relaxation cycle, metabolite transport, muscle metabolism and the cellular stress response. Thus, histological and proteomic profiling of muscle subtypes from mdx mice indicated that distinct skeletal muscles are differentially affected by the loss of the membrane cytoskeletal protein, dystrophin. Varying degrees of perturbed protein

  15. Different sensitivity of miniature endplate currents of the rat extensor digitorum longus, soleus and diaphragm muscles to a novel acetylcholinesterase inhibitor C-547.

    Science.gov (United States)

    Petrov, K A; Kovyazina, L V; Zobov, V V; Bukharaeva, E A; Nikolsky, E E; Vyskocil, F

    2006-01-01

    A novel derivative of 6-methyluracil, C-547, increased the amplitude and prolonged the duration of miniature endplate currents (MEPCs) which is typical for acetylcholinesterase inhibition. In the soleus and extensor digitorum longus significant potentiation was detected at nanomolar concentrations. In contrast, in the diaphragm muscle, the increase in the amplitudes of the MEPCs and the decay time constant appeared only when the concentration of C-547 was elevated to 1 x 10(-7) M. Possible consequences for the exploitation of this drug, which can selectively inhibit AChE in particular synapses, are discussed.

  16. Isolated flexor muscles of the little toe in the feet of an individual with atrophied or lacking 4th head of the M. extensor digitorum brevis and lacking the 4th tendon of the M. extensor digitorum longus.

    Science.gov (United States)

    Claassen, Horst; Wree, Andreas

    2003-01-01

    While dissecting the body of a 75-year-old male we observed variations in the Mm. flexor digitorum brevis and longus of both feet. In the left foot, the 4th tendon of the M. flexor digitorum brevis was atrophied and the respective tendon of the M. flexor digitorum longus to the little toe was absent. In the right foot, the 4th tendons of both the Mm. flexor digitorum brevis and longus to the little toe were absent. The lacking deep flexor tendon to the little toe in the left foot was replaced by an isolated flexor muscle originating from the medial and lateral processes of the calcaneal tuberosity, which additionally had connections to the tendinous plate of the M. flexor digitorum longus and the M. quadratus plantae. The absent superficial and deep flexor tendons to the little toe in the right foot were replaced by an isolated flexor muscle arising from the M. quadratus plantae distal from the medial process of the calcaneal tuberosity. The tendon of both isolated flexor muscles inserted in the distal phalanx of the little toe. The left isolated flexor muscle for the little toe had connections to the M. flexor digitorum longus and the M. quadratus plantae. From these results it seems likely that the M. quadratus plantae could be regarded as additional flexor head (caput breve or plantare) of the M. flexor digitorum longus as is described in classic textbooks. In the individual's lifetime the described variation perhaps led to the possibility of an isolated flexion of the little toe.

  17. Evaluation of muscle function of the extensor digitorum longus muscle ex vivo and tibialis anterior muscle in situ in mice.

    Science.gov (United States)

    Hakim, Chady H; Wasala, Nalinda B; Duan, Dongsheng

    2013-02-09

    absence of dystrophin, the sarcolemma is damaged by the shearing force generated during force transmission. This membrane tearing initiates a chain reaction which leads to muscle cell death and loss of contractile machinery. As a consequence, muscle force is reduced and dead myofibers are replaced by fibrotic tissues (5). This later change increases muscle stiffness (6). Accurate measurement of these changes provides important guide to evaluate disease progression and to determine therapeutic efficacy of novel gene/cell/pharmacological interventions. Here, we present two methods to evaluate both contractile and passive mechanical properties of the extensor digitorum longus (EDL) muscle and the contractile properties of the tibialis anterior (TA) muscle.

  18. Chiasma crurale: intersection of the tibialis posterior and flexor digitorum longus tendons above the ankle. Magnetic resonance imaging-anatomic correlation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Buck, Florian M. [VA San Diego Medical Center, Department of Radiology, San Diego, CA (United States); Institut fuer Diagnostische Radiologie, Zurich (Switzerland); Gheno, Ramon; Nico, Marcelo A.C.; Trudell, Debra J.; Resnick, Donald [VA San Diego Medical Center, Department of Radiology, San Diego, CA (United States); Haghighi, Parviz [VA San Diego Medical Center, Department of Pathology, San Diego, CA (United States)

    2010-06-15

    To determine the precise anatomy and magnetic resonance (MR) imaging appearance of the chiasma crurale in cadavers, paying special attention to degenerative changes Twelve fresh human ankles were harvested from 11 nonembalmed cadavers (mean age at death 77 years) and used according to institutional guidelines. MR imaging and MR tenography were used to investigate the anatomy of the chiasma crurale using proton density-weighted sequences. The gross anatomy of the chiasma crurale was evaluated and compared to the MR imaging findings. Histology was used to elucidate further the structure of the chiasma crurale. Above the chiasma, five specimens had a small amount of fat tissue between the tibialis posterior and flexor digitorum longus tendon. In all specimens both tendons had a sheath below the chiasma but not above it. At the central portion of the chiasma there was no soft tissue between the tendons, except in two specimens that showed an anatomic variant consisting of a thick septum connecting the tibial periosteum and the deep transverse fascia of the leg. In MR images, eight specimens showed what were believed to be degenerative changes in the tendons at the level of the chiasma. However, during gross inspection and histologic analysis of the specimens, there was no tendon degeneration visible. At the central portion of the chiasma, there is no tissue between the tibialis posterior and flexor digitorum longus tendons unless there is an anatomic variant. At the chiasma crurale, areas with irregular tendon surfaces are normal findings and are not associated with tendon degeneration (fraying). (orig.)

  19. Treatment of dystonia in extensor hallucis longus and digitorum muscles with neurotomy of the branches of the deep fibular nerve: Preliminary results.

    Science.gov (United States)

    Allart, E; Rogeau, C; Grauwin, M-Y; Nachef, N; Lannes, X; Rousseaux, M; Thevenon, A; Fontaine, C

    2015-05-01

    Dystonia in extensor hallucis and/or digitorum muscles can be observed in pyramidal and extrapyramidal lesions and results in pain in these toes, spontaneous or when walking, problems and discomfort when putting on shoes and socks, and cutaneous lesions on the toes. The objective of this study was to assess the efficacy and safety of deep fibular nerve neurotomy for the extensor hallucis longus (EHL) and/or the extensor digitorum longus (EDL) branches in the treatment of extension dystonia of the hallux and/or other toes. A deep fibular nerve neurotomy was performed in 20 patients (n=19 for the EHL, n=6 for the EDL). We retrospectively analyzed the treatment's efficacy and safety and assessed the patients' self-reported improvement and overall treatment satisfaction. Dystonia totally disappeared in 15 cases (75%); it persisted at a minimal level in the other patients. The patients reported a decrease in pain (P<0.01) and fewer difficulties putting on shoes and socks (P<0.001) and had a high median level of satisfaction (8.5/10). Adverse effects were rare and transient. The identification of the nerve branches was sometimes difficult. Deep fibular nerve neurotomy for the EHL and/or EDL branches seems to be an effective treatment for extension dystonia of the hallux and/or other toes and its consequences for the adult neurological patient. However, these encouraging preliminary results should be confirmed by prospective, longer-term studies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Effect of Electroacupuncture on the Expression of Glycyl-tRNA Synthetase and Ultrastructure Changes in Atrophied Rat Peroneus Longus Muscle Induced by Sciatic Nerve Injection Injury

    Directory of Open Access Journals (Sweden)

    Meng Wang

    2016-01-01

    Full Text Available Glycyl-tRNA synthetase (GlyRS is one of the key enzymes involved in protein synthesis. Its mutations have been reported to cause Charcot-Marie-Tooth disease which demonstrates muscular atrophy in distal extremities, particularly manifested in peroneus muscles. In this situation, the dysfunctions of mitochondria and sarcoplasmic reticulum (SR affect energy supply and excitation-contraction coupling of muscle fibers, therefore resulting in muscular atrophy. Although the treatment of muscular atrophy is a global urgent problem, it can be improved by electroacupuncture (EA treatment. To investigate the mechanism underlying EA treatment improving muscular atrophy, we focused on the perspective of protein synthesis by establishing a penicillin injection-induced sciatic nerve injury model. In our model, injured rats without treatment showed decreased sciatic functional index (SFI, decreased peroneus longus muscle weight and muscle fiber cross-sectional area, aggregated mitochondria with vacuoles appearing, swollen SR, and downregulated mRNA and protein expression levels of GlyRS and myosin heavy chain IIb (MHC-IIb. The injured rats with EA treatment showed significant recovery. These results indicated that EA stimulation can alleviate peroneus longus muscular atrophy induced by iatrogenic sciatic nerve injury through promoting the recovery of GlyRS and muscle ultrastructure and increasing muscle protein synthesis.

  1. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    Science.gov (United States)

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  2. Unilateral Dislocation of the Posterior Tibialis Tendon (PTT) and Flexor Digitorum Longus Tendon With Contralateral PTT Subluxation in a Patient With Congenitally Shallow Flexor Groove.

    Science.gov (United States)

    Waldron, Jacob E; Bernhardson, Andrew S; Fellars, Todd A

    2017-10-01

    Flexor tendon dislocation from the flexor tendon groove posterior of the medial malleolus has been previously described, and may be difficult to diagnose initially, but is amendable to surgical treatment with good outcomes. We present a unique case of unilateral dislocation of the posterior tibialis and flexor digitorum longus tendons with contralateral flexor digitorum longus subluxation that was treated surgically with a good outcome. A 37-year-old active duty male sustained a dislocation and subluxation of the flexor tendons bilaterally after a forced dorsiflexion injury. Bilateral ankle magnetic resonance imaging revealed the injuries that this patient sustained and aided in surgical planning. Surgical Treatment. Bilateral flexor tendon groove deepening with periosteal flap elevation and retinacular repair. This injury has not been previously described in the literature after a forced dorsiflexion mechanism. Advanced imaging is helpful as this injury may be initially misdiagnosed. This case shows that delayed bilateral reconstruction of the flexor tendon grooves and retinacula are reliable methods for pain relief to allow a patient to return to a physically demanding level of function. Level V.

  3. Different sensitivity of miniature endplate currents in rat external and internal intercostal muscles to the acetylcholinesterase inhibitor C-547 as compared with diaphragm and extensor digitorum longus.

    Science.gov (United States)

    Petrov, K; Kovyazina, I; Zobov, V; Bukharaeva, E; Nikolsky, E E; Vyskocil, F

    2009-01-01

    Derivative of 6-methyluracil, selective cholinesterase inhibitor C-547 potentiates miniature endplate currents (MEPCs) in rat external intercostal muscles (external ICM) more effectively than in internal intercostal muscles (internal ICM). Effect of the C-547 on intercostal muscles was compared with those on extensor digitorum longus (EDL) and diaphragm muscles. Half-effective concentrations for tau of MEPC decay arranged in increasing order were as follows: EDL, locomotor muscle, most sensitive = 1.3 nM, external ICM, inspiration muscle = 6.8 nM, diaphragm, main inspiration muscle = 28 nM, internal ICM, expiration muscle = 71 nM. External ICM might therefore be inhibited, similarly as the limb muscles, by nanomolar concentrations of the drug and do not participate in inspiration in the presence of the C-547. Moreover, internal ICM inhibition can hinder the expiration during exercise-induced fast breathing of C-547- treated experimental animals.

  4. Lean and Obese Zucker Rat Extensor Digitorum Longus Muscle high-frequency electrical stimulation (HFES) Data: Regulation of p70S6kinase Associated Proteins.

    Science.gov (United States)

    Rice, Kevin M; Katta, Anjaiah; Manne, Nandini D P K; Arvapalli, Ravikumar; Ginjupalli, Gautam K; Wu, Miaozong; Asano, Shinichi; Blough, Eric R

    2018-02-01

    Anaerobic exercise has been advocated as a prescribed treatment for the management of diabetes: however, alterations in exercise-induced signaling remain largely unexplored in the diabetic muscle. Here, we compare the basal and the in situ contraction-induced phosphorylation of the AKT, GSK3beta, mTor, p70s6K, Pten, and Shp2 in the lean and obese (fa/fa) Zucker rat Extensor Digitorum Longus (EDL) muscle following a single bout of contractile stimuli. This article represents data associated with prior publications from our lab (Katta et al., 2009a, 2009b; Tullgren et al., 1991) [1-3] and concurrent Data in Brief articles (Ginjupalli et al., 2017a, 2017b; Rice et al., 2017a, 2017b) [4-7].

  5. Lean and Obese Zucker Rat Extensor Digitorum Longus Muscle high-frequency electrical stimulation (HFES Data: Regulation of p70S6kinase Associated Proteins

    Directory of Open Access Journals (Sweden)

    Kevin M. Rice

    2018-02-01

    Full Text Available Anaerobic exercise has been advocated as a prescribed treatment for the management of diabetes: however, alterations in exercise-induced signaling remain largely unexplored in the diabetic muscle. Here, we compare the basal and the in situ contraction-induced phosphorylation of the AKT, GSK3beta, mTor, p70s6K, Pten, and Shp2 in the lean and obese (fa/fa Zucker rat Extensor Digitorum Longus (EDL muscle following a single bout of contractile stimuli. This article represents data associated with prior publications from our lab (Katta et al., 2009a, 2009b; Tullgren et al., 1991 [1–3] and concurrent Data in Brief articles (Ginjupalli et al., 2017a, 2017b; Rice et al., 2017a, 2017b [4–7].

  6. Lean and Obese Zucker Rat Extensor Digitorum Longus Muscle high-frequency electrical stimulation (HFES) Data: Regulation of MAPKs Associated Proteins.

    Science.gov (United States)

    Rice, Kevin M; Katta, Anjaiah; Manne, Nandini D P K; Arvapalli, Ravikumar; Ginjupalli, Gautam K; Wu, Miaozong; Asano, Shinichi; Blough, Eric R

    2018-02-01

    Anaerobic exercise has been advocated as a prescribed treatment for the management of diabetes: however, alterations in exercise-induced signaling remain largely unexplored in the diabetic muscle. Here, we compare the basal and the in situ contraction-induced phosphorylation of the mitogen-activated protein kinases (MAPKs) ERK 1/2, p38, and JNK in the lean and obese (fa/fa) Zucker rat extensor digitorum longus (EDL) muscle following a single bout of contractile stimuli. This article represents data associated with prior publications from our (Katta et al., 2009a, 2009b, 2008) [1-3] and concurrent Data in Brief articles (Ginjupalli et al., 2017a, 2017b; Rice et al., 2017a, 2017b) [4-7].

  7. Myofascial force transmission is increasingly important at lower forces: firing frequency-related length-force characteristics of rat extensor digitorum longus.

    Science.gov (United States)

    Meijer, H J M; Baan, G C; Huijing, P A

    2006-03-01

    Effects of submaximal stimulation frequencies on myofascial force transmission were investigated for rat anterior crural muscles with all motor units activated. Tibialis anterior and extensor hallucis longus (TAEHL) muscles were kept at constant muscle-tendon complex length, but extensor digitorum longus muscle (EDL) was lengthened distally. All muscles were activated simultaneously at 10, 20, 30 and 100 Hz within an intact anterior crural compartment. At lower frequencies, significant proximo-distal EDL force differences exist. Absolute EDL proximo-distal active force differences were highest at 100 Hz (deltaF(dist-prox) = 0.4 N). However, the normalized difference was highest at 10 Hz (deltaF(dist-prox) = 30%F(dist)). Firing-frequency dependent shifts of the ascending limb of the EDL length-force curve to higher lengths were confirmed for a muscle within an intact compartment, although effects of firing frequency assessed at proximal and distal EDL tendons differed quantitatively. As EDL was lengthened distally, TAEHL distal isometric active force decreased progressively. The absolute decrease was highest for 100 Hz (deltaF(from initial) = -0.25 N). However, the highest normalized decrease was found for 10 Hz stimulation (deltaF(from initial) = -40%). At submaximal stimulation frequencies, myofascial force transmission is present and the fraction of force transmitted myofascially increases with progressively lower firing frequencies. Evidently, the stiffness of epimuscular myofascial paths of force transmission decreases less than the stiffness of serial sarcomeres and myotendinous pathways. It is concluded that low firing frequencies as encountered in vivo enhance the relative importance of epimuscular myofascial force transmission with respect to myotendinous force transmission.

  8. Myofascial force transmission in dynamic muscle conditions: effects of dynamic shortening of a single head of multi-tendoned rat extensor digitorum longus muscle.

    Science.gov (United States)

    Maas, Huub; Huijing, Peter A

    2005-08-01

    This study investigated the effects of myofascial force transmission during dynamic shortening of head III of rat extensor digitorum longus muscle (EDL III). The anterior crural compartment was left intact. Force was measured simultaneously at the distal EDL III tendon, the proximal EDL tendon and the distal tendons of tibialis anterior and extensor hallucis longus muscles (TA + EHL). Two types of distal shortening of EDL III were studied: (1) sinusoidal shortening (2 mm) and (2) isokinetic shortening (8 mm). Sinusoidal shortening of EDL III caused a decrease in force exerted at the distal tendon of EDL III: from 0.58 (0.08) N to 0.26 (0.04) N. In contrast, hardly any changes in proximal EDL force and distal TA+EHL force were found. Maximal concentric force exerted at the distal tendon of EDL III was higher than maximal isometric force expected on the basis of the physiological cross-sectional area of EDL III muscle fibers (Maas et al. 2003). Therefore, a substantial fraction of this force must originate from sources other than muscle fibers of EDL III. Isokinetic shortening of EDL III caused high changes in EDL III force from 0.97 (0.15) N to zero. In contrast, changes in proximal EDL force were much smaller: from 2.44 (0.25) N to 1.99 (0.19) N. No effects on TA + EHL force could be shown. These results are explained in terms of force transmission between the muscle belly of EDL III and adjacent tissues. Thus, also in dynamic muscle conditions, muscle fiber force is transmitted via myofascial pathways.

  9. A biomechanical analysis of posterior tibial tendon dysfunction, medial displacement calcaneal osteotomy and flexor digitorum longus transfer in adult acquired flat foot.

    Science.gov (United States)

    Arangio, George A; Salathe, Eric P

    2009-05-01

    Biomechanical models have been used to study stress in the metatarsals, subtalar motion, lateral column lengthening and subtalar arthroereisis. Posterior tibial tendon dysfunction has been associated with increased loads in the arch of the acquired flat foot. We examine whether a 10 millimeter (mm) medial displacement calcaneal osteotomy and flexor digitorum longus transfer to the navicular reduces these increased loads in the flat foot. The response of a normal foot, a foot with posterior tibial tendon dysfunction, and a flat foot to an applied load of 683Newton was analyzed using a multi-segment biomechanical model. The distribution of load on the metatarsals, the moment about each joint, the force on each of the plantar ligaments and the muscle forces were computed. Posterior tibial tendon dysfunction results in increased load on the medial arch, which may cause the foot to flatten. A 10mm medial displacement calcaneal osteotomy substantially decreases the load on the first metatarsal and the moment at the talo-navicular joint and increases the load on the fifth metatarsal and the calcaneal-cuboid joint. Adding the flexor digitorum longus transfer to the medial displacement calcaneal osteotomy has only a small effect on the flattened foot. Our biomechanical analysis illustrates that when the foot becomes flat, the force on the talo-navicular joint increases substantially from its value for the normal foot, and that medial displacement calcaneal osteotomy can reduce this increased force back toward the value occurring in the normal foot. This study provides a biomechanical rationale for medial displacement calcaneal osteotomy treatments for posterior tibial tendon dysfunction.

  10. Microsurgical approach for unusual and unexpected malignant fibrous histiocytoma of the forearm: A case report.

    Science.gov (United States)

    D'Orazi, Valerio; Panunzi, Andrea; Paoloni, Marco; Ortensi, Alice; Anichini, Silvia; Cialini, Michela; Nardoni, Stefano; Urciuoli, Paolo; Pasta, Vittorio; Ortensi, Andrea

    2015-11-01

    Soft tissue sarcomas are rare tumors with a dismal prognosis. Among the most common histological types of sarcomas of the extremities, malignant fibrous histiocytoma (MFH) is the one with the highest incidence. Surgery is considered to be the first choice of treatment for MFH. To the best of our knowledge, this is the first case report in the literature of a patient with MFH within the abductor pollicis longus (APL) muscle. This unusual location was also unexpected by the treating surgeons, as the preoperative magnetic resonance imaging localized the tumor inside a different muscle. A 79-year-old Caucasian man presented with a swelling in the middle third of the dorsal aspect of the left forearm. MFH was diagnosed following biopsy and instrumental diagnostic examinations. Surgical excision and simultaneous reconstruction was performed by the same microsurgical team, achieving an excellent functional outcome. The present case highlights the significance of microsurgical approach for improving strategic planning in oncologic surgery. Accurate surgical dissection, performed by a team of microsurgeons, allowed for the identification of the unusual and unexpected tumor localization within the APL muscle. For this reason, a change of surgical strategy allowed for preservation of the extensor digitorum communis muscle, which would otherwise have to be resected, with tendon transfer and successful restoration of the thumb abduction function.

  11. [Trapeziectomy and ligamentoplasty with Gore-Tex: preliminary results on 43 patients with trapeziometacarpal joint arthritis].

    Science.gov (United States)

    Moineau, G; Richou, J; Gérard, R; Le Nen, D

    2008-09-01

    Trapeziectomy with suspension tendinoplasty is one of the most frequent procedures for the treatment of trapeziometacarpal arthritis of the thumb. The authors describe a new technique of total trapeziectomy and suspension tendinoplasty with Gore-Tex nonabsorbable monofilament. They give radiological and clinical results of their first 43 procedures with a minimum follow-up of 18 months. Forty-two patients (43 thumbs), average age of 61 years, underwent this procedure. According to Comtet's classification, they were 16 stage 1, 17 stage 2 and 10 stage 4. At 30 months average follow-up, 93% patients had good results on pain (Alnot's stage 0 or 1). The average opposition was 9.5 out of 10 according to Kapandji and the angle between the two first metacarpals was 36.5 degrees. The average key-pinch force was equal to 4.8 Kg. The average DASH score was 14.2. Collapse of the trapezial space was constant in the radiological study and at the follow-up, the trapezial space ratio was 63% of the preoperative ratio. The most frequent complication was reflex sympathetic dystrophy found in nine patients. The satisfaction rate was 88% and 93% of patients would agree to repeat this procedure. Our technique of suspension tendinoplasty with Gore-Tex monofilament has comparable results with those published with other transplants (Flexor carpiradialis, palmaris longus, abductor pollicis longus...). Our technique has some advantages over others: simplicity of surgical procedure without the need to harvest a tendon, no morbidity at the donor site and less time taken for the procedure. However, it still retains the advantages of suspension tendinoplasty.

  12. Suspension Arthroplasty Combined with Ligament Reconstruction of the Thumb Carpometacarpal Joint to Salvage Two Failed Arthroplasties: A Case Report.

    Science.gov (United States)

    Kakinoki, Ryosuke; Hashimoto, Kazuhiko; Tanaka, Hiroki; Akagi, Masao

    2017-01-01

    Thumb basal joint arthroplasty with removal of the entire trapezium is often followed by proximal subsidence and impingement of the thumb metacarpal to the scaphoid, which is a common cause of post-operative thumb pain. Treatment of this impingement is a challenge among surgeons. We performed suspension arthroplasty combined with intercarpal ligament reconstruction using a strip of the extensor carpi radialis longus (ECRL) tendon on a patient suffering from pain caused by this type of the impingement and obtained a successful outcome. We treated a 52-year-old female pianist who complained of pain in her left thumb carpometacarpal (CMC) joint. She had undergone two previous ligament reconstruction and tendon interposition arthroplasty procedures on the joint, for which strips of the flexor carpi radialis tendon and the abductor pollicis longus tendon were used in the first and second operations, respectively. The pre-operative X-ray demonstrated proximal subsidence and impingement of the first metacarpal on the scaphoid. We performed suspension arthroplasty combined with intercarpal ligament reconstruction using a strip of the ECRL tendon to create the trapezial space. 3 years after surgery, despite the 3 mm subsidence of the thumb compared with immediately after surgery, her thumb pinch and grip strength had improved, and the thumb basal pain was relieved. This case shows that suspension arthroplasty with intermetacarpal ligament reconstruction using an ECRL strip can be applied in revision surgery for impingement of the first metacarpal with the scaphoid following thumb CMC joint arthroplasty after removal of the entire trapezium. This is the first report to describe the treatment of first metacarpal impingement after CMC joint arthroplasty using suspension arthroplasty combined with intercarpal ligament reconstruction.

  13. Repercusión de la variabilidad anatómica del primer compartimento extensor de la mano en la enfermedad de De Quervain

    Directory of Open Access Journals (Sweden)

    F.J. López Mendoza

    Full Text Available En la enfermedad de De Quervain, la cirugía es la indicación estándar como procedimiento terapéutico y consiste en la liberación de los tendones abductor pollicis longus (APL y extensor pollicis brevis (EPB del primer compartimento de la mano. Está documentada la presencia de un septum dentro del compartimento entre los tendones del extensor corto y del abductor largo del pulgar. La importancia que tiene describir y hallar este subcompartimento radica en que la falta de conocimiento del mismo provoca el fallo en su liberación completa en los pacientes con enfermedad de De Quervain, por lo que los síntomas pueden persistir en el postoperatorio inmediato y tardío. El objetivo de este trabajo es determinar la presencia de un subcompartimento en el primer compartimento extensor de la mano en la población mexicana. Realizamos en el Hospital General Dr. Manuel Gea González de México DF un total de 32 liberaciones del primer compartimento extensor en 30 pacientes, todas secundarias a enfermedad de De Quervain con seguimiento promedio postoperatorio de 7,5 meses. La presencia de este subcompartimento se encontró en 21 pacientes (65,6 % de los casos, conteniendo en el 100 % el tendón EPB. El APL presentó 3 fascículos en el 31,25 % de casos, 2 fascículos en el 53,12 % y 1 fascículo en el 15,6 %. El EPB presentó 2 fascículos en el 6,25 % de los casos y 1 fascículo en el 93,75 % del total. En el seguimiento, ningún paciente presentó recidiva de la enfermedad. Proponemos la falta de identificación de un subcompartimento en el primer compartimento extensor de la mano como la principal causa de recidiva de enfermedad de De Quervain en nuestro medio.

  14. Avulsion Fractures at the Base of the 2(nd) Metacarpal Due to the Extensor Carpi Radialis Longus Tendon: A Case Report and Review of the Literature.

    Science.gov (United States)

    Najefi, Ali; Jeyaseelan, Lucksmana; Patel, Anand; Kapoor, Akhil; Auplish, Sunil

    2016-03-01

    Simultaneous contraction of the extensor carpi radialis longus (ECRL) with forced hyperflexion of the wrist can result in avulsion of the tendon and its bony attachment at its insertion at the dorsum of the base of the second metacarpal. This is a rare and often unreported fracture pattern. We present a 31- year- old male who sustained a hyperflexion injury. He was managed surgically and had good post-operative outcomes. A literature search revealed 16 papers covering 18 cases of similar injuries. 12 were initially managed surgically and 6 were managed conservatively. Of the open reductions and internal fixations, 11 (92%) were successful and patients made a full recovery. Conservative management was unsuccessful in 4 cases; one patient required surgery for metacarpal boss, one patient had retraction of the tendon at one week follow up and another had weak flexion of the wrist. We recommend open reduction and internal fixation for these injuries. It may allow a faster recovery and therefore allow an earlier return to work and activity.

  15. Differential effect of chronic undernutrition on the fiber type composition of fascicles in the extensor digitorum longus muscles of the rat.

    Science.gov (United States)

    Vázquez-Mendoza, Enrique; Rodríguez-Torres, Erika Elizabeth; López-García, Kenia; Hinojosa-Rodríguez, Cindy Xilonen; Jiménez-Estrada, Ismael

    2017-05-01

    Several studies have shown that chronic low food consumption alters the composition and metabolism of the extensor digitorum longus muscle (EDLm) fiber types. EDLm is constituted by four independent fascicles (F2-F5) of different sizes; their constitution and metabolism, however, as well as how chronic undernourishment affects these is virtually unknown. Thus, the aim of this study is to evaluate the relative fiber type composition and metabolism of each independent fascicle in the EDLm, using control and chronically undernourished young male rats by using the alkaline ATPase and NADH-TR histochemical techniques. Our results indicate that all control fascicles showed a higher percentage of intermediate fibers (P0.05), except for F3, in which oxidative fibers increased (P<0.05). After determining the possible predominant metabolism expressed in intermediate fibers, we propose that chronic undernutrition induces the transformation of fast-glycolytic to intermediate-oxidative/glycolytic fibers, mainly in F3 and F5. Our observations confirm that chronic undernourishment differentially affects the fiber types of each fascicle in the EDLm, which could alter their individual physiological contractile properties. Copyright © 2017 Elsevier GmbH. All rights reserved.

  16. Changes in antioxidant enzymes and lipid peroxidation in extensor digitorum longus muscles of streptozotocin-diabetic rats may contribute to muscle atrophy.

    Science.gov (United States)

    Nonaka, Koji; Une, S; Tatsuta, N; Ito, K; Akiyama, J

    2014-12-01

    We investigated muscle atrophy, major antioxidant enzymes and lipid peroxidation in the extensor digitorum longus (EDL, predominantly fast fibers) and soleus (predominantly slow fibers) muscle of streptozotocin-diabetic rats. Female Wistar rats were divided into a control (n = 5) and streptozotocin-induced diabetic group (n = 5). Eight weeks after diabetes induction the EDL and soleus muscles were removed and catalase (CAT), glutathione peroxidase (GPX) and superoxide dismutase activity (SOD), and thiobarbituric acid reactive substances (TBARS) levels measured. The CAT activity increased in both the EDL and soleus muscles of the diabetic rats (p < 0.01), whereas the GPX and SOD activities were increased only in the EDL muscle (p < 0.01 and p < 0.05). The TBARS levels were only increased in the EDL muscle of the diabetic rats (p < 0.01). Both muscles showed significant atrophy but the EDL muscle elicited the greatest atrophy. In conclusion, it appears that adaptive responses to oxidative stress were adequate in the soleus muscle, but not in the EDL muscle, of diabetic rats. Thus fast twitch muscle fibers may be more susceptible to oxidative stress than slow twitch muscle fibers and this may contribute to muscle atrophy under diabetic conditions.

  17. Fiber type composition of unoperated rat soleus and extensor digitorum longus muscles after unilateral isotransplantation of a foreign muscle in long-term experiments.

    Science.gov (United States)

    Soukup, T; Smerdu, V; Zacharová, G

    2009-01-01

    We examined the effects of the unilateral heterochronous isotransplantation on the fiber type composition and myosin heavy chain (MyHC) isoform content of unoperated slow soleus and fast extensor digitorum longus muscles of female inbred Lewis strain rats. Comparison was made between "control" unoperated muscles of experimental rats (after intramuscular transplantation surgery) with the corresponding muscles of completely naive (unoperated) rats of three age groups (5-, 8- and 14-month-old). This was done in order to ascertain whether these muscles can be used as reliable controls to the transplanted and host muscles for our ongoing grafting experiments. The fiber type composition was determined by assessing the histochemical reaction for myofibrillar adenosine triphosphatase, the MyHC isoform content was determined immunocytochemically using monoclonal antibodies specific to different MyHC isoforms and by sodium dodecyl sulphate polyacrylamide gel electrophoresis. Our experiments show that the heterochronous intramuscular isotransplantation procedure had no significant effect on the fiber type composition and MyHC isoform content of the "control" unoperated muscles of the experimental rats when compared to the corresponding muscles of the naive animals. Furthermore, the duration and type of isotransplantation did not also lead to differences among corresponding "control" muscles of experimental animals. We conclude that the unoperated muscles of the experimental rats can be used as controls in our current transplantation project dealing with long-term grafting experiments.

  18. iNOS ablation does not improve specific force of the extensor digitorum longus muscle in dystrophin-deficient mdx4cv mice.

    Directory of Open Access Journals (Sweden)

    Dejia Li

    Full Text Available Nitrosative stress compromises force generation in Duchenne muscular dystrophy (DMD. Both inducible nitric oxide synthase (iNOS and delocalized neuronal NOS (nNOS have been implicated. We recently demonstrated that genetic elimination of nNOS significantly enhanced specific muscle forces of the extensor digitorum longus (EDL muscle of dystrophin-null mdx4cv mice (Li D et al J. Path. 223:88-98, 2011. To determine the contribution of iNOS, we generated iNOS deficient mdx4cv mice. Genetic elimination of iNOS did not alter muscle histopathology. Further, the EDL muscle of iNOS/dystrophin DKO mice yielded specific twitch and tetanic forces similar to those of mdx4cv mice. Additional studies suggest iNOS ablation did not augment nNOS expression neither did it result in appreciable change of nitrosative stress markers in muscle. Our results suggest that iNOS may play a minor role in mediating nitrosative stress-associated force reduction in DMD.

  19. 70 microM caffeine treatment enhances in vitro force and power output during cyclic activities in mouse extensor digitorum longus muscle.

    Science.gov (United States)

    James, Rob S; Kohlsdorf, Tiana; Cox, Val M; Navas, Carlos A

    2005-09-01

    Caffeine ingestion by human athletes has been found to improve endurance performance primarily acting via the central nervous system as an adenosine receptor antagonist. However, a few studies have implied that the resultant micromolar levels of caffeine in blood plasma (70 microM maximum for humans) may directly affect skeletal muscle causing enhanced force production. In the present study, the effects of 70 microM caffeine on force and power output in isolated mouse extensor digitorum longus muscle were investigated in vitro at 35 degrees C. Muscle preparations were subjected to cyclical sinusoidal length changes with electrical stimulation conditions optimised to produce maximal work. 70 microM caffeine caused a small but significant increase (2-3%) in peak force and net work produced during work loops (where net work represents the work input required to lengthen the muscle subtracted from the work produced during shortening). However, these micromolar caffeine levels did not affect the overall pattern of fatigue or the pattern of recovery from fatigue. Our results suggest that the plasma concentrations found when caffeine is used to enhance athletic performance in human athletes might directly enhance force and power during brief but not prolonged activities. These findings potentially confirm previous in vivo studies, using humans, which implied caffeine ingestion may cause acute improvements in muscle force and power output but would not enhance endurance.

  20. 3D visualization and measurement of capillaries supplying metabolically different fiber types in the rat extensor digitorum longus muscle during denervation and reinnervation.

    Science.gov (United States)

    Janácek, Jirí; Cebasek, Vita; Kubínová, Lucie; Ribaric, Samo; Erzen, Ida

    2009-05-01

    The aim of this study was to determine whether capillarity in the denervated and reinnervated rat extensor digitorum longus muscle (EDL) is scaled by muscle fiber oxidative potential. We visualized capillaries adjacent to a metabolically defined fiber type and estimated capillarity of fibers with very high oxidative potential (O) vs fibers with very low oxidative potential (G). Capillaries and muscle fiber types were shown by a combined triple immunofluorescent technique and the histochemical method for NADH-tetrazolium reductase. Stacks of images were captured by a confocal microscope. Applying the Ellipse program, fibers were outlined, and the diameter, perimeter, cross-sectional area, length, surface area, and volume within the stack were calculated for both fiber types. Using the Tracer plug-in module, capillaries were traced within the three-dimensional (3D) volume, the length of capillaries adjacent to individual muscle fibers was measured, and the capillary length per fiber length (Lcap/Lfib), surface area (Lcap/Sfib), and volume (Lcap/Vfib) were calculated. Furthermore, capillaries and fibers of both types were visualized in 3D. In all experimental groups, O and G fibers significantly differed in girth, Lcap/Sfib, and Lcap/Vfib, but not in Lcap/Lfib. We conclude that capillarity in the EDL is scaled by muscle fiber size and not by muscle fiber oxidative potential.

  1. iNOS ablation does not improve specific force of the extensor digitorum longus muscle in dystrophin-deficient mdx4cv mice.

    Science.gov (United States)

    Li, Dejia; Shin, Jin-Hong; Duan, Dongsheng

    2011-01-01

    Nitrosative stress compromises force generation in Duchenne muscular dystrophy (DMD). Both inducible nitric oxide synthase (iNOS) and delocalized neuronal NOS (nNOS) have been implicated. We recently demonstrated that genetic elimination of nNOS significantly enhanced specific muscle forces of the extensor digitorum longus (EDL) muscle of dystrophin-null mdx4cv mice (Li D et al J. Path. 223:88-98, 2011). To determine the contribution of iNOS, we generated iNOS deficient mdx4cv mice. Genetic elimination of iNOS did not alter muscle histopathology. Further, the EDL muscle of iNOS/dystrophin DKO mice yielded specific twitch and tetanic forces similar to those of mdx4cv mice. Additional studies suggest iNOS ablation did not augment nNOS expression neither did it result in appreciable change of nitrosative stress markers in muscle. Our results suggest that iNOS may play a minor role in mediating nitrosative stress-associated force reduction in DMD.

  2. Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance.

    Science.gov (United States)

    Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

    2015-12-01

    Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals. A 4.0-mm-diameter 30° arthroscope is used. Soft tissues around the talus are cleared with a motorized shaver and a radiofrequency device. The posterior aspects of the talus, os trigonum, and FHL tendon surrounded by the tendon sheath are visualized. The dynamic pathology of the FHL tendon is well observed on passive motion of the great toe. The prominent bone fragment of the talus is removed and the tendon sheath is cut with a retrograde knife and a motorized shaver from the superior border down to the entrance of the fibro-osseous tunnel. Arthroscopic release of the FHL tendon sheath is a useful and easy method to directly approach the dynamic pathology of FHL tenosynovitis in female ballet dancers.

  3. Compound mitochondrial DNA mutations in a neurological patient ...

    Indian Academy of Sciences (India)

    tials (CMAPs) over the abductor pollicis brevis and adduc- tor digiti quinti, respectively. In the same way, the MNCVs of peroneal and tibial nerves were determined by stimulat- ing the knee and ankle, while recording CMAPs over the. Keywords. ataxia; myoclonus; deafness; heteroplasmy; mtDNA; polyneuropathy. Journal of ...

  4. The location of the peroneus longus tendon in the cuboid groove: sonographic study in various positions of the ankle-foot in asymptomatic volunteers.

    Science.gov (United States)

    Choo, Hye Jung; Lee, Sun Joo; Huang, Brady K; Resnick, Donald L

    2018-04-10

    To evaluate the normal location of the peroneus longus tendon (PL) in the cuboid groove in various ankle-foot positions by ultrasonography in asymptomatic volunteers. Ultrasonographic assessment of the PL in the cuboid groove was performed in 20 feet of ten healthy volunteers. Each PL was examined in five ankle-foot positions (i.e., neutral, dorsiflexion, plantar-flexion, supination, and pronation). The PL location was qualitatively categorized as "inside" when the PL was entirely within the cuboid groove, as "overlying" when some part of the PL was perched on the cuboid tuberosity, and as "outside" when the PL was entirely on the cuboid tuberosity. For quantitative evaluation of the PL location, the distance between the PL and the cuboid groove was measured. The width of the cuboid groove was measured in the neutral position. The PL location did not significantly change with changes in the ankle-foot position. Qualitatively, an "overlying" PL was the most common type, regardless of the ankle-foot position. "Inside" PLs were found in only 35, 20, 30, 25, and 35% of feet in neutral, dorsiflexion, plantar-flexion, supination, and pronation positions, respectively. The quantitative PL location was also not significantly different among all ankle-foot positions and it was significantly negatively correlated with the cuboid groove width. In healthy volunteers, 65% or more of the PLs were partially or completely located outside of the cuboid groove, regardless of the ankle-foot position. The PL location relative to the cuboid groove was related to the cuboid groove width.

  5. High lateral plantar pressure is related to an increased tibialis anterior/fibularis longus activity ratio in patients with recurrent lateral ankle sprain

    Directory of Open Access Journals (Sweden)

    Mineta S

    2017-06-01

    Full Text Available Shinshiro Mineta,1 Takayuki Inami,2 Raldy Mariano,3 Norikazu Hirose4 1Graduate School of Sport Sciences, 2Institute of Physical Education, Keio University, Hiyoshi, Yokohama, 3Graduate School of Asia-Pacific Studies, Waseda University, Shinjuku, Tokyo, 4Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Japan Introduction: Center of pressure (COP is a sudden displacement at the time of a lateral ankle sprain (LAS. It has been suggested that the distribution of plantar pressure and the quantity of COP displacement are important for assessing the risk of LAS. Therefore, we evaluated the plantar pressure during a single-leg balance test with eyes closed (SLB-C to identify the factors and characteristics of plantar pressure in people with repeated cases of LAS.Methods: We recruited 22 collegiate athletes and divided them into an instability group (IG; n=11 and a control group (CG; n=11. We measured the distribution of plantar pressure and lower extremity muscle activity during a SLB-C along with static alignment and isometric ankle strength.Results: The fibularis longus (FL activity was significantly lower in the IG than in the CG. The lateral plantar pressure (LPP/medial plantar pressure (MPP ratio was also higher in the IG than in the CG. In addition, the LPP/MPP ratio was correlated with the tibialis anterior (TA/FL ratio.Conclusion: These results suggest that increased lateral plantar pressure is related to decreased FL activity and increased TA/FL ratio. Keywords: chronic ankle instability, ankle sprain, postural stability, soccer, prevention

  6. Alteration of excitation-contraction coupling mechanism in extensor digitorum longus muscle fibres of dystrophic mdx mouse and potential efficacy of taurine.

    Science.gov (United States)

    De Luca, A; Pierno, S; Liantonio, A; Cetrone, M; Camerino, C; Simonetti, S; Papadia, F; Camerino, D C

    2001-03-01

    No clear data is available about functional alterations in the calcium-dependent excitation-contraction (e-c) coupling mechanism of dystrophin-deficient muscle of mdx mice. By means of the intracellular microelectrode "point" voltage clamp method, we measured the voltage threshold for contraction (mechanical threshold; MT) in intact extensor digitorum longus (EDL) muscle fibres of dystrophic mdx mouse of two different ages: 8 - 12 weeks, during the active regeneration of hind limb muscles, and 6 - 8 months, when regeneration is complete. The EDL muscle fibres of 8 - 12-week-old wildtype animals had a more negative rheobase voltage (potential of equilibrium for contraction- and relaxation-related calcium movements) with respect to control mice of 6 - 8 months. However, at both ages, the EDL muscle fibres of mdx mice contracted at more negative potentials with respect to age-matched controls and had markedly slower time constants to reach the rheobase. The in vitro application of 60 mM taurine, whose normally high intracellular muscle levels play a role in e-c coupling, was without effect on 6 - 8-month-old wildtype EDL muscle, while it significantly ameliorated the MT of mdx mouse. HPLC determination of taurine content at 6 - 8 months showed a significant 140% rise of plasma taurine levels and a clear trend toward a decrease in amino acid levels in hind limb muscles, brain and heart, suggesting a tissue difficulty in retaining appropriate levels of the amino acid. The data is consistent with a permanent alteration of e-c coupling in mdx EDL muscle fibres. The alteration could be related to the proposed increase in intracellular calcium, and can be ameliorated by taurine, suggesting a potential therapeutic role of the amino acid.

  7. Treatment with Riluzole Restores Normal Control of Soleus and Extensor Digitorum Longus Muscles during Locomotion in Adult Rats after Sciatic Nerve Crush at Birth.

    Science.gov (United States)

    Zmysłowski, Wojciech; Cabaj, Anna M; Sławińska, Urszula

    2017-01-01

    The effects of sciatic nerve crush (SNC) and treatment with Riluzole on muscle activity during unrestrained locomotion were identified in an animal model by analysis of the EMG activity recorded from soleus (Sol) and extensor digitorum longus (EDL) muscles of both hindlimbs; in intact rats (IN) and in groups of rats treated for 14 days with saline (S) or Riluzole (R) after right limb nerve crush at the 1st (1S and 1R) or 2nd (2S and 2R) day after birth. Changes in the locomotor pattern of EMG activity were correlated with the numbers of survived motor units (MUs) identified in investigated muscles. S rats with 2-8 and 10-28 MUs that survived in Sol and EDL muscles respectively showed increases in the duration and duty factor of muscle EMG activity and a loss of correlation between the duty factors of muscle activity, and abnormal flexor-extensor co-activation 3 months after SNC. R rats with 5, 6 (Sol) and 15-29 MUs (EDL) developed almost normal EMG activity of both Sol and control EDL muscles, whereas EDL muscles with SNC showed a lack of recovery. R rats with 8 (Sol) and 23-33 (EDL) MUs developed almost normal EMG activities of all four muscles. A subgroup of S rats with a lack of recovery and R rats with almost complete recovery that had similar number of MUs (8 and 24-28 vs 8 and 23-26), showed that the number of MUs was not the only determinant of treatment effectiveness. The results demonstrated that rats with SNC failed to develop normal muscle activity due to malfunction of neuronal circuits attenuating EDL muscle activity during the stance phase, whereas treatment with Riluzole enabled almost normal EMG activity of Sol and EDL muscles during locomotor movement.

  8. Changes in the Capillarity of the Rat Extensor Digitorum Longus Muscle 4 Weeks after Nerve Injury Studied by 2D Measurement Methods.

    Science.gov (United States)

    Čebašek, Vita; Ribarič, Samo

    2016-01-01

    We have previously shown by 3D study that 2 weeks after nerve injury there was no change in the length of capillaries per muscle fibre length in rat extensor digitorum longus muscle (EDL). The primary goal of the present 2D study was to determine the capillarity of rat EDL 4 weeks after various modes of nerve injury. Additionally, we wished to calculate the same capillary/fibre parameters that were used in our 3D stereological study. EDL muscles derived from denervated (4 weeks after nerve injury), re-innervated (4 weeks after two successive nerve crushes) and age-matched controls from the beginning (CON-1) and the end (CON-2) of the experiment were analysed in two ways. Global indices of capillarity, such as capillary density (CD) and capillary/fibre (C/F) ratio, were determined by automatic analysis, local indices as the number (CAF) and the length of capillaries around individual muscle fibres (Lcap) in relation to muscle fibre size were estimated manually by tracing the muscle fibre outlines and the transversally and longitudinally cut segments of capillaries seen in 5-µm-thin muscle cross sections. Four weeks after both types of nerve injury, CD increased in comparison to the CON-2 group (p < 0.001) due to atrophied muscle fibres in denervated muscles and probably proliferation of capillaries in re-innervated ones. Higher C/F, CAF (both p < 0.001) and Lcap (p < 0.01) in re-innervated than denervated EDL confirmed this assumption. Calculated capillary/fibre parameters were comparable to our previous 3D study, which strengthens the practical value to the adapted 2D method used in this study. © 2016 S. Karger AG, Basel.

  9. The effects of magnetic field on the biomechanics parameters of soleus and extensor digitorum longus muscles in rats with streptozotocin-induced diabetes.

    Science.gov (United States)

    Pelit, A; Ozaykan, B; Tuli, A; Demirkazik, A; Emre, M; Günay, I

    2008-08-01

    The aim of this study was to determine the effects of the magnetic field (MF) on the isometric contractile characteristics of the soleus and extensor digitorum longus (EDL) muscles in rats both with and without diabetes. Biomechanical parameters were recorded in vitro from Wistar rats without diabetes (Group I, n=20), rats without diabetes exposed to MF (Group II, n=20), rats with streptozotocin-induced diabetes (Group III, n=20), and rats with diabetes exposed to MF (Group IV, n=20). Muscle strips were taken from the distal tendon soleus and EDL muscles of rats killed by decapitation. The muscles were hung in organ baths containing Krebs solution (pH 7.4) with a gas mixture of 95% O2 and 5% CO2. Then the muscles were triggered to direct supramaximal stimulation with 0.05 Hz frequency square pulses for periods of 0.5 ms to obtain control values. The contractile parameters were also determined for two muscles of the four groups. Later, the tension-frequency relationship was determined by applying stimulating pulses of 10, 20, 50, and 100 Hz to the muscles. Diabetes caused a certain amount of decrease in the contractile force of the two muscles compared with that of control values. However, MF increased the contractile force of the two muscles in rats both with and without diabetes. The isometric contraction forces obtained by different stimulating frequencies showed a significant linear increase in the tetanic contraction (P0.05). In our study, these results suggest that MF exposure regulates the isometric contractile characteristics of the soleus and EDL muscles of rats with diabetes, positively.

  10. The passive mechanical properties of the extensor digitorum longus muscle are compromised in 2- to 20-mo-old mdx mice.

    Science.gov (United States)

    Hakim, Chady H; Grange, Robert W; Duan, Dongsheng

    2011-06-01

    Muscle rigidity and myotendinous junction (MTJ) deficiency contribute to immobilization in Duchenne muscular dystrophy (DMD), a lethal disease caused by the absence of dystrophin. However, little is known about the muscle passive properties and MTJ strength in a diseased muscle. Here, we hypothesize that dystrophin-deficient muscle pathology renders skeletal muscle stiffer and MTJ weaker. To test our hypothesis, we examined the passive properties of an intact noncontracting muscle-tendon unit in mdx mice, a mouse model for DMD. The extensor digitorum longus (EDL) muscle-tendon preparations of 2-, 6-, 14-, and 20-mo-old mdx and normal control mice were strained stepwisely from 110% to 160% of the muscle optimal length. The stress-strain response and failure position were analyzed. In support of our hypothesis, the mdx EDL preparation consistently developed higher stress before muscle failure. Postfailure stresses decreased dramatically in mdx but not normal preparations. Further, mdx showed a significantly faster stress relaxation rate. Consistent with stress-strain assay results, we observed significantly higher fibrosis in mdx muscle. In 2- and 6-mo-old mdx and 20-mo-old BL10 mice failure occurred within the muscle (2- to 14-mo-old BL10 preparations did not fail). Interestingly, in ≥14-mo-old mdx mice the failure site shifted toward the MTJ. Electron microscopy revealed substantial MTJ degeneration in aged but not young mdx mice. In summary, our results suggest that the passive properties of the EDL muscle and the strength of MTJ are compromised in mdx in an age-dependent manner. These findings offer new insights in studying DMD pathogenesis and developing novel therapies.

  11. Alteration of excitation-contraction coupling mechanism in extensor digitorum longus muscle fibres of dystrophic mdx mouse and potential efficacy of taurine

    Science.gov (United States)

    De Luca, Annamaria; Pierno, Sabata; Liantonio, Antonella; Cetrone, Michela; Camerino, Claudia; Simonetti, Simonetta; Papadia, Francesco; Camerino, Diana Conte

    2001-01-01

    No clear data is available about functional alterations in the calcium-dependent excitation-contraction (e-c) coupling mechanism of dystrophin-deficient muscle of mdx mice. By means of the intracellular microelectrode ‘point' voltage clamp method, we measured the voltage threshold for contraction (mechanical threshold; MT) in intact extensor digitorum longus (EDL) muscle fibres of dystrophic mdx mouse of two different ages: 8–12 weeks, during the active regeneration of hind limb muscles, and 6–8 months, when regeneration is complete. The EDL muscle fibres of 8–12-week-old wildtype animals had a more negative rheobase voltage (potential of equilibrium for contraction- and relaxation-related calcium movements) with respect to control mice of 6–8 months. However, at both ages, the EDL muscle fibres of mdx mice contracted at more negative potentials with respect to age-matched controls and had markedly slower time constants to reach the rheobase. The in vitro application of 60 mM taurine, whose normally high intracellular muscle levels play a role in e-c coupling, was without effect on 6–8-month-old wildtype EDL muscle, while it significantly ameliorated the MT of mdx mouse. HPLC determination of taurine content at 6–8 months showed a significant 140% rise of plasma taurine levels and a clear trend toward a decrease in amino acid levels in hind limb muscles, brain and heart, suggesting a tissue difficulty in retaining appropriate levels of the amino acid. The data is consistent with a permanent alteration of e-c coupling in mdx EDL muscle fibres. The alteration could be related to the proposed increase in intracellular calcium, and can be ameliorated by taurine, suggesting a potential therapeutic role of the amino acid. PMID:11226135

  12. Lpaatδ/Agpat4 deficiency impairs maximal force contractility in soleus and alters fibre type in extensor digitorum longus muscle.

    Science.gov (United States)

    Bradley, Ryan M; Bloemberg, Darin; Aristizabal Henao, Juan J; Hashemi, Ashkan; Mitchell, Andrew S; Fajardo, Val A; Bellissimo, Catherine; Mardian, Emily B; Bombardier, Eric; Paré, Marie-France; Moes, Katherine A; Stark, Ken D; Russell Tupling, A; Quadrilatero, Joe; Duncan, Robin E

    2018-04-05

    Lysophosphatidic acid acyltransferase (LPAAT) δ/acylglycerophosphate acyltransferase 4 is a mitochondrial enzyme and one of five homologues that catalyze the acyl-CoA-dependent synthesis of phosphatidic acid (PA) from lysophosphatidic acid. We studied skeletal muscle LPAATδ and found highest levels in soleus, a red oxidative fibre-type that is rich in mitochondria, and lower levels in extensor digitorum longus (EDL) (white glycolytic) and gastrocnemius (mixed fibre-type). Using Lpaatδ-deficient mice, we found no change in soleus or EDL mass, or in treadmill time-to-exhaustion compared to wildtype littermates. There was, however, a significant reduction in the proportion of type I and type IIA fibres in EDL but, surprisingly, not soleus, where these fibre-types predominate. Also unexpectedly, there was no impairment in force generation by EDL, but a significant reduction by soleus. Oxidative phosphorylation and activity of complexes I, I + II, III, and IV in soleus mitochondria was unchanged and therefore could not explain this effect. However, pyruvate dehydrogenase activity was significantly reduced in Lpaatδ -/- soleus and EDL. Analysis of cellular lipids indicated no difference in soleus triacylglycerol, but specific elevations in soleus PA and phosphatidylethanolamine levels, likely due to a compensatory upregulation of Lpaatβ and Lpaatε in Lpaatδ -/- mice. An anabolic effect for PA as an activator of skeletal muscle mTOR has been reported, but we found no change in serine 2448 phosphorylation, indicating reduced soleus force generation is unlikely due to the loss of mTOR activation by a specific pool of LPAATδ-derived PA. Our results identify an important role for LPAATδ in soleus and EDL. Copyright © 2018. Published by Elsevier B.V.

  13. Increase of the cytotoxic effect of Bothrops jararacussu venom on mouse extensor digitorum longus and soleus by potassium channel blockers and by Na(+)/K(+)-ATPase inhibition.

    Science.gov (United States)

    Tomaz, Marcelo A; Fernandes, Fabrício F A; El-Kik, Camila Z; Moraes, Raphael A M; Calil-Elias, Sabrina; Saturnino-Oliveira, Jeison; Martinez, Ana Maria B; Ownby, Charlotte L; Melo, Paulo A

    2008-09-15

    We investigated the myotoxicity of Bothrops jararacussu crude venom and other cytolytic agents on mouse isolated extensor digitorum longus (EDL) and soleus (SOL) muscles, which present distinct properties: EDL is a fast-twitch, white muscle with predominantly glycolytic fibers, while SOL is slow-twitch, red muscle with predominantly oxidative fibers. Muscles were exposed to B. jararacussu crude venom (25 microg/ml) and other crotaline venoms (Agkistrodon contortrix laticinctus; Crotalus viridis viridis; Crotalus durissus terrificus) at the same concentration. Basal creatine kinase (CK) release to bathing solution was 0.43+/-0.06 for EDL and 0.29+/-0.06 for SOL (U g(-)(1) h(-)(1), n=36 for each muscle). Sixty minutes after exposure to B. jararacussu venom, EDL presented higher increase in the rate of CK release than SOL, respectively, 13.2+/-1.5 and 2.9+/-0.7 U g(-)(1)h(-)(1), n=10-12. Muscle denervation, despite decreasing CK content, did not affect sensitivities to B. jararacussu venom. Ouabain and potassium channel blockers (TEA; clotrimazole; glibenclamide) increased the rate of CK release by B. jararacussu in EDL and SOL muscles, decreasing and almost abolishing the different sensitivity. When we exposed EDL or SOL muscles to Naja naja, Apis mellifera venoms (25 microg/ml), or Triton X-100 (0.01%), they showed similar rate of CK release. Our present data suggest that a mechanism involving intracellular calcium regulation or potassium channels may participate in the different sensitivity of EDL and SOL to B. jararacussu venom.

  14. Treatment with Riluzole Restores Normal Control of Soleus and Extensor Digitorum Longus Muscles during Locomotion in Adult Rats after Sciatic Nerve Crush at Birth.

    Directory of Open Access Journals (Sweden)

    Wojciech Zmysłowski

    Full Text Available The effects of sciatic nerve crush (SNC and treatment with Riluzole on muscle activity during unrestrained locomotion were identified in an animal model by analysis of the EMG activity recorded from soleus (Sol and extensor digitorum longus (EDL muscles of both hindlimbs; in intact rats (IN and in groups of rats treated for 14 days with saline (S or Riluzole (R after right limb nerve crush at the 1st (1S and 1R or 2nd (2S and 2R day after birth. Changes in the locomotor pattern of EMG activity were correlated with the numbers of survived motor units (MUs identified in investigated muscles. S rats with 2-8 and 10-28 MUs that survived in Sol and EDL muscles respectively showed increases in the duration and duty factor of muscle EMG activity and a loss of correlation between the duty factors of muscle activity, and abnormal flexor-extensor co-activation 3 months after SNC. R rats with 5, 6 (Sol and 15-29 MUs (EDL developed almost normal EMG activity of both Sol and control EDL muscles, whereas EDL muscles with SNC showed a lack of recovery. R rats with 8 (Sol and 23-33 (EDL MUs developed almost normal EMG activities of all four muscles. A subgroup of S rats with a lack of recovery and R rats with almost complete recovery that had similar number of MUs (8 and 24-28 vs 8 and 23-26, showed that the number of MUs was not the only determinant of treatment effectiveness. The results demonstrated that rats with SNC failed to develop normal muscle activity due to malfunction of neuronal circuits attenuating EDL muscle activity during the stance phase, whereas treatment with Riluzole enabled almost normal EMG activity of Sol and EDL muscles during locomotor movement.

  15. Coracoclavicular ligament reconstruction with the autogenous anterior half of the peroneus longus tendon for distal clavicle fracture (Neer type Ⅱ-b: A report of 26 cases

    Directory of Open Access Journals (Sweden)

    Guang-you YANG

    2017-12-01

    Full Text Available Objective To explore the clinical effect of coracoclavicular ligament reconstruction with the autogenous anterior half of peroneus longus tendon (AHPLT for distal clavicle fracture (Neer type Ⅱ-b. Methods The clinical data were retrospectively analyzed of 26 Neer type Ⅱ-b distal clavicle fracture surgically treated by coracoclavicular ligament reconstruction with autogenous AHPLT in Ganyu District People's Hospital of Lianyungang from June 2012 to May 2015. Among the 26 cases, 16 males and 10 females, aged from 19-56 years (average 38.7 years. Fracture occurred in left side in 18 cases and in right side in 8 cases. Postoperative observations were done on fracture healing, shoulder and ankle-foot function recovery. Results For all the 26 cases, surgical incisions were healed well, and no infection, vascular and peroneal nerve injury and iatrogenic fracture occurred. Follow-up was carried out for 10-24 months with average of 15.3 months. All the fractures were healed within 12-20 weeks with an average of 14.6 weeks. One patient was found of losing the fracture reduction part during the follow-up process, and then got eventual healing by extending the limb brake time. Another patient was found of slight tendon sensation disorder with no significant effect on daily life and exercise, and the symptoms disappeared 6 months later. At the last follow-up, the Constant-Murley score was 92-100 with an average of 97.8 points. The ankle-hind foot score of American Society of Ankle and Orthopedics was excellent. Conclusion Reconstruction of coracoclavicular ligament with autogenous AHPLT is an effective treatment for Neer type Ⅱ-b distal clavicle fracture with good safety and without negative effect on the ankle-foot function, and thus it is worthy of wider clinical use. DOI: 10.11855/j.issn.0577-7402.2017.12.12

  16. Histochemical alterations of re-innervated rat extensor digitorum longus muscle after end-to-end or graft repair: a comparative histomorphological study

    Science.gov (United States)

    Lehnert, M; Steudel, WI; Marzi, I; Mautes, A

    2003-01-01

    Changes in the histochemical profile of 43 rat extensor digitorum longus muscles undergoing de-innervation and re-innervation were recorded. Assessment of fibre type composition and muscle fibre cross-sectional area was performed at 15, 30, 90 and 180 days post operative (p.o.) after either primary end-to-end repair or autologous graft repair of the common peroneal nerve (n = 5 per time point and type of repair). The size and histochemical profile of single muscle fibres were analysed by computer-assisted quantification on the basis of their myofibrillar ATPase (pH 4.3) and succinate dehydrogenase (SDH) activities in serial, whole-muscle cross-sections. Accordingly, four muscle-fibre types could be functionally identified: (1) slow oxidative (SO, type I); (2) fast-oxidative glycolytic (FOG, type IIA); (3) fast glycolytic (FG, type IIB); and (4) succinate dehydrogenase intermediate (SDH-INT). At 15 days following end-to-end repair, the SDH-INT muscle fibre type was observed. By contrast, 15 days following graft repair, no changes in fibre type composition were observed (vs. control). At 30 days p.o. in the group that received end-to-end repair, type SDH-INT reached its maximum and was significantly higher than in the group that underwent graft repair. At 90 days p.o., the amount of SDH-INT fibres declined after end-to-end repair, but it was still significantly higher than in the group treated with a nerve graft. The increase of the SDH-INT fibre type was mirrored by a proportional disappearance of FG and FOG fibres. These changes were time-dependent, not reversible at 180 days p.o and largely blunted after nerve graft. Muscle-fibre size decreased at 15 and 30 days after both types of nerve repair. This decrease was transient and reversible within 90 days p.o. These findings reflect the fact that the reorganization of the histochemical profile in re-innervated muscles is both time dependent and long lasting. The degree of this reorganization is significantly higher

  17. Myosin heavy chain isoform composition and Ca2+ transients in fibres from enzymatically dissociated murine soleus and extensor digitorum longus muscles

    Science.gov (United States)

    Calderón, Juan C; Bolaños, Pura; Caputo, Carlo

    2010-01-01

    Electrically elicited Ca2+ transients reported with the fast Ca2+ dye MagFluo-4 AM and myosin heavy chain (MHC) electrophoretic patterns were obtained in intact, enzymatically dissociated fibres from adult mice extensor digitorum longus (EDL) and soleus muscles. Thirty nine fibres (23 from soleus and 16 from EDL) were analysed by both fluorescence microscopy and electrophoresis. These fibres were grouped as follows: group 1 included 13 type I and 4 type IC fibres; group 2 included 2 type IIC, 3 IIA and 1 I/IIA/IIX fibres; group 3 included 4 type IIX and 1 type IIX/IIB fibres; group 4 included 2 type IIB/IIX and 9 type IIB fibres. Ca2+ transients obtained in groups 1, 2, 3 and 4 had the following kinetic parameters (mean ±s.e.m.): amplitude (ΔF/F): 0.61 ± 0.05, 0.53 ± 0.08, 0.61 ± 0.06 and 0.61 ± 0.03; rise time (ms): 1.64 ± 0.05, 1.35 ± 0.05, 1.18 ± 0.06 and 1.14 ± 0.04; half-amplitude width (ms): 19.12 ± 1.85, 11.86 ± 3.03, 4.62 ± 0.31 and 4.23 ± 0.37; and time constants of decay (τ1 and τ2, ms): 3.33 ± 0.13 and 52.48 ± 3.93, 2.69 ± 0.22 and 41.06 ± 9.13, 1.74 ± 0.06 and 12.88 ± 1.93, and 1.56 ± 0.11 and 9.45 ± 1.03, respectively. The statistical differences between the four groups and the analysis of the distribution of the parameters of Ca2+ release and clearance show that there is a continuum from slow to fast, that parallels the MHC continuum from pure type I to pure IIB. However, type IIA fibres behave more like IIX and IIB fibres regarding Ca2+ release but closer to type I fibres regarding Ca2+ clearance. In conclusion, we show for the first time the diversity of Ca2+ transients for the whole continuum of fibre types and correlate this functional diversity with the structural and biochemical diversity of the skeletal muscle fibres. PMID:19884322

  18. Myosin heavy chain isoform composition and Ca(2+) transients in fibres from enzymatically dissociated murine soleus and extensor digitorum longus muscles.

    Science.gov (United States)

    Calderón, Juan C; Bolaños, Pura; Caputo, Carlo

    2010-01-01

    Electrically elicited Ca(2+) transients reported with the fast Ca(2+) dye MagFluo-4 AM and myosin heavy chain (MHC) electrophoretic patterns were obtained in intact, enzymatically dissociated fibres from adult mice extensor digitorum longus (EDL) and soleus muscles. Thirty nine fibres (23 from soleus and 16 from EDL) were analysed by both fluorescence microscopy and electrophoresis. These fibres were grouped as follows: group 1 included 13 type I and 4 type IC fibres; group 2 included 2 type IIC, 3 IIA and 1 I/IIA/IIX fibres; group 3 included 4 type IIX and 1 type IIX/IIB fibres; group 4 included 2 type IIB/IIX and 9 type IIB fibres. Ca(2+) transients obtained in groups 1, 2, 3 and 4 had the following kinetic parameters (mean +/- s.e.m.): amplitude (F/F): 0.61 +/- 0.05, 0.53 +/- 0.08, 0.61 +/- 0.06 and 0.61 +/- 0.03; rise time (ms): 1.64 +/- 0.05, 1.35 +/- 0.05, 1.18 +/- 0.06 and 1.14 +/- 0.04; half-amplitude width (ms): 19.12 +/- 1.85, 11.86 +/- 3.03, 4.62 +/- 0.31 and 4.23 +/- 0.37; and time constants of decay (tau(1) and tau(2), ms): 3.33 +/- 0.13 and 52.48 +/- 3.93, 2.69 +/- 0.22 and 41.06 +/- 9.13, 1.74 +/- 0.06 and 12.88 +/- 1.93, and 1.56 +/- 0.11 and 9.45 +/- 1.03, respectively. The statistical differences between the four groups and the analysis of the distribution of the parameters of Ca(2+) release and clearance show that there is a continuum from slow to fast, that parallels the MHC continuum from pure type I to pure IIB. However, type IIA fibres behave more like IIX and IIB fibres regarding Ca(2+) release but closer to type I fibres regarding Ca(2+) clearance. In conclusion, we show for the first time the diversity of Ca(2+) transients for the whole continuum of fibre types and correlate this functional diversity with the structural and biochemical diversity of the skeletal muscle fibres.

  19. PET/CT imaging in polymyalgia rheumatica: praepubic18F-FDG uptake correlates with pectineus and adductor longus muscles enthesitis and with tenosynovitis.

    Science.gov (United States)

    Rehak, Zdenek; Sprlakova-Pukova, Andrea; Bortlicek, Zbynek; Fojtik, Zdenek; Kazda, Tomas; Joukal, Marek; Koukalova, Renata; Vasina, Jiri; Eremiasova, Jana; Nemec, Petr

    2017-03-01

    %) after treatment with steroids. Increased praepubic 18 F-FDG uptake in patients with PMR is relatively common and this region should be systematically evaluated during differential diagnosis of rheumatic and malignant disease. Praepubic inflammation is probably related to enthesitis and tenosynovitis at the origin of pectineus and adductor longus muscles ventrally from the pubis.

  20. Tendon rupture associated with excessive smartphone gaming.

    Science.gov (United States)

    Gilman, Luke; Cage, Dori N; Horn, Adam; Bishop, Frank; Klam, Warren P; Doan, Andrew P

    2015-06-01

    Excessive use of smartphones has been associated with injuries. A 29-year-old, right hand-dominant man presented with chronic left thumb pain and loss of active motion from playing a Match-3 puzzle video game on his smartphone all day for 6 to 8 weeks. On physical examination, the left extensor pollicis longus tendon was not palpable, and no tendon motion was noted with wrist tenodesis. The thumb metacarpophalangeal range of motion was 10° to 80°, and thumb interphalangeal range of motion was 30° to 70°. The clinical diagnosis was rupture of the left extensor pollicis longus tendon. The patient subsequently underwent an extensor indicis proprius (1 of 2 tendons that extend the index finger) to extensor pollicis longus tendon transfer. During surgery, rupture of the extensor pollicis longus tendon was seen between the metacarpophalangeal and wrist joints. The potential for video games to reduce pain perception raises clinical and social considerations about excessive use, abuse, and addiction. Future research should consider whether pain reduction is a reason some individuals play video games excessively, manifest addiction, or sustain injuries associated with video gaming.

  1. Surgical approach for elastic stable intramedullary nail in pediatric radius shaft fracture

    DEFF Research Database (Denmark)

    Nørgaard, Sandra L.; Schødt Riber, Sara; Danielsson, Frederik B.

    2018-01-01

    . An electronic search of databases was performed. Titles of articles were screened, and abstracts and full text were read. Data were extracted in terms of demographics and complications. The dorsal approach had a 2.6% rate of extensor pollicis longus tendon rupture, whereas the lateral approach had a 2.9% rate...

  2. Anatomy of the pectoral and forelimb muscles of wildtype and green fluorescent protein-transgenic axolotls and comparison with other tetrapods including humans: a basis for regenerative, evolutionary and developmental studies.

    Science.gov (United States)

    Diogo, R; Tanaka, E M

    2012-12-01

    stated in the literature, A. mexicanum has a muscle coracoradialis that has both a well developed proximal fleshy belly and a distal long and thin tendon, supporting the idea that this muscle very likely corresponds to at least part of the amniote biceps brachii. Our observations also: (i) confirmed that the flexores digitorum minimi, interphalangeus digiti 3, pronator quadratus and palmaris profundus 1 are present as distinct muscles in A. mexicanum, supporting the idea that the latter muscle does not correspond to the pronator accessorius of reptiles; (ii) confirmed that the so-called extensor antebrachii radialis is present as a distinct muscle in this species and, importantly, indicated that this muscle corresponds to the supinator of other tetrapods; (iii) showed that, contrary to some other urodeles, including some other Ambystoma species, there is no distinct muscle epitrochleoanconeus in A. mexicanum and; (iv) showed that the ulnar and radial bundles of the abductor et extensor digiti 1 correspond to the abductor pollicis longus and extensor pollicis longus of other tetrapods, respectively. © 2012 The Authors. Journal of Anatomy © 2012 Anatomical Society.

  3. Variations of anatomy on MRI of the first extensor compartment of the wrist and association with DeQuervain tenosynovitis

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Kheterpal, Arvin B.; Terneria Vicentini, Joao Rafael; Huang, Ambrose J. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)

    2017-08-15

    To study anatomical variations on MRI of the first extensor compartment of the wrist in DeQuervain tenosynovitis (DQT). A retrospective search for DQT patients yielded 47 subjects (51 ± 15 years, 36 female, 11 male). The age-matched control group (normal first extensor compartment) was 49 ± 15 years (29 female, 18 male). Two independent readers reviewed: the number of abductor pollicis longus (APL) tendon slips, tendon sheath septations (compartmentalization), and APL and EPB cross-sectional area (CSA) at the radial styloid. A tendon slip was defined as a discrete structure for ≥5 contiguous slices with its own insertion. The distribution of APL tendon slips was different for the DQT and control groups (Reader 1/Reader 2: P = 0.0001 and 0.001). The most common arrangement for both groups was two APL tendon slips. One tendon slip was less common (P = 0.03 and 0.1) and compartmentalization was more common (P = 0.003; < 0.0001) for the DQT group than the control group. There was no difference in tendon slip insertions on one or multiple bones (P = 0.1; 0.7). APL and EPB compartment CSAs were also higher for the DQT group (combined first extensor compartment area: 21.3 ± 7.6 mm{sup 2}; 21.0 ± 7.1) than the control group (17.2 ± 3.8; 17.1 ± 3.9) (P = 0.002; 0.002). We found a statistically significantly increased proportion of supernumerary tendon slips and compartmentalization of the first extensor compartment in patients with DQT and greater CSA of the first extensor compartment at the radial styloid, consistent with previous anatomical, surgical, and ultrasound studies. (orig.)

  4. Differential Contributions of Vision, Touch and Muscle Proprioception to the Coding of Hand Movements

    Science.gov (United States)

    Blanchard, Caroline; Roll, Régine; Roll, Jean-Pierre; Kavounoudias, Anne

    2013-01-01

    To further elucidate the mechanisms underlying multisensory integration, this study examines the controversial issue of whether congruent inputs from three different sensory sources can enhance the perception of hand movement. Illusory sensations of clockwise rotations of the right hand were induced by either separately or simultaneously stimulating visual, tactile and muscle proprioceptive channels at various intensity levels. For this purpose, mechanical vibrations were applied to the pollicis longus muscle group in the subjects’ wrists, and a textured disk was rotated under the palmar skin of the subjects’ right hands while a background visual scene was projected onto the rotating disk. The elicited kinaesthetic illusions were copied by the subjects in real time and the EMG activity in the adductor and abductor wrist muscles was recorded. The results show that the velocity of the perceived movements and the amplitude of the corresponding motor responses were modulated by the nature and intensity of the stimulation. Combining two sensory modalities resulted in faster movement illusions, except for the case of visuo-tactile co-stimulation. When a third sensory input was added to the bimodal combinations, the perceptual responses increased only when a muscle proprioceptive stimulation was added to a visuo-tactile combination. Otherwise, trisensory stimulation did not override bimodal conditions that already included a muscle proprioceptive stimulation. We confirmed that vision or touch alone can encode the kinematic parameters of hand movement, as is known for muscle proprioception. When these three sensory modalities are available, they contribute unequally to kinaesthesia. In addition to muscle proprioception, the complementary kinaesthetic content of visual or tactile inputs may optimize the velocity estimation of an on-going movement, whereas the redundant kinaesthetic content of the visual and tactile inputs may rather enhance the latency of the perception

  5. Anatomía arterial de los colgajos musculares de extensor carpi radialis longus y extensor carpi radialis brevis para su uso en transferencia muscular funcional libre Arterial anatomy of the extensor carpi radialis longus and extensor carpi radialis brevis muscle flaps related to its use in free functioning muscle transfer

    Directory of Open Access Journals (Sweden)

    A. Rodríguez Lorenzo

    2008-09-01

    Full Text Available El objetivo de este trabajo es documentar el aporte arterial y el patrón vascular intramuscular de los músculos Extensor Carpi Radialis Longus (ECRL y Extensor Carpi Radialis Brevis (ECRB para analizar su utilización como colgajos libres en transferencia muscular funcional para reanimación facial. Realizamos un estudio anatómico en 29 brazos humanos en fresco. Las técnicas de inyección utilizadas fueron la modificada de oxido de plomo y gelatina en 11 cadáveres y la de inyección pulsátil de látex color en 18. Disecamos los músculos ECRL y ECRB y sus pedículos, los fotodocumentamos y radiografiamos valorando los resultados en función del patrón vascular intramuscular, relaciones anatómicas, calibres y longitud de pedículos. Encontramos dos patrones vasculares diferentes en las 29 disecciones siguiendo la clasificación de Mathes y Nahai de la anatomía vascular de los músculos (en función del número de pedículos vasculares y su dominancia: Tipo I( 37,9% ECRL y 20,7% ECRB y Tipo II(62,1% del ECRL y 79,3% del ECRB. El pedículo principal del ECRL (de diámetro medio 1,73 mm y longitud de pedículo media de 32,32 mm es en el 100% de los casos rama de la arteria recurrente radial y el pedículo principal del ECRB (de diámetro medio 1,11 mm y longitud de pedículo media de 27,77 mm es rama de la arteria radial en el 68,9% de los casos y de la arteria recurrente radial en el 31,1% de los casos. Concluimos que El ECRL y ECRB presentan dos tipos de patrones vasculares: tipo I y tipo II, siendo más frecuente en nuestro trabajo el tipo II, que hacen que ambos puedan ser transferidos como colgajos libres por su pedículo principal. Ambos músculos presentan un tamaño, contorno, contenido fascial importante para el anclaje de suturas y una longitud de pedículo y calibre vascular adecuados para su transferencia microvascular libre en reanimación facial. De los dos, el más realizable como colgajo libre es el ECRB ya que la relaci

  6. [Arthrodesis of the carpometacarpal joint of the thumb using a cannulated screw].

    Science.gov (United States)

    Zdráhal, Marek

    2009-08-01

    To present the results of surgical treatment of carpometacarpal joint arthritis of the thumb, using cannulated screw fixation which is stable and, after bony union, allows the patient to do also harder manual work In the years 2000 to 2005, this method was used for 20 operations in 18 patients (16 women and two men); one man and one woman had bilateral surgery. The right hand was operated on in seven cases and the left one in 13 cases. The average age of the patients was 61 years. The procedure was performed from the dorsoradial approach, access to the joint was gained between the extensor pollicis brevis and abductor pollicis longus tendons, and care was taken to protect the superficial branch of the radial nerve. The articular surface of the trapezium bone and the first metacarpal base including osteophytes were resected and arthrodesis was carried out by means of a 4.5 mm cannulated screw. The final position of the thumb axis was at 40 degrees to 45 degrees palmar abduction, 20 degrees to 25 degrees extension and 10 degrees to 15 degrees pronation. A plaster hand splint was applied for 6 to 8 weeks post- operatively. The patients were capable of full use of the hand at 3 months after surgery. Evaluation included a pain scale of 1 to 5 grades, range of motion, reduction of muscle strength and fine motor function. All operative wounds healed by first intention, no infection or neurological complications were recorded. Primary union was achieved in 18 cases, two developed pseudoarthrosis. The patients reported improvement on the pain scale by 2 grades on average. However, in thumb opposition tasks, the range between the tip of the thumb and the fifth metacarpophalangeal joint decreased on average by 20 mm. Fourteen patients reported deterioration of fine motor function. All patients were satisfied with improved muscle strength enabling them to do more demanding physical work. The results of carpometacarpal joint arthrodesis by means of a cannulated screw are

  7. Trapezio-metacarpal arthrodesis: procedure and results.

    Science.gov (United States)

    Galán, Adolfo; Arenas, Javier R; del Águila, Belén; Guerado, Enrique; Andrés-Cano, Pablo

    2015-04-01

    The high prevalence of trapezio-metacarpal joint (TMJ) osteoarthritis leads to develop techniques to improve surgical outcomes when conservative treatment has failed. We have evaluated 18 patients with Eaton III TMJ osteoarthritis, who underwent an arthrodesis. Using a dorsal-radial curved shaped skin incision the TMJ was exposed through the space between the abductor pollicis longus and the extensor pollicis brevis muscles. The articular capsule was divided and the TMJ was opened. Neat curettage was then performed in both joint surfaces by removing all the articular cartilage until some cancellous bone hints appeared underneath. The joint was then fixed in the optimal position by a 1.6 mm Kirschner wire and a 1.1 mm guide wire. A cannulated drill for the guide wire was used and matched to a cannulated lag screw. Then, a cylinder-shaped cancellous bone autograft harvested from the distal radius by a percutaneous approach was applied in the hole by drilling backwards in order to spread the bone about onto the hole walls. The joint was then definitively fixed by the cannulated lag screw. The K wires were removed by that time. DASH score changed from an average of 68 in the preoperative assessment to 39.4 at the end of the evolution time. The evolution of pain has decreased from 9.2 points preoperatively to 3.9 points in the postoperative using the visual analogue scale. In terms of mobility, it has decreased from 4 points preoperatively to 3.9 postoperatively, 14 patients got opposition of the thumb to the fifth finger, two of them to the head of the fifth metacarpal bone, one patient to the fourth finger, and one to the third. This slight decrease of mobility had no effect on performing activities of daily life, as expressed by the patients. The grip strength increased from 17 to 21.7 kg and the thumb opposition from 7.8 to 11.2 kg. All patients, except one, would have the operation again after knowing the final results. This patient said that results did not

  8. Migration and Development? An Assessment of Recent EU Pollicy Initiatives

    Directory of Open Access Journals (Sweden)

    Natasja Reslow

    2010-05-01

    Full Text Available The idea that migration policy and development policy are interrelated and influence each other has gained ground over the past few years. The EU has been keen to link migration policy to development policy in several of its policy initiatives. Based on a discussion of the notion of 'migration and development', this article identifies four policy dilemmas facing policy-makers who aim to link migration policy and development policy. It then goes on to examine four EU policy initiatives (the Global Approach to Migration; the Policy Plan on Legal Migration; the thematic programme for the cooperation with third countries in the areas of migration and asylum; and the Mobility Partnerships to determine how these initiatives aim to link migration policy and development policy. It finds that none of the policy initiatives adequately address the policy dilemmas. Only the two most recent initiatives (the thematic programme and the Mobility Partnerships address the broad range of suggested policies which link migration policy and development policy. Generally, it is clear from the initiatives that the EU prioritises the reduction of illegal immigration to its territory. Inconsistencies between the EU's various policies, as well as between its different institutional actors, are problematic for attempts to achieve a 'comprehensive' policy in the area of migration and development.

  9. Effect of heparin treatment on the expression and activity of different ion-motive P-type ATPase isoforms from mouse extensor digitorum longus muscle during degeneration and regeneration after Bothrops jararacussu venom injection.

    Science.gov (United States)

    Schaffazick, Naiara; Amaral, Luciana S; Fonseca, Tatiane F; Tomaz, Marcelo A; Gaban, Glauco A; Borges, Paula A; Calil-Elias, Sabrina; Noël, François; Melo, Paulo A; Quintas, Luis Eduardo M; Cunha, Valéria M N

    2010-01-01

    Ca(2+) ions are essential to myonecrosis, a serious complication of snake envenomation, and heparin seems to counteract this effect. We investigated the effect of local injection of Bothrops jararacussu venom in mouse fast-twitch extensor digitorum longus (EDL) muscle, without or with heparin, on functional/molecular alterations of two central proteins involved in intracellular Ca(2+) homeostasis, sarco(endo)plasmic reticulum Ca(2+)-ATPase (SERCA) and Na(+)/K(+)-ATPase. EDL-specific SERCA1 isoform expression dropped significantly just after venom administration (up to 60% compared to control EDL values at days 1 and 3; p<0.05) while SERCA2 and Na(+)/K(+)-ATPase alpha(1) isoform expression increased at the same time (3-6- and 2-3-fold, respectively; p<0.05). Although not significant, Na(+)/K(+)-ATPase alpha(2) isoform followed the same trend. Except for SERCA2, all proteins reached basal levels at the 7th day. Intravenous heparin treatment did not affect these profiles. Ca(2+)-ATPase activity was also decreased during the first days after venom injection, but here heparin was effective to reinstate activity to control levels within 3 days. We also showed that B. jararacussu venom directly inhibited Ca(2+)-ATPase activity in a concentration-dependent manner. Our results indicate that EDL SERCA and Na(+)/K(+)-ATPase are importantly affected by B. jararacussu venom and heparin has protective effect on activity but not on protein expression.

  10. Levels of myosin heavy chain mRNA transcripts and protein isoforms in the fast extensor digitorum longus muscle of 7-month-old rats with chronic thyroid status alterations.

    Science.gov (United States)

    Vadászová, A; Hudecová, S; Krizanová, O; Soukup, T

    2006-01-01

    We have studied the effect of chronic thyroid status alterations on the myosin heavy chain (MyHC) isoform composition (by SDS-PAGE) and on MyHC mRNA levels (by RT-PCR) in the fast extensor digitorum longus (EDL) muscle of 7-month-old inbred Lewis strain female rats and compared this with corresponding results of the previously studied slow soleus muscle. Our findings show that in the EDL muscle, all four types 1, 2a, 2x/d and 2b of MyHC mRNA transcripts and protein isoforms are present in euthyroid, hypothyroid and hyperthyroid rats, i.e. after chronic treatment with methimazole and T(3), respectively. This is in contrast with the soleus, where only MyHC1 and 2a protein isoforms are expressed under similar conditions. Except for 2x/d MyHC mRNA transcripts in the EDL muscles, there was always significant difference between hypothyroid and hyperthyroid rats both at mRNA and protein levels. From our results we can conclude that extended alteration of the thyroid status leads to typical changes in the expression of MyHC mRNA transcripts and MyHC protein isoforms in the fast EDL and the slow soleus muscles. These changes correspond to those described after shorter periods of altered thyroid status. The characteristic phenotype differences between soleus and EDL muscles remain, however, preserved even after 7 months of thyroid hormone status alteration.

  11. Hand weakness in Charcot-Marie-Tooth disease 1X.

    LENUS (Irish Health Repository)

    Arthur-Farraj, P J

    2012-07-01

    There have been suggestions from previous studies that patients with Charcot-Marie-Tooth disease (CMT) have weaker dominant hand muscles. Since all studies to date have included a heterogeneous group of CMT patients we decided to analyse hand strength in 43 patients with CMT1X. We recorded handedness and the MRC scores for the first dorsal interosseous and abductor pollicis brevis muscles, median and ulnar nerve compound motor action potentials and conduction velocities in dominant and non-dominant hands. Twenty-two CMT1X patients (51%) had a weaker dominant hand; none had a stronger dominant hand. Mean MRC scores were significantly higher for first dorsal interosseous and abductor pollicis brevis in non-dominant hands compared to dominant hands. Median nerve compound motor action potentials were significantly reduced in dominant compared to non-dominant hands. We conclude that the dominant hand is weaker than the non-dominant hand in patients with CMT1X.

  12. Anatomy of the lateral antebrachial cutaneous and superficial radial nerves in the forearm: a cadaveric and clinical study.

    Science.gov (United States)

    Beldner, Steven; Zlotolow, Dan A; Melone, Charles P; Agnes, Ann Marie; Jones, Morgan H

    2005-11-01

    To define the anatomy of the lateral antebrachial cutaneous nerve (LACN) and the superficial radial nerve (SRN) in relation to easily identifiable landmarks in the dorsoradial forearm to minimize the risk to both nerves during surgical approaches to the dorsal radius. In this study 37 cadaveric forearms and 20 patients having distal radius external fixation were dissected to identify these nerves in relation to various anatomic landmarks. Based on these dissections the anatomy was divided into 2 zones that can be identified by easily visible and palpable landmarks. Zone 1 extends from the elbow to the cross-over of the abductor pollicis longus with the extensor carpi radialis brevis and longus. Zone 2 is distal to the cross-over. In zone 1 the 2 nerves can be differentiated through limited incisions based on their depth and anatomic location. Within this zone the SRN is deep to the brachioradialis until 1.8 cm proximal to zone 2 (9 cm proximal to the radial styloid), where it becomes superficial and pierces the fascia of the mobile wad and then remains deep to the subcutaneous fat. In contrast the LACN pierces the fascia between the brachialis and biceps muscles at the level of the elbow. In all specimens the LACN ran parallel to the cephalic vein within the subcutaneous fat. In 31 specimens it ran volar to the vein and in 5 specimens the nerve crossed under the cephalic vein at the elbow and ran dorsal to the vein in the forearm. One specimen had 2 branches with 1 on either side of the vein. Differentiation of these nerves was found to be possible through limited incisions in zone 1 during placement of external fixation pins for distal radius fractures. The LACN always was located in the superficial fat running with the cephalic vein, whereas the SRN was deeper to this nerve either covered by the brachioradialis or closely adherent to it within the investing fascia of the mobile wad. In zone 2 the nerves arborized and ran in the same tissue plane, making

  13. Value of MRI and DTI as Biomarkers for Classifying Acute Spinal Cord Injury

    Science.gov (United States)

    2014-10-29

    extremities, these muscles include the biceps, radial wrist extensors , triceps, flexor digitorum profundus, and the abductor digiti minimi. For the...lower extremities, these muscles consist of the hip flexors, knee extensors , tibialis anterior, extensor hallucis longus , and the gastro-soleus

  14. North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury: A Consortium of Military, Veterans Administration and Civilian Hospitals

    Science.gov (United States)

    2012-03-01

    Policis, C8- Extensor Digitorum , DIII Finger Flexor, Flexor Policis Longus , T1-DV Finger Abductor, First Dorsal Interossei Traditional motor...Domain – Strength 3. Strength Motor grading of 10 arm and hand muscles C5-Anterior Deltoid, Biceps, C6-Triceps, C7-Wrist Extensor , Opponens

  15. Graft repair of the peroneal nerve restores histochemical profile after long-term reinnervation of the rat extensor digitorum longus muscle in contrast to end-to-end repair

    Science.gov (United States)

    Lehnert, M; Maier, B; Frank, J M; Steudel, W I; Marzi, I; Mautes, A

    2004-01-01

    Declining motor function is a prominent feature of ageing physiology. One reason for this is a reduction in plasticity that normally compensates for ongoing reorganization of motor units under physiological conditions. Previous work from our laboratory has shown that microsurgical repair of the transected peroneal nerve is followed by considerable changes in the histochemical profile of the reinnervated extensor digitorum longus (EDL) muscle and that these changes are dependent on both the time and the type of nerve repair. At 6 months postoperatively, a trend toward reversibility could be discerned. In the present work, we analysed the long-term reorganization of histochemical motor unit distribution patterns 15 months after performing either end-to-end repair or grafting of the peroneal nerve in 3-month-old rats. In addition, the EDL muscles of an age-matched control group (age 18 months) were analysed for age-dependent changes. We observed a loss of histochemical organization of motor units leading to an additional fibre type (SDH-INT) in the control group. Fifteen months after end-to-end repair, the histochemical profile showed a decrease in fibre type IIA and an increase in fibre type SDH-INT (P < 0.05), indicating a profound histochemical disorganization of motor units. In contrast, nerve grafting largely restored the histochemical profile of reinnervated EDL muscles. Fibre type grouping was present after both types of nerve repair. These findings show that reorganization of the histochemical profile in reinnervated muscles is dependent on the time and type of nerve repair and is long lasting. In this study, grafting provided superior results compared with end-to-end repair. These long-term results after peripheral nerve repair are influenced by age-dependent changes. Accordingly, nerve repair reduces the normal functional plasticity of motor unit organization. This reduction is enhanced by increasing age. PMID:15610394

  16. Proteomic analysis reveals the distinct energy and protein metabolism characteristics involved in myofiber type conversion and resistance of atrophy in the extensor digitorum longus muscle of hibernating Daurian ground squirrels.

    Science.gov (United States)

    Chang, Hui; Jiang, Shanfeng; Ma, Xiufeng; Peng, Xin; Zhang, Jie; Wang, Zhe; Xu, Shenhui; Wang, Huiping; Gao, Yunfang

    2018-02-13

    Previous hibernation studies demonstrated that such a natural model of skeletal muscle disuse causes limited muscle atrophy and a significant fast-to-slow fiber type shift. However, the underlying mechanism as defined in a large-scale analysis remains unclarified. Isobaric tags for relative and absolute quantification (iTRAQ) based quantitative analysis were used to examine proteomic changes in the fast extensor digitorum longus muscles (EDL) of Daurian ground squirrels (Spermophilus dauricus). Although the wet weights and fiber cross-sectional area of the EDL muscle showed no significant decrease, the percentage of slow type fiber was 61% greater (P 1.2-fold and P < 0.05) in the hibernation group, of which 23 proteins were categorized into energy production and conversion and translation and 22 proteins were categorized into ribosomal structure and biogenesis. Along with the validation by western blot, MAPKAP kinase 2, ATP5D, ACADSB, calcineurin, CSTB and EIF2S were up-regulated in the hibernation group, whereas PDK4, COX II and EIF3C were down-regulated in the hibernation group. MAPKAP kinase 2 and PDK4 were associated with glycolysis, COX II and ATP5D were associated with oxidative phosphorylation, ACADSB was associated with fatty acid metabolism, calcineurin and CSTB were associated with catabolism, and EIF2S and EIF3C were associated with anabolism. Moreover, the total proteolysis rate of EDL in the hibernation group was significantly inhibited compared with that in the pre-hibernation group. These distinct energy and protein metabolism characteristics may be involved in myofiber type conversion and resistance to atrophy in the EDL of hibernating Daurian ground squirrels. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Endolaryngeal Surgery of Bilateral Vocal Cord Abductor Paralysis ...

    African Journals Online (AJOL)

    The treatment of bilateral recurrent laryngeal nerve palsy is discussed and the method of endolaryngeal arytenoidectomy and cordopexy is described in detail. Two cases successfully treated by this method of surgery are presented. S. Afr. Med. J., 45, 1337 (1971) ...

  18. Radiological diagnosis of abductor denervation after hip surgery

    Energy Technology Data Exchange (ETDEWEB)

    Roy, B.R.; Binns, M.S. [Dept. of Orthopaedics, Pontefract General Infirmary (United Kingdom); Horsfall, H. [Dept. of Radiology, Pontefract General Infirmary (United Kingdom)

    2001-02-01

    A case of total hip arthroplasty through a direct lateral approach is described. The patient had a markedly positive Trendelenburg test at follow-up. Radiographs showed features consistent with the denervation of the gluteus medius. This was confirmed on CT scan. The standard post-operative radiograph following a total hip replacement may suggest denervation of the gluteus medius. (orig.)

  19. Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series Treino excêntrico para abdutores do ombro melhora dor, função e desempenho isocinético em sujeitos com síndrome do impacto: série de casos

    Directory of Open Access Journals (Sweden)

    Paula R. Camargo

    2012-02-01

    Full Text Available BACKGROUND: Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS, such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS. OBJECTIVES: To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS. METHODS: Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°. The Disabilities of the Arm, Shoulder and Hand (DASH questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer. RESULTS: DASH scores, peak torque, total work and acceleration time improved (pCONTEXTUALIZAÇÃO: Tratamentos conservadores têm sido propostos para pessoas com síndrome do impacto (SI do ombro, como fortalecimento do manguito rotador e dos músculos escapulares e alongamento dos tecidos moles do ombro. No entanto, são escassos os estudos que analisaram a eficácia do treinamento excêntrico no tratamento da SI. OBJETIVOS: Avaliar os efeitos do treinamento excêntrico para abdutores do ombro na dor, função e desempenho isocinético durante a abdução concêntrica e excêntrica do ombro em indivíduos com SI. MÉTODOS: Vinte indivíduos (sete

  20. COMPARATIVE ANATOMICAL STUDY AND INCIDENCE OF OS PERONEUM IN PERONEUS LONGUS TENDON AND ITS CLINICAL SIGNIFICANCE. Estudio anatómico comparativo e incidencia del os peroneum en el tendón de peroneo largo y su significación clínica

    Directory of Open Access Journals (Sweden)

    Poonam Verma

    2016-03-01

    Full Text Available Introducción: El objetivo de nuestro estudio fue evaluar la tasa de incidencia del os peroneo (OP en el tendón del peroneo lateral largo (PLT y su importancia clínica. Métodos: La disección de 60 cadáveres embalsamados (56 hombres y 4 mujeres del grupo de mediana edad se hizo para tener acceso a la  tasa de incidencia del os peroneo en PLT. Resultados: En nuestro estudio se observó que la  tasa de incidencia del os peroneo fue de  86,6% (52  extremidades. La ubicación del os peroneo es también un tema de controversia. La mayoría de los autores afirman que se relaciona con el hueso cuboides y de vez en cuando se ve inferior al calcáneo distal a la articulación calcáneo-cuboidea. Pero en el presente estudio el os- peroneo estuvo en relación al hueso cuboides en 40 extremidades (76.9%  y distal a articulación calcaneocuboidea en el resto de las 12 extremidades (23.1%. Conclusión: Este estudio sugiere que existe una alta tasa de incidencia de un OP en cadaveres. Esto puede ser como consecuencia de la técnica utilizada para localizar el mismo. La importancia clínica ha sido mencionada en relación con la ubicación del os peroneo, que puede ser confundido con fracturas estiloides y de Jones. Introduction: The aim of our study was to assess the incidence rate of the os peroneum (OP in the peroneus longus tendon (PLT and its clinical significance. Methods: Dissection of 60 embalmed cadavers (56 male and 4 female of middle age group was done to access the incidence rate of os peroneum in peroneus longus tendon. Results: In our study the incidence rate of os peroneum was 86.6% (52 limbs. The location of os peroneum is also a subject of dispute. Most authors stated that it is related to the cuboid bone and occasionally it is seen inferior to the calcaneum distal to the calcaneocuboid joint. But in the present study os peroneum was in relation to cuboid bone in 40 limbs (76.9% and distal to calcaneocuboid joint in 12 limbs (23

  1. The medial oblique foot x-ray: identification of soft tissue shadows seen plantarly.

    Science.gov (United States)

    Lieber, G A

    1983-01-01

    A soft tissue shadow is present on oblique foot x-rays in the arc between the lateral process of the calcaneus and the styloid process of the fifth metatarsal. Surgical placement of metal wires, followed by x-ray examination, has conclusively shown the shadow to have two components, namely, the tendon of peroneus longus and the muscle belly and tendon of abductor digiti minimi. Double screen intensifying cassettes are highly recommended to obtain soft tissue resolution.

  2. The correlation of neurophysiological findings with clinical and functional status in patients following traumatic nerve injury.

    Science.gov (United States)

    Şahin, F; Atalay, N Ş; Akkaya, N; Ercidoğan, Ö; Başakçi, B; Kuran, B

    2014-02-01

    In this study, we aimed to determine whether there is a correlation between the electrodiagnostic findings and the functional status, muscle strength and sensibility in patients with traumatic nerve injury to the wrists. We assessed 50 patients at a mean of 11.6 months (SD 5.85) (range 6-25) after nerve injury. Sensibility was assessed by monofilament testing. Motor function was evaluated by assessing the manual muscle grade of the abductor pollicis brevis and abductor digiti minimi muscles. Function was evaluated by the Sollerman Hand Function Test. The amplitudes of the compound muscle action potential and the sensory nerve action potential were determined by electroneuromyography. While the compound muscle action potential and sensory nerve action potential amplitudes had significant correlation with muscle grade and Semmes Weinstein Monofilament tests, there was no correlation with the functional scores.

  3. Twitch interpolation: superimposed twitches decline progressively during a tetanic contraction of human adductor pollicis.

    Science.gov (United States)

    Gandevia, S C; McNeil, C J; Carroll, T J; Taylor, J L

    2013-03-01

    The assessment of voluntary activation of human muscles usually depends on measurement of the size of the twitch produced by an interpolated nerve or cortical stimulus. In many forms of fatiguing exercise the superimposed twitch increases and thus voluntary activation appears to decline. This is termed 'central' fatigue. Recent studies on isolated mouse muscle suggest that a peripheral mechanism related to intracellular calcium sensitivity increases interpolated twitches. To test whether this problem developed with human voluntary contractions we delivered maximal tetanic stimulation to the ulnar nerve (≥60 s at physiological motoneuronal frequencies, 30 and 15 Hz). During the tetani (at 30 Hz) in which the force declined by 42%, the absolute size of the twitches evoked by interpolated stimuli (delivered regularly or only in the last second of the tetanus) diminished progressively to less than 1%. With stimulation at 30 Hz, there was also a marked reduction in size and area of the interpolated compound muscle action potential (M wave). With a 15 Hz tetanus, a progressive decline in the interpolated twitch force also occurred (to ∼10%) but did so before the area of the interpolated M wave diminished. These results indicate that the increase in interpolated twitch size predicted from the mouse studies does not occur. Diminution in superimposed twitches occurred whether or not the M wave indicated marked impairment at sarcolemmal/t-tubular levels. Consequently, the increase in superimposed twitch, which is used to denote central fatigue in human fatiguing exercise, is likely to reflect low volitional drive to high-threshold motor units, which stop firing or are discharging at low frequencies.

  4. Extensor Pollicis Brevis tendon damage presenting as de Quervain?s disease following kettlebell training

    OpenAIRE

    Karthik, Karuppaiah; Carter-Esdale, Charles William; Vijayanathan, Sanjay; Kochhar, Tony

    2013-01-01

    Kettlebell exercises are more efficient for an athlete to increase his or her muscle strength. However it carries the risk of injury especially in the beginners. A 39 year old gentleman came to our clinic with radial sided wrist pain following kettlebell exercises. Clinically patient had swelling and tenderness over the tendons in the first dorsal wrist compartment, besides Finklesten test was positive. Patient had a decreased excursion of the thumb when compared to the opposite side. Ultraso...

  5. [The effective analysis of microsurgical repair of radial nerve deep branch injury].

    Science.gov (United States)

    Li, Jinyong; Hu, Hongliang; Wang, Huanxin; Cheng, Xuefeng

    2012-11-01

    To investigate the effectiveness and surgical skills of microsurgical repair of radial nerve deep branch injury. Between March 2001 and February 2011, 49 cases of radial nerve deep branch injury were treated by microsurgical technique. There were 40 males and 9 females with an average age of 32 years (range, 19-58 years), including 13 cases of knife-cut injury, 9 cases of electric-saw injury, 7 cases of dagger-stab injury, 6 cases of glass-cut injury, 5 cases of iatrogenic injury, 4 cases of Monteggia fracture, 3 cases of nailgun injury, and 2 cases of crush injury of the forearm complicated by fracture of the proximal radius. The disease duration ranged from 3 hours to 3 years and 8 months (mean, 4.9 months). The sites of injury were at front of supinator tube in 15 cases, in the supinator tube in 23 cases, and at back of supinator tube in 11 cases. One-stage repair was performed by end-to-end suture in 21 cases, including 9 cases of epineurial neurorrhaphy and 12 cases of perineurial neurorrhaphy; two-stage repair was performed in 28 cases, including 26 cases of sural nerve graft and 2 cases of neurolysis. Postoperative wounds primarily healed. All patients were followed up 21.5 months on average (range, 12-39 months). At last follow-up, in 21 cases of one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 13 cases, and level 4 in 8 cases; in 28 cases of two-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 2 cases, level 4 in 21 cases, level 3 in 4 cases, and level 2 in 1 case; and significant difference was found (Z=-5.340, P=0.000). In 9 cases undergoing epineurial neurorrhaphy at one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 3 cases, and level 4 in 6 cases; in 12 cases undergoing perineurial neurorrhaphy at one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 10 cases, and level 4 in 2 cases; and significant difference was found

  6. Electromyographic correlates of learning during robotic surgical training in virtual reality.

    Science.gov (United States)

    Suh, Irene H; Mukherjee, Mukul; Schrack, Ryan; Park, Shi-Hyun; Chien, Jung-Hung; Oleynikov, Dmitry; Siu, Ka-Chun

    2011-01-01

    The purpose of this study was to investigate the muscle activation and the muscle frequency response of the dominant arm muscles (flexor carpi radialis and extensor digitorum) and hand muscles (abductor pollicis and first dorsal interosseous) during robotic surgical skills training in a virtual environment. The virtual surgical training tasks consisted of bimanual carrying, needle passing and mesh alignment. The experimental group (n=5) was trained by performing four blocks of the virtual surgical tasks using the da Vinci™ surgical robot. During the pre- and post-training tests, all subjects were tested by performing a suturing task on a "life-like" suture pad. The control group (n=5) performed only the suturing task without any virtual task training. Differences between pre- and post-training tests were significantly greater in the virtual reality group, as compared to the control group in the muscle activation of the hand muscle (abductor pollicis) for both the suture tying and the suture running (pvirtual reality leads to specific changes in neuromotor control of robotic surgical tasks.

  7. A Fleshy Palmaris Longus Muscle | Ramesh | Anatomy Journal of ...

    African Journals Online (AJOL)

    Anatomy Journal of Africa. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (2015) >. Log in or Register to get access to full text downloads.

  8. Comparative musculoskeletal anatomy of chameleon limbs, with implications for the evolution of arboreal locomotion in lizards and for teratology.

    Science.gov (United States)

    Molnar, Julia L; Diaz, Raul E; Skorka, Tautis; Dagliyan, Grant; Diogo, Rui

    2017-09-01

    Chameleon species have recently been adopted as models for evo-devo and macroevolutionary processes. However, most anatomical and developmental studies of chameleons focus on the skeleton, and information about their soft tissues is scarce. Here, we provide a detailed morphological description based on contrast enhanced micro-CT scans and dissections of the adult phenotype of all the forelimb and hindlimb muscles of the Veiled Chameleon (Chamaeleo calyptratus) and compare these muscles with those of other chameleons and lizards. We found the appendicular muscle anatomy of chameleons to be surprisingly conservative considering the remarkable structural and functional modifications of the limb skeleton, particularly the distal limb regions. For instance, the zygodactyl autopodia of chameleons are unique among tetrapods, and the carpals and tarsals are highly modified in shape and number. However, most of the muscles usually present in the manus and pes of other lizards are present in the same configuration in chameleons. The most obvious muscular features related to the peculiar opposable autopodia of chameleons are: (1) presence of broad, V-shaped plantar and palmar aponeuroses, and absence of intermetacarpales and intermetatarsales, between the digits separated by the cleft in each autopod; (2) oblique orientation of the superficial short flexors originating from these aponeuroses, which may allow these muscles to act as powerful adductors of the "super-digits"; and (3) well-developed abductor digiti minimi muscles and abductor pollicis/hallucis brevis muscles, which may act as powerful abductors of the "super-digits." © 2017 Wiley Periodicals, Inc.

  9. Experimentally reduced hip abductor function during walking: Implications for knee joint loads

    DEFF Research Database (Denmark)

    Henriksen, Marius; Aaboe, Jens; Simonsen, Erik B

    2009-01-01

    -dimensional trunk and lower extremity joint kinematics and kinetics. Surface electromyography (EMG) of the glutei, quadriceps, and hamstring muscles were also measured. The peak GM EMG activity had temporal concurrence with peaks in frontal plane moments at both hip and knee joints. The EMG activity in the GM...... muscle was significantly reduced by pain (-39.6%). All other muscles were unaffected. Peaks in the frontal plane hip and knee joint moments were significantly reduced during pain (-6.4% and -4.2%, respectively). Lateral trunk lean angles and midstance hip joint adduction and knee joint extension angles...... loads at the knee joint during level walking....

  10. Proposal for progressive loading of the hip abductors under mechanically unstable conditions: An electromyography study

    Directory of Open Access Journals (Sweden)

    Nejc Sarabon

    2010-12-01

    Full Text Available The aim of this study was to test the effect of the stance width and asymmetry on muscle activation patterns during balancing on a tilt board. Eleven young healthy volunteers took part in the tests. After the standardized warm-up and customization protocol had been carried out, they balanced five times for 60 seconds on a tilt board, using a different foot position each time - (i wide symmetrical, (ii narrow symmetrical, (iii moderate asymmetrical, (iv extreme asymmetrical, and (v single leg. Pair of electromyographic electrodes was glued over the gluteus medius muscle on both sides from which signals were acquired. The average values of the pre-processed signals were normalized and quantified. Repeated measures analysis of variance and t-tests revealed a systematic effect of the foot positions on the amount of the gluteus medius activation. Its activation was significantly increased in both asymmetrical stances when the foot was moved closer to the tilt board`s axis of rotation and most prominently when the single leg stance was used. These results point out the importance of the foot positioning for the actual muscle function while balancing on a tilt board. We believe that different levels of feet positioning asymmetry should be used for gradual loading of the extremity and for provoking activity in hip side stabilizers.

  11. Atrophy of hip abductor muscles is related to clinical severity in a hip osteoarthritis population.

    Science.gov (United States)

    Zacharias, Anita; Green, Rodney A; Semciw, Adam; English, Daniel J; Kapakoulakis, Theo; Pizzari, Tania

    2018-02-15

    Osteoarthritis mainly affects weight-bearing joints such as the hip and knee and is the most common form of arthritis. Greater muscle atrophy with fatty infiltration of gluteal muscles and decreased hip abduction strength has previously been identified with increasing severity of radiological hip OA. However, it is well documented that radiographic findings of OA do not always correlate with clinical severity. The aim of this secondary analysis was to examine whether atrophy and strength of gluteus maximus (GMax), medius (GMed), minimus (GMin), and tensor fascia lata (TFL) is associated with the clinical severity of OA. Twenty participants with unilateral hip OA and 20 age- and sex-matched asymptomatic controls were classified on the basis of clinical severity (mild, moderate-severe and asymptomatic groups) using the Oxford hip score. Muscle volumes of GMax, GMed, GMin, and TFL were determined using magnetic resonance imaging and expressed as asymmetry between limbs. A hand-held dynamometer was used to identify hip rotation and abduction strength. Regression analyzes were used to identify the association between muscle asymmetry and patient-reported severity of hip OA. Both symptomatic groups (mild and moderate-severe) demonstrated significant asymmetry in GMax (P abduction strength was reduced in both symptomatic groups. Gluteal muscle atrophy was associated with the clinical severity of OA. Clinical severity could be a useful tool for clinicians interpreting likely gluteal muscle changes and planning rehabilitation strategies for hip OA patients. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  12. Responses of human hip abductor muscles to lateral balance perturbations during walking

    NARCIS (Netherlands)

    Hof, A.L.; Duysens, J.E.J.

    2013-01-01

    Lateral stability during gait is of utmost importance to maintain balance. This was studied on human subjects walking on a treadmill who were given 100-ms perturbations of known magnitude and timing with respect to the gait cycle by means of a computer-controlled pneumatic device. This method has

  13. Abductor dysfunction and related sciatic nerve palsy, a new complication of metal-on-metal arthroplasty.

    Science.gov (United States)

    Beaver, Walter B; Fehring, Thomas K

    2012-08-01

    The optimal bearing for use in young patients with hip arthritis remains elusive. Current options include metal-on-cross-linked polyethylene, ceramic-on-cross-linked polyethylene, ceramic on ceramic, and metal on metal. Each of these bearing couples has advantages and disadvantages. Metal-on-metal designs allow the use of large heads that decrease impingement and improve stability. This fact has made this bearing an attractive option for surgeons and patients alike. This case report will illustrate a severe adverse reaction to metal debris with necrosis of soft tissues and subsequent damage to the sciatic nerve. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Automatic assessment of volume asymmetries applied to hip abductor muscles in patients with hip arthroplasty

    Science.gov (United States)

    Klemt, Christian; Modat, Marc; Pichat, Jonas; Cardoso, M. J.; Henckel, Joahnn; Hart, Alister; Ourselin, Sebastien

    2015-03-01

    Metal-on-metal (MoM) hip arthroplasties have been utilised over the last 15 years to restore hip function for 1.5 million patients worldwide. Althoug widely used, this hip arthroplasty releases metal wear debris which lead to muscle atrophy. The degree of muscle wastage differs across patients ranging from mild to severe. The longterm outcomes for patients with MoM hip arthroplasty are reduced for increasing degrees of muscle atrophy, highlighting the need to automatically segment pathological muscles. The automated segmentation of pathological soft tissues is challenging as these lack distinct boundaries and morphologically differ across subjects. As a result, there is no method reported in the literature which has been successfully applied to automatically segment pathological muscles. We propose the first automated framework to delineate severely atrophied muscles by applying a novel automated segmentation propagation framework to patients with MoM hip arthroplasty. The proposed algorithm was used to automatically quantify muscle wastage in these patients.

  15. Comparison of foot muscle morphology and foot kinematics between recreational runners with normal feet and with asymptomatic over-pronated feet.

    Science.gov (United States)

    Zhang, Xianyi; Aeles, Jeroen; Vanwanseele, Benedicte

    2017-05-01

    Over-pronated feet are common in adults and are associated with lower limb injuries. Studying the foot muscle morphology and foot kinematic patterns is important for understanding the mechanism of over-pronation related injuries. The aim of this study is to compare the foot muscle morphology and foot inter-segmental kinematics between recreational runners with normal feet and those with asymptomatic over-pronated feet. A total of 26 recreational runners (17 had normal feet and 9 had over-pronated feet) participated in this study and their foot type was assessed using the 6-item Foot Posture Index. Selected foot muscles were scanned using an ultrasound device and the scanned images were processed to measure the thickness and cross-sectional area of the muscles. Muscles of interest include abductor hallucis, abductor digiti minimi, flexor digitorum brevis and longus, tibialis anterior and peroneus muscles. Foot kinematic data during walking was collected using a 3D motion capture system incorporating the Oxford Foot Model. The results show that individuals with over-pronated feet have larger size of abductor hallucis, flexor digitorum brevis and longus and smaller abductor digiti minimi than controls. Higher rearfoot peak eversion and forefoot peak supination during walking were observed in individuals with over-pronated feet. However, during gait the forefoot peak abduction was comparable. These findings indicate that in active asymptomatic individuals with over-pronated feet, the foot muscle morphology is adapted to increase control of the foot motion. The morphological characteristics of the foot muscles in asymptomatic individuals with over-pronated feet may affect their foot kinematics and benefit prevention from injuries. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Complications arising from a misdiagnosed giant lipoma of the hand and palm: a case report

    Directory of Open Access Journals (Sweden)

    Pagonis Thomas

    2011-11-01

    Full Text Available Abstract Introduction Lipomas are benign tumors which may appear in almost any human organ. Their diagnosis rate in the hand region is not known. Case Presentation We present the case of a 63-year-old Greek Caucasian woman with a giant lipoma of the hand and palm which was not initially diagnosed. After repeated surgical decompression of the carpal tunnel the patient was referred with persisting symptoms of median and ulnar nerve compression and a prominent mass of her left palm and thenar eminence. Clinical examination, magnetic resonance imaging, nerve conduction study and biopsy, revealed a giant lipoma in the deep palmar space (8.0 × 4.0 × 3.75 cm, which was also infiltrating the carpal tunnel. She had already undergone two operations for carpal tunnel syndrome with no relief of her symptoms and she also ended up with a severed flexor pollicis longus tendon. Definitive treatment was performed by marginal resection of the lipoma and restoration of the flexor pollicis longus with an intercalated graft harvested from the palmaris longus. Thirty months after surgery the patient had a fully functional hand without any neurological deficit. Conclusion Not all lipomas of the wrist and hand are diagnosed. Our report tries to emphasize the hidden danger of lipomas in cases with carpal tunnel symptoms. The need for a high index of suspicion in conjunction with good clinical evaluation and the use of appropriate investigative studies is mandatory in order to avoid unnecessary operations and complications. Marginal excision of these tumors is restorative.

  17. Characterization of corticospinal activation of finger motor neurons during precision and power grip in humans

    DEFF Research Database (Denmark)

    Svane, Christian; Forman, Christian Riis; Nielsen, Jens Bo

    2018-01-01

    Direct and indirect corticospinal pathways to finger muscles may play a different role in control of the upper extremity. We used transcranial magnetic stimulation (TMS) and coherence analysis to characterize the corticospinal drive to the first dorsal interosseous (FDI) and abductor pollicis bre...... brevis (APB) when active during a precision and power grip task. In experiment 1, single motor units were recorded during precision grip and power grip in 20 adults (25.2 ± 7.1 years). Post-stimulus time histograms (PSTH) were obtained following TMS. In experiment 2, coherence and cross...... system) is equally involved in the control of both tasks. The data do not support that indirect pathways would make a larger contribution to power grip....

  18. Transient impairment of the axolemma following regional anaesthesia by lidocaine in humans

    DEFF Research Database (Denmark)

    Moldovan, Mihai; Lange, Kai Henrik Wiborg; Aachmann-Andersen, Niels Jacob

    2014-01-01

    The local anaesthetic lidocaine is known to block voltage-gated Na(+) channels (VGSCs), although at high concentration it was also reported to block other ion channel currents as well as to alter lipid membranes. The aim of this study was to investigate whether the clinical regional anaesthetic...... action of lidocaine could be accounted for solely by the block of VGSCs or whether other mechanisms are also relevant. We tested the recovery of motor axon conduction and multiple measures of excitability by 'threshold-tracking' after ultrasound-guided distal median nerve regional anaesthesia in 13...... healthy volunteers. Lidocaine caused rapid complete motor axon conduction block localized at the wrist. Within 3 h, the force of the abductor pollicis brevis muscle and median motor nerve conduction studies returned to normal. In contrast, the excitability of the motor axons at the wrist remained markedly...

  19. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Archibald, Simon J; Madison, Roger D

    2002-01-01

    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...... predictors. Thus, nerve gap distance and repair type exert their influence through time to muscle reinnervation. These findings emphasize that factors that control early axonal outgrowth influence the final level of recovery attained years later. They also highlight that a time window exists within which...... muscle action potentials in the abductor pollicis brevis muscle, (2) the number and size of motor units in reinnervated muscle, and (3) compound sensory action potentials from digital nerve. A statistical model was used to assess the influence of three variables (repair type, nerve gap distance, and time...

  20. Increase in H-reflex gain following 1 week of immobilization

    DEFF Research Database (Denmark)

    Jensen, Jesper Lundbye; Sørensen, Mie; Nielsen, Jens Bo

    It is well established that motor experience induces structural and functional plasticity within the central nervous system. It is less well investigated whether reduced motor activity in relation to immobilization is also associated with plastic neuronal changes. The present experiment examined...... the effect of 1 week of immobilization on transmission in the corticospinal pathway and the central part of the monosynaptic stretch reflex. In ten healthy volunteers the nondominant forearm, hand and fingers were immobilized by a cast for one week. EMG was obtained from m. Flexor Carpi Radialis (FCR) and m....... Abductor Pollicis Brevis (APB). Motor evoked potentials (MEPS) elicited by transcranial magnetic stimulation and H-reflexes were obtained at rest and during tonic contraction (10% of MVC) in both muscles. Maximal voluntary flexion torque decreased significantly following immobilization without any changes...

  1. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Archibald, Simon J; Madison, Roger D

    2002-01-01

    Regeneration in the peripheral nervous system is often incomplete though it is uncertain which factors, such as the type and extent of the injury or the method or timing of repair, determine the degree of functional recovery. Serial electrophysiological techniques were used to follow recovery from...... median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...... muscle action potentials in the abductor pollicis brevis muscle, (2) the number and size of motor units in reinnervated muscle, and (3) compound sensory action potentials from digital nerve. A statistical model was used to assess the influence of three variables (repair type, nerve gap distance, and time...

  2. Psychophysiological patterns during cell phone text messaging: a preliminary study.

    Science.gov (United States)

    Lin, I-Mei; Peper, Erik

    2009-03-01

    This study investigated the psychophysiological patterns associated with cell phone text messaging (texting). Twelve college students who were very familiar with texting were monitored with surface electromyography (SEMG) from the shoulder (upper trapezius) and thumb (abductor pollicis brevis/opponens pollicis); blood volume pulse (BVP) from the middle finger, temperature from the index finger, and skin conductance (SC) from the palm of the non-texting hand; and respiration from the thorax and abdomen. The counter-balanced procedure consisted of a 2 min pre-baseline, 1 min receiving text messages, 2 min middle baseline, 1 min sending text messages and 2 min post-baseline. The results indicated that all subjects showed significant increases in respiration rate, heart rate, SC, and shoulder and thumb SEMG as compared to baseline measures. Eighty-three percentage of the participants reported hand and neck pain during texting, and held their breath and experienced arousal when receiving text messages. Subjectively, most subjects were unaware of their physiological changes. The study suggests that frequent triggering of these physiological patterns (freezing for stability and shallow breathing) may increase muscle discomfort symptoms. Thus, participants should be trained to inhibit these responses to prevent illness and discomfort.

  3. The variability of motor evoked potential latencies in neurosurgical motor mapping by preoperative navigated transcranial magnetic stimulation.

    Science.gov (United States)

    Sollmann, Nico; Bulubas, Lucia; Tanigawa, Noriko; Zimmer, Claus; Meyer, Bernhard; Krieg, Sandro M

    2017-01-03

    Recording of motor evoked potentials (MEPs) is used during navigated transcranial magnetic stimulation (nTMS) motor mapping to locate motor function in the human brain. However, factors potentially underlying MEP latency variability in neurosurgical motor mapping are vastly unknown. In the context of this study, one hundred brain tumor patients underwent preoperative nTMS-based motor mapping of the tumor hemisphere between 2010 and 2013. Fourteen predefined predictor variables were recorded, and MEP latencies of abductor pollicis brevis muscle (APB), abductor digiti minimi muscle (ADM), and flexor carpi radialis muscle (FCR) were analyzed using linear mixed-effect multiple regression analysis with the forward step-wise model comparison approach. Common factors (relevant to APB, ADM, and FCR) for MEP latency variability were gender, most likely due to body height, and antiepileptic drug (AED) intake. Muscle-specific factors (relevant to APB, ADM, or FCR) for MEP latency variability were resting motor threshold (rMT), tumor side, and tumor location. Based on a large cohort of neurosurgical patients, this study provides data on a wide range of clinical factors that may underlie MEP latency variability. The factors that significantly contributed to MEP latency variability should be standardly recorded and taken into consideration during neurosurgical motor mapping.

  4. Clinical Factors Underlying the Inter-individual Variability of the Resting Motor Threshold in Navigated Transcranial Magnetic Stimulation Motor Mapping.

    Science.gov (United States)

    Sollmann, Nico; Tanigawa, Noriko; Bulubas, Lucia; Sabih, Jamil; Zimmer, Claus; Ringel, Florian; Meyer, Bernhard; Krieg, Sandro M

    2017-01-01

    Correctly determining individual's resting motor threshold (rMT) is crucial for accurate and reliable mapping by navigated transcranial magnetic stimulation (nTMS), which is especially true for preoperative motor mapping in brain tumor patients. However, systematic data analysis on clinical factors underlying inter-individual rMT variability in neurosurgical motor mapping is sparse. The present study examined 14 preselected clinical factors that may underlie inter-individual rMT variability by performing multiple regression analysis (backward, followed by forward model comparisons) on the nTMS motor mapping data of 100 brain tumor patients. Data were collected from preoperative motor mapping of abductor pollicis brevis (APB), abductor digiti minimi (ADM), and flexor carpi radialis (FCR) muscle representations among these patients. While edema and age at exam in the ADM model only jointly reduced the unexplained variance significantly, the other factors kept in the ADM model (gender, antiepileptic drug intake, and motor deficit) and each of the factors kept in the APB and FCR models independently significantly reduced the unexplained variance. Hence, several clinical parameters contribute to inter-individual rMT variability and should be taken into account during initial and follow-up motor mappings. Thus, the present study adds basic evidence on inter-individual rMT variability, whereby some of the parameters are specific to brain tumor patients.

  5. Onset Latency of Motor Evoked Potentials in Motor Cortical Mapping with Neuronavigated Transcranial Magnetic Stimulation.

    Science.gov (United States)

    Kallioniemi, Elisa; Pitkänen, Minna; Säisänen, Laura; Julkunen, Petro

    2015-01-01

    Cortical motor mapping in pre-surgical applications can be performed using motor evoked potential (MEP) amplitudes evoked with neuronavigated transcranial magnetic stimulation. The MEP latency, which is a more stable parameter than the MEP amplitude, has not so far been utilized in motor mapping. The latency, however, may provide information about the stress in damaged motor pathways, e.g. compression by tumors, which cannot be observed from the MEP amplitudes. Thus, inclusion of this parameter could add valuable information to the presently used technique of MEP amplitude mapping. In this study, the functional cortical representations of first dorsal interosseous (FDI), abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles were mapped in both hemispheres of ten healthy righthanded volunteers. The cortical muscle representations were evaluated by the area and centre of gravity (CoG) by using MEP amplitudes and latencies. As expected, the latency and amplitude CoGs were congruent and were located in the centre of the maps but in a few subjects, instead of a single centre, several loci with short latencies were observed. In conclusion, MEP latencies may be useful in distinguishing the cortical representation areas with the most direct pathways from those pathways with prolonged latencies. However, the potential of latency mapping to identify stressed motor tract connections at the subcortical level will need to be verified in future studies with patients.

  6. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence.

    Science.gov (United States)

    Houdayer, Elise; Cursi, Marco; Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits.

  7. Surround Inhibition in the Primary Motor Cortex is Task-specifically Modulated in Non-professional Musicians but not in Healthy Controls During Real Piano Playing.

    Science.gov (United States)

    Márquez, Gonzalo; Keller, Martin; Lundbye-Jensen, Jesper; Taube, Wolfgang

    2018-03-01

    Research has indicated that at the onset of a finger movement, unwanted contractions of adjacent muscles are prevented by inhibiting the cortical areas representing these muscles. This so-called surround inhibition (SI) seems relevant for the performance of selective finger movements but may not be necessary for tasks involving functional coupling between different finger muscles. Therefore, the present study compared SI between isolated finger movement and complex selective finger movements while playing a three-finger sequence on the piano in nine non-professional musicians and 10 untrained control participants. Transcranial magnetic stimulation (TMS) was applied to the contralateral motor cortex to assess SI in the first dorsal interosseous (FDI), abductor pollicis brevis (APB) and abductor digiti minimi (ADM) during the movement preparation and the late phasic phases. The results reveal stronger SI during the preparation phase than during the phasic phase (30.6% vs. 10.7%; P  0.05). Thus, musicians were able to modulate SI between conditions whereas control participants revealed constant levels of SI. Therefore, it may be assumed that long-term training as observed in skilled musicians is accompanied by task-specific effects on SI modulation potentially relating to the ability to perform selective and complex finger movements. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  8. Quantitative muscle ultrasound is useful for evaluating secondary axonal degeneration in chronic inflammatory demyelinating polyneuropathy.

    Science.gov (United States)

    Hokkoku, Keiichi; Matsukura, Kiyoshi; Uchida, Yudai; Kuwabara, Midori; Furukawa, Yuichi; Tsukamoto, Hiroshi; Hatanaka, Yuki; Sonoo, Masahiro

    2017-10-01

    In chronic inflammatory demyelinating polyneuropathy (CIDP), exclusion of secondary axonal degeneration is challenging with conventional methods such as nerve conduction study (NCS), needle electromyography, and nerve biopsy. Increased echo intensity (EI) and decreased muscle thickness (MT) identified on muscle ultrasound (MUS) examination represent muscle denervation due to axonal degeneration in neurogenic disorders, suggesting MUS as a new tool to detect secondary axonal degeneration in patients with CIDP. EI and MT of abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles were measured in 16 CIDP patients. Raw values were converted into z -scores using data from 60 normal controls (NCs). Six of 45 muscles showed abnormally high EI and low MT, suggesting denervation following secondary axonal degeneration. These six muscles belonged to two patients with long disease history, unresponsiveness to treatment, and long interval from onset to initial therapy. There were no significant differences in EI and MT ( p  = .23 and .67, respectively) between the CIDP and NC groups, although NCS results revealed obvious demyelinating abnormalities in all CIDP patients, suggesting the fact that muscle structures will be preserved, and EI and MT will not change unless secondary axonal degeneration occurs in CIDP. MUS is a promising tool for evaluating secondary axonal degeneration in patients with CIDP.

  9. MR imaging findings of trigger thumb

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Eric Y.; Chen, Karen C.; Chung, Christine B. [VA San Diego Healthcare System, Radiology Service, San Diego, CA (United States); University of California, San Diego Medical Center, Department of Radiology, San Diego, CA (United States)

    2015-08-15

    Trigger finger (or trigger thumb), also known as sclerosing tenosynovitis, is a common clinical diagnosis that rarely presents for imaging. Because of this selection bias, many radiologists may not be familiar with the process. Furthermore, patients who do present for imaging frequently have misleading examination indications. To our knowledge, magnetic resonance (MR) imaging findings of trigger thumb have not been previously reported in the literature. In this article, we review the entity of trigger thumb, the anatomy involved, and associated imaging findings, which include flexor pollicis longus tendinosis with a distinct nodule, A1 pulley thickening, and tenosynovitis. In addition, in some cases, an abnormal Av pulley is apparent. In the rare cases of trigger finger that present for MR imaging, accurate diagnosis by the radiologist can allow initiation of treatment and avoid further unnecessary workup. (orig.)

  10. MR imaging findings of trigger thumb

    International Nuclear Information System (INIS)

    Chang, Eric Y.; Chen, Karen C.; Chung, Christine B.

    2015-01-01

    Trigger finger (or trigger thumb), also known as sclerosing tenosynovitis, is a common clinical diagnosis that rarely presents for imaging. Because of this selection bias, many radiologists may not be familiar with the process. Furthermore, patients who do present for imaging frequently have misleading examination indications. To our knowledge, magnetic resonance (MR) imaging findings of trigger thumb have not been previously reported in the literature. In this article, we review the entity of trigger thumb, the anatomy involved, and associated imaging findings, which include flexor pollicis longus tendinosis with a distinct nodule, A1 pulley thickening, and tenosynovitis. In addition, in some cases, an abnormal Av pulley is apparent. In the rare cases of trigger finger that present for MR imaging, accurate diagnosis by the radiologist can allow initiation of treatment and avoid further unnecessary workup. (orig.)

  11. The Usefulness of Ultrasonography as a Guide for the Treatment of Delayed Diagnosed Tendon Injury in a 2-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Issei Nagura

    2013-01-01

    Full Text Available In children, flexor pollicis longus (FPL tendon injuries are uncommon. In delayed diagnosed cases, CT and MRI are hard to perform, even though to confirm the location of the lacerated proximal tendon end is preferable for the planning of operation procedure. In such condition, ultrasonography is suitable because of its characteristic feature of easy-to-perform procedure even in children. In this report, preoperative ultrasonography was practical in the delayed diagnosis of FPL tendon in a 2-year-old child to schedule the primary repair because the precise location of both FPL proximal and distal ends was identified. In addition, routine postoperative ultrasonography was also useful to track its healing process without concern about mutual communication due to the patient’s age, which helped to promote active motion.

  12. Effects of smartphone overuse on hand function, pinch strength, and the median nerve.

    Science.gov (United States)

    İnal, Esra Erkol; Demİrcİ, kadİr; Çetİntürk, Azİze; Akgönül, Mehmet; Savaş, Serpİl

    2015-08-01

    In this study we investigated the flexor pollicis longus (FPL) tendon and median nerve in smartphone users by ultrasonography to assess the effects of smartphone addiction on the clinical and functional status of the hands. One hundred two students were divided into 3 groups: non-users, and high or low smartphone users. Smartphone Addiction Scale (SAS) scores and grip and pinch strengths were recorded. Pain in thumb movement and rest and hand function were evaluated on the visual analog scale (VAS) and the Duruöz Hand Index (DHI), respectively. The cross-sectional areas (CSAs) of the median nerve and the FPL tendon were calculated bilaterally using ultrasonography. Significantly higher median nerve CSAs were observed in the dominant hands of the high smartphone users than in the non-dominant hands (PSmartphone overuse enlarges the median nerve, causes pain in the thumb, and decreases pinch strength and hand functions. © 2015 Wiley Periodicals, Inc.

  13. Evolution and homologies of primate and modern human hand and forearm muscles, with notes on thumb movements and tool use.

    Science.gov (United States)

    Diogo, Rui; Richmond, Brian G; Wood, Bernard

    2012-07-01

    In this paper, we explore how the results of a primate-wide higher-level phylogenetic analysis of muscle characters can improve our understanding of the evolution and homologies of the forearm and hand muscles of modern humans. Contrary to what is often suggested in the literature, none of the forearm and hand muscle structures usually present in modern humans are autapomorphic. All are found in one or more extant non-human primate taxa. What is unique is the particular combination of muscles. However, more muscles go to the thumb in modern humans than in almost all other primates, reinforcing the hypothesis that focal thumb movements probably played an important role in human evolution. What makes the modern human thumb myology special within the primate clade is not so much its intrinsic musculature but two extrinsic muscles, extensor pollicis brevis and flexor pollicis longus, that are otherwise only found in hylobatids. It is likely that these two forearm muscles play different functional roles in hylobatids and modern humans. In the former, the thumb is separated from elongated digits by a deep cleft and there is no pulp-to-pulp opposition, whereas modern humans exhibit powerful thumb flexion and greater manipulative abilities, such as those involved in the manufacture and use of tools. The functional and evolutionary significance of a third peculiar structure, the intrinsic hand structure that is often called the 'interosseous volaris primus of Henle' (and which we suggest is referred to as the musculus adductor pollicis accessorius) is still obscure. The presence of distinct contrahentes digitorum and intermetacarpales in adult chimpanzees is likely the result of prolonged or delayed development of the hand musculature of these apes. In relation to these structures, extant chimpanzees are more neotenic than modern humans. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Quality Control of Motor Unit Number Index (MUNIX Measurements in 6 Muscles in a Single-Subject "Round-Robin" Setup.

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    Christoph Neuwirth

    Full Text Available Motor Unit Number Index (MUNIX is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS has been established, but inter-rater variability between multiple raters in one single subject has not been investigated.To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced and to determine variables associated with variability of measurements.Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB, abductor digiti minimi (ADM, biceps brachii (BB, tibialis anterior (TA, extensor dig. brevis (EDB, abductor hallucis (AH twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV between different raters and their levels of experience with MUNIX were compared.Mean intra-rater COV of MUNIX was 14.0% (±6.4 ranging from 5.8 (APB to 30.3% (EDB. Mean inter-rater COV was 18.1 (±5.4 ranging from 8.0 (BB to 31.7 (AH. No significant differences of variability between experienced and less experienced raters were detected.We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method.

  15. Bridging external fixation versus non-bridging external fixation for unstable distal radius fractures: A systematic review and meta-analysis.

    Science.gov (United States)

    Gu, Wan-Li; Wang, Jun; Li, Dong-Qing; Gong, Ming-Zhi; Chen, Peng; Li, Zhong-Yi; Yang, Li-Feng; Liu, Wei; Zhou, Ye

    2016-01-01

    A systematic review and meta-analysis was conducted to compare the relative effectiveness of bridging external fixation and non-bridging external fixation for distal radius fractures treatment. Relevant literature were comprehensively searched using the PubMed, Springer Link, Karger Medical and Scientific Publishers, Chinese Biomedical Database (CBM) and Chinese National Knowledge Infrastructure (CNKI) databases without any language restrictions. STATA Version 12.0 software and Comprehensive Meta-analysis 2.0 were applied. A total of 905 patients with distal radius fracture from six eligible cohort studies were selected for statistical analysis. Our meta-analysis results indicate that the non-bridging cases had a higher risk of pin track infection, rupture of the extensor pollicis longus and nerve injury than the bridging cases. Subgroup analysis stratified by country indicated non-bridging patients showed evidence of an increased risk of pin track infection and higher risk of rupture of the extensor pollicis longus compared with the patients treated with bridging external fixation in the UK population. The follow-up results showed flexion degree of patients treated with non-bridging external fixation was slightly better than that of patients treated with bridging external fixation (P review and meta-analysis to support that bridging external fixation can reduce the incidence of pin tract infections and nerve injury compared to non-bridging external fixation, but have no significant difference in other complications and the recovery of wrist joint function. Bridging external fixation could therefore be a better choice in patients with distal radius fractures. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  16. EFFECT OF UNIPOLAR ACU-STIM ON MUSCLE RE-EDUCATION FOLLOWING TENDON TRANSFER - A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Prof. Srikanth R

    2015-02-01

    Full Text Available Background: Tendon transfer surgery is usually done to improve function, following damage to either major nerve trunks or peripheral nerves. Re-education of the muscle is of utmost importance to gain functional activity.To achieve this, along with re-education exercises, faradic stimulation is usually used. Unipolar Acu-Stim (UAS, is an innovative technique where an acupuncture needle is used to stimulate the transferred tendon with Surged Faradic Currents (SFC. The objective of the study is to identify if the application of SFC using UAS method, is effective to re-educate a transferred muscle. Case Description: The subject was a 24 year old male who had a loss of finger and thumb extension following Posterior Interosseous Nerve (PIN palsy, for which Flexor Carpi Radialis (FCR was transferred to Extensor Digitorum Communis (EDC and Palmaris Longus (PL was transferred to Extensor Pollicis Longus (EPL. Following removal of the POP, UAS with surged faradic current was applied for 4 weeks along with re-education exercises. Prognosis of finger extension was assessed by goniometry and video recordings. Outcome: At the end of 8th week, as observed on goniometry and video recordings, complete finger extension was achieved. Discussion: UAS with SFC, is useful in re-education of a transferred muscle, as desired movement can be achieved with low intensity.

  17. Isolated anterior interosseous nerve deficit due to a false aneurysm of the humeral artery: an unusual complication of penetrating arm injury. Case report and literature review.

    Science.gov (United States)

    Dunet, B; Pallaro, J; Boullet, F; Tournier, C; Fabre, T

    2013-12-01

    Anterior interosseous nerve (AIN) injuries account for only 1% of all the nerve injuries at the upper limb. We report the case of a 22-year-old male who sustained a penetrating injury to the arm. No neurological deficit was found at the initial evaluation. However, 6 weeks later, he had a motor deficit confined to the territory of the AIN with weakness of the flexor pollicis longus and flexor digitorum longus to the index. He also reported paraesthesia. Tinel's test was positive over the pinpoint wound in the arm, where a painful swelling was felt. Electroneurophysiological testing indicated a deficit of the AIN. Surgical exploration identified a thrombosed false aneurysm of the humeral artery responsible for compression of the median nerve. One month later, the patient had achieved a full recovery. Immediate routine exploration of deep penetrating wounds, although mandatory, may fail to detect any lesions. Close monitoring must be provided subsequently, as gradual nerve compression can result in delayed neurological deficits. Copyright © 2013. Published by Elsevier Masson SAS.

  18. Dorsal capsulodesis associated with arthoscopy-assisted scapholunate ligament reconstruction using a palmaris longus tendon graft

    Directory of Open Access Journals (Sweden)

    Victor Bignatto Carvalho

    Full Text Available ABSTRACT OBJECTIVES: To measure the quality of life, the time to work return, and clinical, functional, and radiographic parameters of patients treated with dorsal capsulodesis associated with scapholunate (SL reconstruction, assisted by arthroscopy. METHODS: From January 2015 to September 2016, 14 adult patients with SL dissociation underwent surgical treatment with the SL reconstruction procedure assisted by arthroscopy, using the new technique proposed in this study. All patients were assessed by the occupational therapy department at regular intervals after surgery and performed the same sequence of rehabilitation. The parameters analyzed were: range of motion (ROM, Disability of the Arm, Shoulder, and Hand (DASH, visual analog scale (VAS, and radiographic analysis to visualize the pre- and postoperative SL gap and the pre- and postoperative dorsal intercalated segment instability (DISI deformity the. The complications and the time to return to work activities were described. RESULTS: The follow-up time was 12 months (3-17. The ROM averaged 321° (96.9% of the normal side. VAS was 1.79/10 (1-6. DASH was 6.50/100 (1-30. The time to work return work was 4.42 months (2-17. As for complications, one patient developed SLAC, and underwent four-corner fusion one year after ligament reconstruction. Currently, he has experienced pain relief, with a functional range of motion of the wrist, and has not yet returned to professional activities. The preoperative SL gap was 4.29 mm (2-7; in the postoperative period, it was 1.79 mm (1-4. The DISI deformity was present in ten patients with SL angle > 70° (preoperative and it was corrected after surgery, in all patients. SLAC stage I was identified in a patient. Arthroscopy was performed in all cases. The SL instability was classified as Geissler grade III in four cases and as grade IV in ten cases. CONCLUSION: The new approach (dorsal capsulodesis associated with SL reconstruction, assisted by arthroscopy presented in this study is safe and effective in the treatment of SL dissociation, since it offers satisfactory clinical, radiographic and functional results, showing low rates of complications. For patients, it allows the return to their social and professional activities, and increases their life quality.

  19. Fibre type composition of soleus and extensor digitorum longus muscles in normal female inbred Lewis rats

    Czech Academy of Sciences Publication Activity Database

    Soukup, Tomáš; Zachařová, Gisela; Smerdu, V.

    2002-01-01

    Roč. 104, č. 4 (2002), s. 399-405 ISSN 0065-1281 R&D Projects: GA ČR GA304/00/1653 Grant - others:CZ - SI Czech-Slovenian Intergovernmental S&T Co-operation(XC) - Institutional research plan: CEZ:AV0Z5011922 Keywords : inbred Lewis rats * skeletal muscles * soleus and EDL muscles Subject RIV: FH - Neurology Impact factor: 0.867, year: 2002

  20. Satellite cell frequency in cross-age transplanted rat extensor digitorum longus muscles

    Czech Academy of Sciences Publication Activity Database

    Rudež, M.; Carlson, B. M.; Sajko, Š.; Kubínová, Lucie; Wernig, A.; Eržen, I.

    2004-01-01

    Roč. 14, č. 3 (2004), s. 155-159 ISSN 1120-9992 Grant - others:European programme(XE) QLKG-1999-02034 Institutional research plan: CEZ:AV0Z5011922 Keywords : aging * confocal microscopy * satellite cells Subject RIV: EA - Cell Biology

  1. Electromyographic Analysis of the Peroneous Longus during Bicycle Ergometry across Work Load and Pedal Type.

    Science.gov (United States)

    1983-01-01

    reported for the vastus lateralis and gastrocnemius muscles with load held constant. However, for the tibialis anterior and gluteus maximus muscles this...curvilinear for the gluteus maximus and anterior tibialis. The other muscles displayed changing relationships between IEMG and work load with changing...11 Goto and co-workers used bicycle ergometry with three male subjects to study the relationship between WIG and both work load and speed.3 The gluteus

  2. Representing tools as hand movements: early and somatotopic visuomotor transformations.

    Science.gov (United States)

    Bartoli, Eleonora; Maffongelli, Laura; Jacono, Marco; D'Ausilio, Alessandro

    2014-08-01

    The term affordance defines a property of objects, which relates to the possible interactions that an agent can carry out on that object. In monkeys, canonical neurons encode both the visual and the motor properties of objects with high specificity. However, it is not clear if in humans exists a similarly fine-grained description of these visuomotor transformations. In particular, it has not yet been proven that the processing of visual features related to specific affordances induces both specific and early visuomotor transformations, given that complete specificity has been reported to emerge quite late (300-450ms). In this study, we applied an adaptation-stimulation paradigm to investigate early cortico-spinal facilitation and hand movements׳ synergies evoked by the observation of tools. We adapted, through passive observation of finger movements, neuronal populations coding either for precision or power grip actions. We then presented the picture of one tool affording one of the two grasps types and applied single-pulse Transcranial Magnetic Stimulation (TMS) to the hand primary motor cortex, 150ms after image onset. Cortico-spinal excitability of the Abductor Digiti Minimi and Abductor Pollicis Brevis showed a detailed pattern of modulations, matching tools׳ affordances. Similarly, TMS-induced hand movements showed a pattern of grip-specific whole hand synergies. These results offer a direct proof of the emergence of an early visuomotor transformation when tools are observed, that maintains the same amount of synergistic motor details as the actions we can perform on them. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Primary Motor Cortex Representation of Handgrip Muscles in Patients with Leprosy.

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    Vagner Wilian Batista E Sá

    Full Text Available Leprosy is an endemic infectious disease caused by Mycobacterium leprae that predominantly attacks the skin and peripheral nerves, leading to progressive impairment of motor, sensory and autonomic function. Little is known about how this peripheral neuropathy affects corticospinal excitability of handgrip muscles. Our purpose was to explore the motor cortex organization after progressive peripheral nerve injury and upper-limb dysfunction induced by leprosy using noninvasive transcranial magnetic stimulation (TMS.In a cross-sectional study design, we mapped bilaterally in the primary motor cortex (M1 the representations of the hand flexor digitorum superficialis (FDS, as well as of the intrinsic hand muscles abductor pollicis brevis (APB, first dorsal interosseous (FDI and abductor digiti minimi (ADM. All participants underwent clinical assessment, handgrip dynamometry and motor and sensory nerve conduction exams 30 days before mapping. Wilcoxon signed rank and Mann-Whitney tests were performed with an alpha-value of p<0.05.Dynamometry performance of the patients' most affected hand (MAH, was worse than that of the less affected hand (LAH and of healthy controls participants (p = 0.031, confirming handgrip impairment. Motor threshold (MT of the FDS muscle was higher in both hemispheres in patients as compared to controls, and lower in the hemisphere contralateral to the MAH when compared to that of the LAH. Moreover, motor evoked potential (MEP amplitudes collected in the FDS of the MAH were higher in comparison to those of controls. Strikingly, MEPs in the intrinsic hand muscle FDI had lower amplitudes in the hemisphere contralateral to MAH as compared to those of the LAH and the control group. Taken together, these results are suggestive of a more robust representation of an extrinsic hand flexor and impaired intrinsic hand muscle function in the hemisphere contralateral to the MAH due to leprosy.Decreased sensory-motor function induced by

  4. Primary Motor Cortex Representation of Handgrip Muscles in Patients with Leprosy

    Science.gov (United States)

    Rangel, Maria Luíza Sales; Sanchez, Tiago Arruda; Moreira, Filipe Azaline; Hoefle, Sebastian; Souto, Inaiacy Bittencourt; da Cunha, Antônio José Ledo Alves

    2015-01-01

    Background Leprosy is an endemic infectious disease caused by Mycobacterium leprae that predominantly attacks the skin and peripheral nerves, leading to progressive impairment of motor, sensory and autonomic function. Little is known about how this peripheral neuropathy affects corticospinal excitability of handgrip muscles. Our purpose was to explore the motor cortex organization after progressive peripheral nerve injury and upper-limb dysfunction induced by leprosy using noninvasive transcranial magnetic stimulation (TMS). Methods In a cross-sectional study design, we mapped bilaterally in the primary motor cortex (M1) the representations of the hand flexor digitorum superficialis (FDS), as well as of the intrinsic hand muscles abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM). All participants underwent clinical assessment, handgrip dynamometry and motor and sensory nerve conduction exams 30 days before mapping. Wilcoxon signed rank and Mann-Whitney tests were performed with an alpha-value of pDynamometry performance of the patients’ most affected hand (MAH), was worse than that of the less affected hand (LAH) and of healthy controls participants (p = 0.031), confirming handgrip impairment. Motor threshold (MT) of the FDS muscle was higher in both hemispheres in patients as compared to controls, and lower in the hemisphere contralateral to the MAH when compared to that of the LAH. Moreover, motor evoked potential (MEP) amplitudes collected in the FDS of the MAH were higher in comparison to those of controls. Strikingly, MEPs in the intrinsic hand muscle FDI had lower amplitudes in the hemisphere contralateral to MAH as compared to those of the LAH and the control group. Taken together, these results are suggestive of a more robust representation of an extrinsic hand flexor and impaired intrinsic hand muscle function in the hemisphere contralateral to the MAH due to leprosy. Conclusion Decreased sensory

  5. Bone and muscular anatomy of the forearm and hand in Tapirus terrestris (Perissodactyla, Tapiridae

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    Saulo Gonçalves Pereira

    2017-05-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2017v30n2p35 In Brazil, there are two species of tapirs, the largest land mammals in Brazil, which belong to the order Perissodactyla, as do horses. Our aim was to describe the bone and muscular anatomy of the forearm and hand in T. terrestris and to propose adaptive functions. We used five anatomical specimens donated from a breeder to the Laboratory for Teaching and Research on Wild Animals of the Federal University of Uberlandia after death with no trauma. The bones were analyzed, the muscles dissected, and both described. The bones of the forearm and hand of the tapir are the ulna, radius, Os. metacarpalia, Os. carpi, phalanx and Os. sesamoideum. The muscles are M. extensor carpi radialis, M. ulnaris lateralis; M. flexor carpi radialis; M. extensor radialis communis; M. extensor digitorum longus II, III, IV and V, M. extensor digitorum lateralis; M. extensor digitorum; M. abductor longus; M. flexor digiti superficialis; M. flexor digitalis; M. flexor carpi ulnaris; M. flexor carpi obliquus; and M. interossei and M. lumbricales. Characteristics of bone and muscle structure are adapted to the development of the animal’s niche.

  6. Bone and muscular anatomy of the forearm and hand in Tapirus terrestris (Perissodactyla, Tapiridae

    Directory of Open Access Journals (Sweden)

    Saulo Gonçalves Pereira

    2017-05-01

    Full Text Available In Brazil, there are two species of tapirs, the largest land mammals in Brazil, which belong to the order Perissodactyla, as do horses. Our aim was to describe the bone and muscular anatomy of the forearm and hand in T. terrestris and to propose adaptive functions. We used five anatomical specimens donated from a breeder to the Laboratory for Teaching and Research on Wild Animals of the Federal University of Uberlandia after death with no trauma. The bones were analyzed, the muscles dissected, and both described. The bones of the forearm and hand of the tapir are the ulna, radius, Os. metacarpalia, Os. carpi, phalanx and Os. sesamoideum. The muscles are M. extensor carpi radialis, M. ulnaris lateralis; M. flexor carpi radialis; M. extensor radialis communis; M. extensor digitorum longus II, III, IV and V, M. extensor digitorum lateralis; M. extensor digitorum; M. abductor longus; M. flexor digiti superficialis; M. flexor digitalis; M. flexor carpi ulnaris; M. flexor carpi obliquus; and M. interossei and M. lumbricales. Characteristics of bone and muscle structure are adapted to the development of the animal’s niche.

  7. Relação eletromiográfica integrada dos músculos vasto medial oblíquo e vasto lateral longo na marcha em sujeitos com e sem síndrome de dor femoropatelar Relación electromiográfica integrada de los músculos vasto medial oblicuo y vasto lateral largo en marcha en individuos con y sin síndrome de dolor femoropatelar Integrated electromyographic ratio of the vastus medialis oblique and vastus lateralis longus muscles in gait in subjects with and without patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    Gilmar Moraes Santos

    2007-02-01

    actividad eléctrica de los músculos VMO y VLL, en individuos con y sin SDFP es igual en el trote tanto en superficie plana como la que tiene inclinación de 5°.The aim of this study was to determine if there is difference between the vastus medialis oblique and vastus lateralis longus (VMO/VLL muscles activation during treadmill gait level and ascending to 5% degree between healthy subjects and others with patellofemoral pain syndrome. Electromyographic data from the VMO and VLL muscles were obtained in 15 subjects without and 12 with patellofemoral pain syndrome (PFPS during treadmill gait with and without 5 degrees inclination. The value of the VMO/VLL ratio was determined from the mean of 8 strides, in each condition, during 12 s. The t-Student test did not show significant difference in the VMO/VLL ratio between the two groups, regardless the condition. Although there was not significant difference, the subjects of the control group showed higher values in the VMO/VLL ratio in the two tested conditions than the subject of the PFPS group. The findings suggest that the ratio of the electric activity of the VMO and VLL muscles in individuals with and without SDFP is equal in the gait on flat surface as well as slanted to 5 degrees.

  8. Ultrasound evaluation of foot muscles and plantar fascia in pes planus.

    Science.gov (United States)

    Angin, Salih; Crofts, Gillian; Mickle, Karen J; Nester, Christopher J

    2014-01-01

    Multiple intrinsic and extrinsic soft tissue structures that apply forces and support the medial longitudinal arch have been implicated in pes planus. These structures have common functions but their interaction in pes planus is not fully understood. The aim of this study was to compare the cross-sectional area (CSA) and thickness of the intrinsic and extrinsic foot muscles and plantar fascia thickness between normal and pes planus feet. Forty-nine adults with a normal foot posture and 49 individuals with pes planus feet were recruited from a university population. Images of the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles and the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. The CSA and thickness of AbH, FHB and PER muscles were significantly smaller (AbH -12.8% and -6.8%, FHB -8.9% and -7.6%, PER -14.7% and -10%), whilst FDL (28.3% and 15.2%) and FHL (24% and 9.8%) were significantly larger in the pes planus group. The middle (-10.6%) and anterior (-21.7%) portions of the plantar fascia were thinner in pes planus group. Greater CSA and thickness of the extrinsic muscles might reflect compensatory activity to support the MLA if the intrinsic foot muscle function has been compromised by altered foot structure. A thinner plantar fascia suggests reduced load bearing, and regional variations in structure and function in feet with pes planus. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Contributions of foot muscles and plantar fascia morphology to foot posture.

    Science.gov (United States)

    Angin, Salih; Mickle, Karen J; Nester, Christopher J

    2018-01-27

    The plantar foot muscles and plantar fascia differ between different foot postures. However, how each individual plantar structure contribute to foot posture has not been explored. The purpose of this study was to investigate the associations between static foot posture and morphology of plantar foot muscles and plantar fascia and thus the contributions of these structures to static foot posture. A total of 111 participants were recruited, 43 were classified as having pes planus and 68 as having normal foot posture using Foot Posture Index assessment tool. Images from the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles, and the calcaneal (PF1), middle (PF2) and metatarsal (PF3) regions of the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. In order of decreasing contribution, PF3 > FHB > FHL > PER > FDB were all associated with FPI and able to explain 69% of the change in FPI scores. PF3 was the highest contributor explaining 52% of increases in FPI score. Decreased thickness was associated with increased FPI score. Smaller cross sectional area (CSA) in FHB and PER muscles explained 20% and 8% of increase in FPI score. Larger CSA of FDB and FHL muscles explained 4% and 14% increase in FPI score respectively. The medial plantar structures and the plantar fascia appear to be the major contributors to static foot posture. Elucidating the individual contribution of multiple muscles of the foot could provide insight about their role in the foot posture. Copyright © 2018. Published by Elsevier B.V.

  10. Laterality of motor cortical function measured by transcranial magnetic stimulation threshold tracking.

    Science.gov (United States)

    Shibuya, Kazumoto; Park, Susanna B; Howells, James; Huynh, William; Noto, Yu-Ichi; Shahrizaila, Nortina; Matamala, José M; Vucic, Steve; Kiernan, Matthew C

    2017-03-01

    Threshold tracking paired-pulse transcranial magnetic stimulation (TTTMS) examines cortical function and is useful for diagnosis of motor neuron disorders. Differences in cortical function have been identified between dominant and non-dominant limbs using constant stimulus methods, but they remain unclear, potentially due to methodological differences. In this study we aimed to clarify differences in cortical function between dominant and non-dominant limbs using TTTMS. Single-pulse TMS, TTTMS, and nerve conduction studies were performed in 25 healthy, right-handed participants by recording from the abductor pollicis brevis muscle. There were no side-to-side differences observed in resting motor threshold, motor evoked potential (MEP) amplitude, MEP latency, central motor conduction time, cortical silent period, short-interval intracortical inhibition and facilitation, compound muscle action potential (CMAP) amplitude, CMAP latency, F-wave latency, or neurophysiological index. These findings suggest that, when using TTTMS, there are no differences in cortical function between dominant and non-dominant hemispheres. Muscle Nerve 55: 424-427, 2017. © 2016 Wiley Periodicals, Inc.

  11. Measuring ipsilateral silent period: Effects of muscle contraction levels and quantification methods.

    Science.gov (United States)

    Kuo, Yi-Ling; Dubuc, Tobin; Boufadel, Danielle F; Fisher, Beth E

    2017-11-01

    Ipsilateral silent period (iSP) is a frequently measured index of interhemispheric inhibition. However, the methodology used across studies has been inconsistent and variable. We investigated the optimal contraction level and quantification methods for achieving iSP measurement consistency. Twenty-five healthy adults performed right isometric thumb abduction under three conditions (30%, 50%, and 100% of maximal voluntary contraction) while transcranial magnetic stimulation was applied over the primary motor cortex representational area of the abductor pollicis brevis. iSP was quantified by: iSP duration, iSP area and normalized iSP. Measurement consistency was determined by the homogeneity of variance test and by the coefficient of variation. iSP was consistent across all contraction levels when measured by iSP duration and normalized iSP. Normalized iSP showed the least measurement variability. We propose that future investigations examining interhemispheric inhibition use normalized iSP for measurement consistency and the ability to compare results across studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Normal sensorimotor plasticity in complex regional pain syndrome with fixed posture of the hand.

    Science.gov (United States)

    Morgante, Francesca; Naro, Antonino; Terranova, Carmen; Russo, Margherita; Rizzo, Vincenzo; Risitano, Giovanni; Girlanda, Paolo; Quartarone, Angelo

    2017-01-01

    Movement disorders associated with complex regional pain syndrome type I have been a subject of controversy over the last 10 years regarding their nature and pathophysiology, with an intense debate about the functional (psychogenic) nature of this disorder. The aim of this study was to test sensorimotor plasticity and cortical excitability in patients with complex regional pain syndrome type I who developed a fixed posture of the hand. Ten patients with complex regional pain syndrome type I in the right upper limb and a fixed posture of the hand (disease duration less than 24 months) and 10 age-matched healthy subjects were enrolled. The following parameters of corticospinal excitability were recorded from the abductor pollicis brevis muscle of both hands by transcranial magnetic stimulation: resting and active motor thresholds, short-interval intracortical inhibition and facilitation, cortical silent period, and short- and long-latency afferent inhibition. Sensorimotor plasticity was tested using the paired associative stimulation protocol. Short-interval intracortical inhibition and long-latency afferent inhibition were reduced only in the affected right hand of patients compared with control subjects. Sensorimotor plasticity was comparable to normal subjects, with a preserved topographic specificity. Our data support the view that motor disorder in complex regional pain syndrome type I is not associated with abnormal sensorimotor plasticity, and it shares pathophysiological abnormalities with functional (psychogenic) dystonia rather than with idiopathic dystonia. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  13. Electrically and hybrid-induced muscle activations: effects of muscle size and fiber type

    Directory of Open Access Journals (Sweden)

    Kelly Stratton

    2016-07-01

    Full Text Available The effect of three electrical stimulation (ES frequencies (10, 35, and 50 Hz on two muscle groups with different proportions of fast and slow twitch fibers (abductor pollicis brevis (APB and vastus lateralis (VL was explored. We evaluated the acute muscles’ responses individually and during hybrid activations (ES superimposed by voluntary activations. Surface electromyography (sEMG and force measurements were evaluated as outcomes. Ten healthy adults (mean age: 24.4 ± 2.5 years participated after signing an informed consent form approved by the university Institutional Review Board. Protocols were developed to: 1 compare EMG activities during each frequency for each muscle when generating 25% Maximum Voluntary Contraction (MVC force, and 2 compare EMG activities during each frequency when additional voluntary activation was superimposed over ES-induced 25% MVC to reach 50% and 75% MVC. Empirical mode decomposition (EMD was utilized to separate ES artifacts from voluntary muscle activation. For both muscles, higher stimulation frequency (35 and 50Hz induced higher electrical output detected at 25% of MVC, suggesting more recruitment with higher frequencies. Hybrid activation generated proportionally less electrical activity than ES alone. ES and voluntary activations appear to generate two different modes of muscle recruitment. ES may provoke muscle strength by activating more fatiguing fast acting fibers, but voluntary activation elicits more muscle coordination. Therefore, during the hybrid activation, less electrical activity may be detected due to recruitment of more fatigue-resistant deeper muscle fibers, not reachable by surface EMG.

  14. Effect of neurofeedback and electromyographic-biofeedback therapy on improving hand function in stroke patients.

    Science.gov (United States)

    Rayegani, S M; Raeissadat, S A; Sedighipour, L; Rezazadeh, I Mohammad; Bahrami, M H; Eliaspour, D; Khosrawi, S

    2014-01-01

    The aim of the present study was to evaluate the effect of applying electroencephalogram (EEG) biofeedback (neurobiofeedback) or electromyographic (EMG) biofeedback to conventional occupational therapy (OT) on improving hand function in stroke patients. This study was designed as a preliminary clinical trial. Thirty patients with stroke were entered the study. Hand function was evaluated by Jebsen Hand Function Test pre and post intervention. Patients were allocated to 3 intervention cohorts: (1) OT, (2) OT plus EMG-biofeedback therapy, and (3) OT plus neurofeedback therapy. All patients received 10 sessions of conventional OT. Patients in cohorts 2 and 3 also received EMG-biofeedback and neurofeedback therapy, respectively. EMG-biofeedback therapy was performed to strengthen the abductor pollicis brevis (APB) muscle. Neurofeedback training was aimed at enhancing sensorimotor rhythm after mental motor imagery. Hand function was improved significantly in the 3 groups. The spectral power density of the sensorimotor rhythm band in the neurofeedback group increased after mental motor imagery. Maximum and mean contraction values of electrical activities of the APB muscle during voluntary contraction increased significantly after EMG-biofeedback training. Patients in the neurofeedback and EMG-biofeedback groups showed hand improvement similar to conventional OT. Further studies are suggested to assign the best protocol for neurofeedback and EMG-biofeedback therapy.

  15. Enhancement of motor coordination by applying high frequency repetitive TMS on the sensory cortex.

    Science.gov (United States)

    Choi, Eun-Hi; Yoo, Woo-Kyoung; Ohn, Suk Hoon; Ahn, SeungHo; Kim, Han Jun; Jung, Kwang-Ik

    2016-06-01

    The sensory function plays an important role for successful motor performance. We investigated the modulating effects of high frequency repetitive transcranial magnetic stimulation (rTMS) on sensory discrimination and motor coordination. Twenty healthy participants were assigned into two random groups; the real- and sham-rTMS group. Total of 900 rTMS pulses at a frequency of 10Hz (stimulus intensity of 90% RMT) were given over deltoid representational areas of the somatosensory cortex. Sensory discrimination ability was evaluated using two-point discrimination test. Motor coordination was measured by the latency difference between the synchronized contraction of deltoid and abductor pollicis brevis muscles before and after rTMS. The sensory discrimination was significantly increased only in the deltoid area and the difference in the latency of synchronized contraction of two muscles was significantly shortened after real-rTMS compared sham condition, which had tendency of negative correlation following real-rTMS condition. The results of this study demonstrated rTMS-induced enhancement of sensorimotor integration, which may contribute to develop effective therapeutic strategies for rehabilitation of various sensorimotor disorders in the clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Utility of repetitive nerve stimulation test for ALS diagnosis.

    Science.gov (United States)

    Hatanaka, Yuki; Higashihara, Mana; Chiba, Takashi; Miyaji, Yosuke; Kawamura, Yasuomi; Sonoo, Masahiro

    2017-05-01

    Decremental responses in the repetitive nerve stimulation (RNS) test in amyotrophic lateral sclerosis (ALS) patients have been reported, although their possible diagnostic role has received little investigation. We investigated their diagnostic role in differentiation between ALS and cervical spondylotic amyotrophy (CSA), an important ALS mimic especially in Japan. Patients were prospectively enrolled and the diagnosis was confirmed by follow-up. RNS was performed on the abductor pollicis brevis (APB), upper trapezius (trapezius) and deltoid muscles. Enrolled subjects consisted of 53 ALS and 37 CSA patients. Abnormal decremental responses (>5%) were observed in 32%, 51% and 75% of ALS patients and 3%, 0% and 20% of CSA patients for the APB, trapezius and deltoid muscles, respectively. The sensitivity for 23 ALS patients with upper-limb onset was 78% for the trapezius and 100% for the deltoid muscles. An abnormal decremental response in the trapezius muscle was 100% specific to ALS in comparison with CSA: abnormal decrement in this muscle would strongly suggest ALS. No decrement in the deltoid muscle might exclude ALS in patients having symptoms with upper-limb onset. RNS is useful in differentiation between ALS and CSA. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  17. “Tratamiento de la Displasia Acetabular Pura mediante cojín de Frejka y aparato abductor tipo Rhino R”

    OpenAIRE

    Islas Picazo, José Luís

    2012-01-01

    La Displasia del desarrollo de la cadera tiene una incidencia de 1 x 1000 nacidos, lo cual la hace uno de los problemas más comunes del aparato locomotor en los niños. Su comportamiento es dinámico, razón ésta para que su término médico actual sea Displasia de la cadera en desarrollo (DCD) (1-5). El mejor pronóstico lo hace su detección temprana, lo cual motiva a divulgar e instruir ampliamente a nivel primario de atención, acerca de una excelente evaluación clínica y el rec...

  18. Different hip rotations influence hip abductor muscles activity during isometric side-lying hip abduction in subjects with gluteus medius weakness.

    Science.gov (United States)

    Lee, Ji-Hyun; Cynn, Heon-Seock; Kwon, Oh-Yun; Yi, Chung-Hwi; Yoon, Tae-Lim; Choi, Woo-Jeong; Choi, Sil-Ah

    2014-04-01

    The purpose of this study was to establish the effects of different hip rotations during isometric side-lying hip abduction (SHA) in subjects with gluteus medius (Gmed) weakness by investigating the electromyographic (EMG) amplitude of the Gmed, tensor fasciae latae (TFL) activity, and gluteus maximus (Gmax), and the activity ratio of the Gmed/TFL, Gmax/TFL, and Gmed/Gmax. Nineteen subjects with Gmed weakness were recruited for this study. Subjects performed three isometric hip abductions: frontal SHA with neutral hips (SHA-N), frontal SHA with hip medial rotation (SHA-MR), and frontal SHA with hip lateral rotation (SHA-LR). Surface EMG amplitude was measured to collect the EMG data from the Gmed, TFL, and Gmax. A one-way repeated-measures analysis of variance was used to determine the statistical significance of the Gmed, TFL, and Gmax EMG activity and the Gmed/TFL, Gmax/TFL, and Gmed/Gmax EMG activity ratios. Gmed EMG activity was significantly greater in SHA-MR than in SHA-N. TFL EMG activity was significantly greater in SHA-LR than in SHA-N. The Gmed/TFL and Gmed/Gmax EMG activity ratios were also significantly greater in SHA-MR than in SHA-N or SHA-LR. The results of this study suggest that SHA-MR can be used as an effective method to increase Gmed activation and to decrease TFL activity during SHA exercises. Published by Elsevier Ltd.

  19. Distal intersection tenosynovitis of the wrist: a lesser-known extensor tendinopathy with characteristic MR imaging features

    International Nuclear Information System (INIS)

    Parellada, Antoni J.; Gopez, Angela G.; Morrison, William B.; Sweet, Stephanie; Leinberry, Charles F.; Reiter, Sean B.; Kohn, Mark

    2007-01-01

    To present the MRI imaging findings of extensor tenosynovitis at the distal intersection or crossover between the second (extensor carpi radialis longus (ECRL) and brevis (ECRB)) and third (extensor pollicis longus (EPL)) extensor compartment tendons, and the anatomical details that may play a role in the pathogenesis of this condition. The imaging studies and clinical records of five patients (three females and two males, with ages ranging between 22 and 78 years; mean age, 49 years) presenting with pain on the dorsal and radial aspect of the wrist were reviewed by two musculoskeletal radiologists in consensus. Three cases were identified serendipitously during routine clinical reading sessions; a follow-up computerized database search for additional cases reported in the prior two years yielded two additional cases. The overall number of cases screened was 1,031. The diagnosis of tendinopathy affecting the second and third compartment extensor tendons was made on the basis of MRI findings and clinical follow-up, or synovectomy. All patients showed signs of tenosynovitis: in four patients both the tendons of the second and third extensor compartments were affected; the fifth patient showed signs of tenosynovitis of the EPL tendon, and tendinosis of the extensor carpi radialis tendons. Three patients showed tenosynovitis proximal and distal to the point of intersection; and in two of them, a discrete point of constriction was appreciated at the crossover site in relation to the extensor retinaculum. Two patients showed tenosynovitis limited to the segment distal to the point of decussation. Tendinosis tended to follow the presence of tenosynovitis. In one of the patients, subtendinous reactive marrow edema in Lister's tubercle was noted. Distal intersection tenosynovitis may be related to the biomechanical pulley effect exerted by Lister's tubercle on the EPL tendon as it leaves the third compartment and crosses over the extensor carpi radialis tendons, as well as

  20. Distal intersection tenosynovitis of the wrist: a lesser-known extensor tendinopathy with characteristic MR imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Parellada, Antoni J. [DII - Diagnostic Imaging, Inc., Philadelphia, PA (United States); Frankford Hospitals - Torresdale Campus, Department of Radiology, Philadelphia, PA (United States); Gopez, Angela G.; Morrison, William B. [Thomas Jefferson University, Department of Radiology, Philadelphia, PA (United States); Sweet, Stephanie [Thomas Jefferson University, Philadelphia Hand Center, Philadelphia, PA (United States); Leinberry, Charles F. [Thomas Jefferson University, Department of Orthopedic Surgery - Hand Surgery, Philadelphia, PA (United States); Reiter, Sean B.; Kohn, Mark [DII - Diagnostic Imaging, Inc., Philadelphia, PA (United States)

    2007-03-15

    To present the MRI imaging findings of extensor tenosynovitis at the distal intersection or crossover between the second (extensor carpi radialis longus (ECRL) and brevis (ECRB)) and third (extensor pollicis longus (EPL)) extensor compartment tendons, and the anatomical details that may play a role in the pathogenesis of this condition. The imaging studies and clinical records of five patients (three females and two males, with ages ranging between 22 and 78 years; mean age, 49 years) presenting with pain on the dorsal and radial aspect of the wrist were reviewed by two musculoskeletal radiologists in consensus. Three cases were identified serendipitously during routine clinical reading sessions; a follow-up computerized database search for additional cases reported in the prior two years yielded two additional cases. The overall number of cases screened was 1,031. The diagnosis of tendinopathy affecting the second and third compartment extensor tendons was made on the basis of MRI findings and clinical follow-up, or synovectomy. All patients showed signs of tenosynovitis: in four patients both the tendons of the second and third extensor compartments were affected; the fifth patient showed signs of tenosynovitis of the EPL tendon, and tendinosis of the extensor carpi radialis tendons. Three patients showed tenosynovitis proximal and distal to the point of intersection; and in two of them, a discrete point of constriction was appreciated at the crossover site in relation to the extensor retinaculum. Two patients showed tenosynovitis limited to the segment distal to the point of decussation. Tendinosis tended to follow the presence of tenosynovitis. In one of the patients, subtendinous reactive marrow edema in Lister's tubercle was noted. Distal intersection tenosynovitis may be related to the biomechanical pulley effect exerted by Lister's tubercle on the EPL tendon as it leaves the third compartment and crosses over the extensor carpi radialis tendons

  1. Rodent Research-1 (RR1) NASA Validation Flight: Mouse extensor digitorum longus muscle transcriptomic and epigenomic data

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA s Rodent Research (RR) project is playing a critical role in advancing biomedical research on the physiological effects of space environments. Due to the...

  2. Thumb troubles in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    G. Garofalo

    2011-09-01

    Full Text Available Thumb involvement may play a relevant role in inducing a severe functional impairment in rheumatoid arthritis. The aim of this sonographic vignette is to show the value of sonography in detailing anatomic changes involving the thumb during a phase of active synovitis. The patient was a 50-year old man who presented with a 3-year history of rheumatoid arthritis. He complained of a 4-week history of a marked recrudescence inflammatory thumb involvement associated with clinical signs of carpal tunnel syndrome. Sonographic images were obtained with a real-time ultrasound system equipped with a 13 MHz linear transducer. Sonographic examination on longitudinal dorsal scan of the metacarpophalangeal joint of the thumb showed a moderate joint cavity widening with two evident bone erosions, one at the metacarpal head and the other one at the basis of the proximal phalanx. The longitudinal volar scan of the first metacarpophalangeal joint confirmed the presence of synovitis detecting a marked joint cavity widening, with aspect of synovial proliferation. The flexor pollicis longus tendon was severely involved (marked tendon sheath widening, synovial proliferation, loss of the normal homogeneous fibrillar echotexture, and a large intratendinous tear. Sonography allowed the depiction of a wide range of otherwise undetectable pathologic changes in the standard clinical setting.

  3. An anomalous accessory extensor proprius indicis muscle: A case report

    Directory of Open Access Journals (Sweden)

    Mustafa Kurklu

    2013-12-01

    Full Text Available Variations related to tendon insertion and musculotendinous junction of the extensor proprius indicis muscle are commonly encountered. An anomalous extensor indicis proprius muscle (EIP tendon was detected in a fifty-year-old female cadaver during routine dissection of the right upper extremity. The body of tendon was initiated from the posterior ulna as a one muscle body, then continued as two separate muscle bodies and tendons and finally they were separated into two slips after passing the fourth dorsal compartment. As a radial part, it was divided into two slips at the level of the first metacarpophalangeal joint, and conjugated with the extensor pollicis longus (EPL muscle. Then, as an ulnar part, it was terminated at the radial side of the lateral band of the second metacarpophalangeal joint. Familiarity with the normal anatomy and variations of the tendons may help to prevent confusion and mistakes during tendon repairs, and tendon transfers. [Hand Microsurg 2013; 2(3.000: 122-124

  4. Single-stage reconstruction of flexor tendons with vascularized tendon transfers.

    Science.gov (United States)

    Cavadas, P C; Pérez-García, A; Thione, A; Lorca-García, C

    2015-03-01

    The reconstruction of finger flexor tendons with vascularized flexor digitorum superficialis (FDS) tendon grafts (flaps) based on the ulnar vessels as a single stage is not a popular technique. We reviewed 40 flexor tendon reconstructions (four flexor pollicis longus and 36 finger flexors) with vascularized FDS tendon grafts in 38 consecutive patients. The donor tendons were transferred based on the ulnar vessels as a single-stage procedure (37 pedicled flaps, three free flaps). Four patients required composite tendon and skin island transfer. Minimum follow-up was 12 months, and functional results were evaluated using a total active range of motion score. Multiple linear regression analysis was performed to evaluate the factors that could be associated with the postoperative total active range of motion. The average postoperative total active range of motion (excluding the thumbs) was 178.05° (SD 50°). The total active range of motion was significantly lower for patients who were reconstructed with free flaps and for those who required composite tendon and skin island flap. Age, right or left hand, donor/motor tendon and pulley reconstruction had no linear effect on total active range of motion. Overall results were comparable with a published series on staged tendon grafting but with a lower complication rate. Vascularized pedicled tendon grafts/flaps are useful in the reconstruction of defects of finger flexor tendons in a single stage, although its role in the reconstructive armamentarium remains to be clearly established. © The Author(s) 2014.

  5. Structural Diversity of the Extensor Digitorum Profundus Muscle Complex in Platyrrhini.

    Science.gov (United States)

    Novikova, Mellin A; Panyutina, Aleksandra A

    2017-01-01

    Separate extension of fingers in the hand of primates is performed by 3 muscles: m. extensor pollicis longus, m. extensor digiti secundi, and m. extensor digitorum lateralis. Here it is proposed to consider them as parts of the extensor digitorum profundus muscular complex. The diversity in structure of these muscles in primates is examined based both on original anatomical study of New World monkeys and analysis of extensive published data on primates from different taxonomic groups. It is shown that in these muscles there are 2 main types of structure variations - the division of the muscle belly into several heads which give rise to separate tendons, and the split of the single terminal tendon into several branches. The first type of modification ensures the possibility of a separate management of the fingers, and the second, on the contrary, ensures the coupled control of extension of fingers. A scheme of evolutionary transformations of muscles belonging to the complex of the deep extensors of fingers is proposed. © 2017 S. Karger AG, Basel.

  6. Arthroscopic Hemitrapeziectomy for First Carpometacarpal Arthritis: Results at 7-year Follow-up

    Science.gov (United States)

    Leak, Robert S.; Culp, Randall W.; Osterman, A. Lee

    2008-01-01

    The purpose of this study was to determine the outcome of arthroscopic hemitrapeziectomy combined with thermal capsular plication and temporary K-wire fixation in patients with painful thumb basal joint due to either osteoarthritis or posttraumatic arthritis. There were 18 thumbs that were evaluated in this retrospective study of arthroscopic hemitrapeziectomy of the distal trapezium in addition to a pancapsular thermal shrinkage at an average of 7.6-year follow-up. No patient has required further surgery. A subjective improvement in pain, pinch activities, strength, and range of motion (ROM) was noted in all patients, and no patient had further surgery on their thumb. On exam, no patient had a first carpal–metacarpal grind or laxity. Total ROM of the thumb axis decreased by 20%, but all patients could oppose to the fifth finger. Grip strength remained unchanged, key pinch improved from 8 to 11 lbs, and tip pinch improved from 4 to 5 lbs. Radiographs showed a metacarpal subsidence of 1.8 mm (0–4 mm). Four complications were noted: two cases of dorsal radial nerve neuritis, one rupture of the flexor pollicis longus, and one prolonged hematoma. Results demonstrate that arthroscopic hemitrapeziectomy and capsular shrinkage for first carpometacarpal arthritis is an effective technique that provides high patient satisfaction, a functional pain-free thumb, and a reliable rate of return to activity. PMID:18820976

  7. Varied anatomy of the thumb pulley system: implications for successful trigger thumb release.

    Science.gov (United States)

    Schubert, Manuel F; Shah, Vandan S; Craig, Clifford L; Zeller, John L

    2012-11-01

    The anatomical arrangement of the thumb pulley system continues to be revised through ongoing investigative research, changing our previous assumptions. This study demonstrates the components and anatomical features of this pulley system in an effort to improve surgical outcomes and to clarify current misconceptions. Researchers procured 75 hand specimens from 41 adult cadavers through our institution's anatomical donations program. Dissections of the thumb and thenar compartment identified the various pulleys. A detailed analysis of the thumb pulleys was performed through various measurements. Four different pulley categories were identified: type I (n = 5), type II (n = 29), type III (n = 29), and type IV (n = 12). The variable annular pulley was present in 70 of 75 hands (93%) in 1 of 3 arrangements: transverse, oblique, or fused with the A1 pulley. The pulley system of the thumb is composed of 4 components, as opposed to the traditional view of only 3. Along with the A1 pulley, the additional variable annular pulley might contribute to stenosis in trigger thumb. This might necessitate a more extensive surgical incision and its partial release to relieve triggering. Understanding the anatomical configuration of the thumb pulley system will aid in the surgical attempt to resolve triggering while avoiding complications such as bowstringing of the flexor pollicis longus tendon and iatrogenic nerve injury. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  8. The pulley system of the thumb: anatomic and biomechanical study.

    Science.gov (United States)

    Bayat, Ardeshir; Shaaban, Hassan; Giakas, Giannis; Lees, Vivien C

    2002-07-01

    To examine the precise conformation of the annular and oblique pulleys of the thumb flexor sheath, anatomic dissections were undertaken on 14 hands. In all specimens a distinct pulley was found between the A1 and oblique pulleys. This is named the variable annular pulley or Av pulley. There appear to be 3 discrete forms of this pulley designated type I to III. The biomechanical study was done on 8 limbs by using linear strain transduction techniques. The analysis showed that the strain in the oblique pulley was greater in extension than in flexion of the thumb. This statement remains true even after division of either the A1 or Av pulley and after section of both pulleys. The oblique pulley does not prevent bowstringing of the flexor pollicis longus when A1 and Av pulleys have been sectioned. These studies challenge current concepts of both the anatomy and mechanics of the thumb pulley system with implications for clinical procedures such as trigger thumb release and pulley reconstruction.

  9. Radial and ulnar bursae of the wrist: cadaveric investigation of regional anatomy with ultrasonographic-guided tenography and MR imaging

    International Nuclear Information System (INIS)

    Aguiar, R.O.C.; Gasparetto, E.L.; Marchiori, E.; Escuissato, D.L.; Trudell, D.J.; Haghighi, P.; Resnik, D.

    2006-01-01

    To demonstrate the anatomy of the radial and ulnar bursae of the wrist using MR and US images. Ultrasonographic-guided tenography of the tendon sheath of flexor pollicis longus (FPL) and the common tendon sheath of the flexor digitorum of the fifth digit (FD5) of ten cadaveric hands was performed, followed by magnetic resonance imaging and gross anatomic correlation. Patterns of communication were observed between these tendon sheaths and the radial and ulnar bursae of the wrist. The tendon sheath of the FPL communicated with the radial bursa in 100% (10/10) of cases, and the tendon sheath of the FD5 communicated with the ulnar bursa in 80% (8/10). Communication of the radial and ulnar bursae was evident in 100% (10/10), and presented an ''hourglass'' configuration in the longitudinal plane. The ulnar and radial bursae often communicate. The radial bursa communicates with the FPL tendon sheath, and the ulnar bursa may communicate with the FD5 tendon sheath

  10. Do we really need new medical information about the Turin Shroud?

    Science.gov (United States)

    Bevilacqua, M; Fanti, G; D'Arienzo, M; De Caro, R

    2014-02-01

    Image processing of the Turin Shroud (TS) shows that the Man represented in it has undergone an under glenoidal dislocation of the humerus on the right side and lowering of the shoulder, and has a flattened hand and enophthalmos; conditions that have not been described before, despite several studies on the subject. These injuries indicate that the Man suffered a violent blunt trauma to the neck, chest and shoulder from behind, causing neuromuscular damage and lesions of the entire brachial plexus. The posture of the left claw-hand is indicative of an injury of the lower brachial plexus, as is the crossing of the hands on the pubis, not above the pubis as it would normally be, and are related to traction of the limbs as a result of the nailing to the patibulum. The disappearance of the thumbprints is because of entrainment of the flexor pollicis longus tendons while the nails were driven through the wrists. The blunt chest trauma, which resulted in the body falling forwards, was the direct cause of a lung contusion and haemothorax, confirmed by the post-mortem leakage of clots and serum from the chest caused by the stabbing with the spear, and was a likely cause of cardiac contusion. All the evidence is in favour of the hypothesis that the TS Man is Jesus of Nazareth. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Hand tendon involvement in rheumatoid arthritis: an ultrasound study.

    Science.gov (United States)

    Filippucci, Emilio; Gabba, Alessandra; Di Geso, Luca; Girolimetti, Rita; Salaffi, Fausto; Grassi, Walter

    2012-06-01

    To assess the prevalence and the distribution of tendon involvement in the hands and wrists of patients with rheumatoid arthritis (RA) describing in detail the ultrasound (US) morphostructural and vascular tendon abnormalities. Ninety consecutive RA patients were included in the study. The following tendons were scanned bilaterally: flexor pollicis longus tendon, flexor digitorum superficialis, and profundus tendons of the II to the V fingers (at both finger and carpal tunnel levels), flexor carpi radialis tendon, and extensor tendons of the 6 compartments on the dorsal aspect of the wrist. The presence of US findings indicative of tenosynovitis and tendon damage was investigated. Tenosynovitis was found in at least 1 anatomic site of 44 (48.8%) of 90 patients. Tendon damage was found in at least 1 anatomic site of 39 (43.3%) of 90 patients. The focal tendon echotexture derangement was found in 294 of 5400 (5.4%) tendons, the partial and complete tears in 14 (0.3%), and in 3 (0.06%) tendons, respectively. The most frequently involved tendons were the flexor tendons of the II, III, and IV fingers and the extensor carpi ulnaris tendon. The present study provides evidence in favor of the ability of US to reveal a relatively high frequency of tendon involvement at the hand and wrist level in RA patients. These data can both facilitate US examinations in daily clinical practice and direct further investigations in the US assessment of tendon involvement in RA. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Forearm reconstruction after loss of radius: Case report

    Directory of Open Access Journals (Sweden)

    Manojlović Radovan

    2013-01-01

    Full Text Available Introduction. Osteomyelitis of the radius resulting in the radial clubhand is a very rare condition and few studies have been published about its prognosis and treatment. Case Outline. This is a case report of hematogenous osteomyelitis of the radius with a complete loss of the radius leaving only the distal radial metaphysis to carry the carpus. In order to achieve best functional results, four-step operative protocol was performed for reconstruction; lengthening of the forearm by external fixator, radioulnar transposition to create a one-bone forearm, plate removal and transposition of brachioradialis to the extensor pollicis longus as well as proximal row carpectomy. After nine years of the last operation, the function of the elbow and hands is good with acceptable cosmetic result. The forearm is 5 cm shorter and there has been a persistent mild limitation of palmar flexion. Conclusion. Creation of the one-bone forearm normalizes the elbow and wrist function, corrects forearm malalignment, and improves forearm growth potential.

  13. Volar morphology of the distal radius in axial planes: a quantitative analysis.

    Science.gov (United States)

    Oura, Keiichiro; Oka, Kunihiro; Kawanishi, Yohei; Sugamoto, Kazuomi; Yoshikawa, Hideki; Murase, Tsuyoshi

    2015-04-01

    To investigate the cause of rupture of the flexor pollicis longus (FPL) after volar plate fixation of distal radius fractures, previous studies have examined the shape of the distal radius in the sagittal plane or in the lateral view. However, there are no reports on the anatomical shape of the volar surface concavity of the distal radius in the axial plane. We hypothesized that this concavity might contribute to the mismatch between the plate and the surface of the radius. To test this hypothesis, we constructed three-dimensional models of the radius and FPL based on computed tomography scans of 70 normal forearms. We analyzed axial cross-sectional views with 2 mm intervals. In all cases, the volar surface of the distal radius was concave in the axial plane. The concavity depth was maximum at 6 mm proximal to the palmar edge of the lunate fossa and progressively decreased toward the proximal radius. FPL was closest to the radius at 2 mm proximal to the palmar edge of the lunate fossa. The volar surface of the distal radius was externally rotated from proximal to distal. These results may help to develop new implants which fit better to the radius and decrease tendon irritation. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. Asymptomatic Flexor Tendon Damages after Volar Locking Plate Fixation of Distal Radius Fractures.

    Science.gov (United States)

    Tokunaga, Susumu; Abe, Yoshihiro

    2017-03-01

    To investigate asymptomatic flexor tendon damages after volar locking plate fixation of distal radius fractures in 32 wrists of 32 patients with distal radius fractures fixed using two plate types. Sixteen patients received the Acu-Loc volar distal radius plate, and the remaining 16 patients received the Aptus distal radius correction plate. The flexor pollicis longus (FPL) tendon and flexor digitorum profundus were evaluated according to intraoperative findings at plate removal. Ultrasonography was used to measure the distance between the FPL tendon and distal edge of the plates (FPL plate distance) before plate removal, the distance between the FPL tendon and distal edge of the radius (FPL radius distance) after plate removal, in the contralateral wrist, and the angle between an extension line of a volar surface line on the proximal FPL tendon and a second volar surface line on the distal FPL tendon (FPL angles). Erosion of the FPL tendon was identified in four wrists, and erosion of the flexor digitorum profundus of the index finger was identified in one wrist. All five cases of wrists with flexor tendon damage had Acu-Loc plates installed. The average FPL angle before plate removal was 15.4° in the wrists with tendon damage, which was statistically significantly larger than the average FPL angle in the wrists without erosion. The type of plate and larger FPL angle on ultrasonography may be the risk factors for flexor tendon damage.

  15. The posterior cricoarytenoid muscle is spared from MuRF1-mediated muscle atrophy in mice with acute lung injury.

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    D Clark Files

    Full Text Available Skeletal muscle wasting in acute lung injury (ALI patients increases the morbidity and mortality associated with this critical illness. The contribution of laryngeal muscle wasting to these outcomes is unknown, though voice impairments and aspiration are common in intensive care unit (ICU survivors. We evaluated the intrinsic laryngeal abductor (PCA, posterior cricoarytenoid, adductor (CT, cricothyroid and limb (EDL, extensor digitorum longus muscles in a mouse model of ALI.Escherichia coli lipopolysaccharides were instilled into the lungs of adult male C57Bl6J mice (ALI mice. Limb and intrinsic laryngeal muscles were analyzed for fiber size, type, protein expression and myosin heavy chain (MyHC composition by SDS-PAGE and mass spectroscopy.Marked muscle atrophy occurred in the CT and EDL muscles, while the PCA was spared. The E3 ubiquitin ligase muscle ring finger-1 protein (MuRF1, a known mediator of limb muscle atrophy in this model, was upregulated in the CT and EDL, but not in the PCA. Genetic inhibition of MuRF1 protected the CT and EDL from ALI-induced muscle atrophy. MyHC-Extraocular (MyHC-EO comprised 27% of the total MyHC in the PCA, distributed as hybrid fibers throughout 72% of PCA muscle fibers.The vocal cord abductor (PCA contains a large proportion of fibers expressing MyHC-EO and is spared from muscle atrophy in ALI mice. The lack of MuRF1 expression in the PCA suggests a previously unrecognized mechanism whereby this muscle is spared from atrophy. Atrophy of the vocal cord adductor (CT may contribute to the impaired voice and increased aspiration observed in ICU survivors. Further evaluation of the sparing of muscles involved in systemic wasting diseases may lead to potential therapeutic targets for these illnesses.

  16. The responsiveness of sensibility and strength tests in patients undergoing carpal tunnel decompression

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    Miller Leanne

    2011-10-01

    Full Text Available Abstract Background Several clinical measures of sensory and motor function are used alongside patient-rated questionnaires to assess outcomes of carpal tunnel decompression. However there is a lack of evidence regarding which clinical tests are most responsive to clinically important change over time. Methods In a prospective cohort study 63 patients undergoing carpal tunnel decompression were assessed using standardised clinician-derived and patient reported outcomes before surgery, at 4 and 8 months follow up. Clinical sensory assessments included: touch threshold with monofilaments (WEST, shape-texture identification (STI™ test, static two-point discrimination (Mackinnon-Dellon Disk-Criminator and the locognosia test. Motor assessments included: grip and tripod pinch strength using a digital grip analyser (MIE, manual muscle testing of abductor pollicis brevis and opponens pollicis using the Rotterdam Intrinsic Handheld Myometer (RIHM. The Boston Carpal Tunnel Questionnaire (BCTQ was used as a patient rated outcome measure. Results Relative responsiveness at 4 months was highest for the BCTQ symptom severity scale with moderate to large effects sizes (ES = -1.43 followed by the BCTQ function scale (ES = -0.71. The WEST and STI™ were the most responsive sensory tests at 4 months showing moderate effect sizes (WEST ES = 0.55, STI ES = 0.52. Grip and pinch strength had a relatively higher responsiveness compared to thenar muscle strength but effect sizes for all motor tests were very small (ES ≤0.10 or negative indicating a decline compared to baseline in some patients. Conclusions For clinical assessment of sensibility touch threshold assessed by monofilaments (WEST and tactile gnosis measured with the STI™ test are the most responsive tests and are recommended for future studies. The use of handheld myometry (RIHM for manual muscle testing, despite more specifically targeting thenar muscles, was less responsive than grip or tripod

  17. The responsiveness of sensibility and strength tests in patients undergoing carpal tunnel decompression

    Science.gov (United States)

    2011-01-01

    Background Several clinical measures of sensory and motor function are used alongside patient-rated questionnaires to assess outcomes of carpal tunnel decompression. However there is a lack of evidence regarding which clinical tests are most responsive to clinically important change over time. Methods In a prospective cohort study 63 patients undergoing carpal tunnel decompression were assessed using standardised clinician-derived and patient reported outcomes before surgery, at 4 and 8 months follow up. Clinical sensory assessments included: touch threshold with monofilaments (WEST), shape-texture identification (STI™ test), static two-point discrimination (Mackinnon-Dellon Disk-Criminator) and the locognosia test. Motor assessments included: grip and tripod pinch strength using a digital grip analyser (MIE), manual muscle testing of abductor pollicis brevis and opponens pollicis using the Rotterdam Intrinsic Handheld Myometer (RIHM). The Boston Carpal Tunnel Questionnaire (BCTQ) was used as a patient rated outcome measure. Results Relative responsiveness at 4 months was highest for the BCTQ symptom severity scale with moderate to large effects sizes (ES = -1.43) followed by the BCTQ function scale (ES = -0.71). The WEST and STI™ were the most responsive sensory tests at 4 months showing moderate effect sizes (WEST ES = 0.55, STI ES = 0.52). Grip and pinch strength had a relatively higher responsiveness compared to thenar muscle strength but effect sizes for all motor tests were very small (ES ≤0.10) or negative indicating a decline compared to baseline in some patients. Conclusions For clinical assessment of sensibility touch threshold assessed by monofilaments (WEST) and tactile gnosis measured with the STI™ test are the most responsive tests and are recommended for future studies. The use of handheld myometry (RIHM) for manual muscle testing, despite more specifically targeting thenar muscles, was less responsive than grip or tripod pinch testing using

  18. Sustantial Observation on Foot Taeyang Meridian Muscle in Human Lower Limb from a Anatomical Viewpoint

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    Kyoung-Sik Park

    2009-06-01

    Full Text Available Objective : This study was carried to identify the anatomical component of FTMM(Foot Taeyang Meridian Muscle in human lower limb, and further to help the accurate application to real acupuncture. Methods : FTM at the surface of the lower limb was labelled with latex. And cadaver was stripped off to demonstrate muscles, nerves and the others and to display the internal structures of FTMM, being divided into outer, middle, and inner layer. Results : FTMM in human lower limb is composed of muscles, nerves, ligaments etc. The internal composition of the FTMM in human lower limb are as follows : 1 Muscle : Gluteus maximus. biceps femoris, semitendinosus, gastrocnemius, triceps calf, fibularis brevis tendon, superior peroneal retinacula, calcaneofibular ligament, inferior extensor retinaculum, abductor digiti minimi, sheath of flexor tendon at outer layer, biceps femoris, semimembranosus, plantaris, soleus, posterior tibialis, fibularis brevis, extensor digitorum brevis, flexor digiti minimi at middle layer, and for the last time semimembranosus, adductor magnus, plantaris, popliteus, posterior tibialis, flexor hallucis longus, dorsal calcaneocuboidal ligament at inner layer. 2 Nerve : Inferior cluneal nerve, posterior femoral cutaneous n., sural cutaneous n., proper plantar branch of lateral plantar n. at outer layer, sciatic nerve, common peroneal n., medial sural cutaneous n., tibial n. at middle layer, and for the last time tibial nerve, flexor hallucis longus branch of tibial n. at inner layer. Conclusions : This study proves comparative differences from already established studies from the viewpoint of constituent elements of FTMM in the lower limb, and also in the aspect of substantial assay method. We can guess that there are conceptional differences between terms (that is, nerves which control muscles of FTMM and those which pass near by FTMM in human anatomy.

  19. 38 CFR 4.73 - Schedule of ratings-muscle injuries.

    Science.gov (United States)

    2010-07-01

    ...) extensor digitorum longus; (3) extensor hallucis longus; (4) peroneus tertius Severe 30 Moderately Severe... Dorsal: (1) Extensor hallucis brevis; (2) extensor digitorum brevis. Other important dorsal structures... longus; (4) peroneus brevis; (5) flexor hallucis longus; (6) flexor digitorum longus; (7) popliteus; (8...

  20. An Emotion-Enriched Context Influences the Effect of Action Observation on Cortical Excitability

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    Giovanna Lagravinese

    2017-10-01

    Full Text Available Observing other people in action activates the “mirror neuron system” that serves for action comprehension and prediction. Recent evidence suggests that this function requires a high level codification triggered not only by components of motor behavior, but also by the environment where the action is embedded. An overlooked component of action perceiving is the one related to the emotional information provided by the context where the observed action takes place. Indeed, whether valence and arousal associated to an emotion might exert an influence on motor system activation during action observation has not been assessed so far. Here, cortico-spinal excitability of the left motor cortex was recorded in three groups of subjects. In the first condition, motor-evoked potential (MEPs were recorded from a muscle involved in the grasping movement (i.e., abductor pollicis brevis, APB while participants were watching the same reach-to-grasp movement embedded in contexts with negative emotional valence, but different levels of arousal: sadness (low arousal, and disgust (high arousal (“Context plus Movement-APB” condition. In the second condition, MEPs were recorded from APB muscle while participants were observing static images representing the contexts in which the movement observed by participants in “Context plus Movement-APB” condition took place (“Context Only-APB” condition. Finally, in the third condition, MEPS were recorded from a muscle not involved in the grasping action, i.e., abductor digiti minimi, ADM, while participants were watching the same videos shown during the “Context plus Movement-APB” condition (“Context plus Movement-ADM” condition. Results showed a greater increase of cortical excitability only during the observation of the hand moving in the context eliciting disgust, and these changes were specific for the muscle involved in the observed action. Our findings show that the emotional context in which a

  1. Four-pulse transcranial magnetic stimulation using multiple conditioning inputs. Normative MEP responses.

    Science.gov (United States)

    Calancie, Blair; Wang, Dongliang; Young, Eufrosina; Alexeeva, Natalia

    2018-04-01

    A four-pulse pattern of transcranial magnetic stimulation (TMS) was compared to traditional dual-pulse TMS for its ability to modulate motor cortical excitability. This novel pattern consisted of a three-pulse train of subthreshold conditioning pulses followed by a suprathreshold test pulse (i.e., SC-T). The intervals between these superconditioning (SC) pulses (1, 3, or 6 ms) and the follow-on test pulse (1, 3, 10, or 25 ms) were varied, and the resultant MEPs were compared to those elicited by: (1) single-pulse TMS; and (2) dual-pulse conditioning-test (C-T) TMS with either short (3 ms) or long (10 ms) intervals to elicit short-interval intracortical inhibition (SICI) or intracortical facilitation (ICF), respectively. Testing included abductor pollicis brevis (APB) and tibialis anterior (TA) in 15 neurologically normal adults. For superconditioning inputs, 10 ms test intervals caused especially strong facilitation of the test MEP, while 1 ms test intervals were particularly effective at causing inhibition of the test response. For both muscles and across all subjects, the most effective of the 12 SC-T inputs tested for causing either facilitation or inhibition was-with rare exception-superior to the dual-pulse TMS input for causing facilitation (i.e., ICF) or inhibition (i.e., SICI), while the overall magnitude of effect was more pronounced in APB compared to TA. Nevertheless, after normalization, the impact of a superconditioning input train on the test MEP was similar in APB and TA muscles, suggesting similar mechanisms of action. Limited findings from a single subject with amyotrophic lateral sclerosis (ALS) are included to further illustrate the potential advantages of using a train of conditioning pulses preceding a TMS test pulse to selectively investigate abnormal motor cortical excitatory and inhibitory circuitry.

  2. Electrical Stimulation Frequency and Skeletal Muscle Characteristics: Effects on Force and Fatigue.

    Science.gov (United States)

    Vromans, Maria; Faghri, Pouran

    2017-12-05

    This investigation aimed to determine the force and muscle surface electromyography (EMG) responses to different frequencies of electrical stimulation (ES) in two groups of muscles with different size and fiber composition (fast- and slow-twitch fiber proportions) during a fatigue-inducing protocol. Progression towards fatigue was evaluated in the abductor pollicis brevis (APB) and vastus lateralis (VL) when activated by ES at three frequencies (10, 35, and 50Hz). Ten healthy adults (mean age: 23.2 ± 3.0 years) were recruited; participants signed an IRB approved consent form prior to participation. Protocols were developed to 1) identify initial ES current intensity required to generate the 25% maximal voluntary contraction (MVC) at each ES frequency and 2) evaluate changes in force and EMG activity during ES-induced contraction at each frequency while progressing towards fatigue. For both muscles, stimulation at 10Hz required higher current intensity of ES to generate the initial force. There was a significant decline in force in response to ES-induced fatigue for all frequencies and for both muscles (pmuscles. During the progression towards fatigue, the APB displayed an initial drop in force followed by an increase in EMG activity and the VL displayed a decrease in EMG activity for all frequencies. Overall, it appeared that there were some significant interactions between muscle size and fiber composition during progression towards fatigue for different ES frequencies. It could be postulated that muscle characteristics (size and fiber composition) should be considered when evaluating progression towards fatigue as EMG and force responses are not consistent between muscles.

  3. Electrical Stimulation Frequency and Skeletal Muscle Characteristics: Effects on Force and Fatigue

    Directory of Open Access Journals (Sweden)

    Maria Vromans

    2017-12-01

    Full Text Available This investigation aimed to determine the force and muscle surface electromyography (EMG responses to different frequencies of electrical stimulation (ES in two groups of muscles with different size and fiber composition (fast- and slow-twitch fiber proportions during a fatigue-inducing protocol. Progression towards fatigue was evaluated in the abductor pollicis brevis (APB and vastus lateralis (VL when activated by ES at three frequencies (10, 35, and 50Hz. Ten healthy adults (mean age: 23.2 ± 3.0 years were recruited; participants signed an IRB approved consent form prior to participation. Protocols were developed to 1 identify initial ES current intensity required to generate the 25% maximal voluntary contraction (MVC at each ES frequency and 2 evaluate changes in force and EMG activity during ES-induced contraction at each frequency while progressing towards fatigue. For both muscles, stimulation at 10Hz required higher current intensity of ES to generate the initial force. There was a significant decline in force in response to ES-induced fatigue for all frequencies and for both muscles (p<0.05. However, the EMG response was not consistent between muscles. During the progression towards fatigue, the APB displayed an initial drop in force followed by an increase in EMG activity and the VL displayed a decrease in EMG activity for all frequencies. Overall, it appeared that there were some significant interactions between muscle size and fiber composition during progression towards fatigue for different ES frequencies. It could be postulated that muscle characteristics (size and fiber composition should be considered when evaluating progression towards fatigue as EMG and force responses are not consistent between muscles.

  4. Transient impairment of the axolemma following regional anaesthesia by lidocaine in humans

    Science.gov (United States)

    Moldovan, Mihai; Lange, Kai Henrik Wiborg; Aachmann-Andersen, Niels Jacob; Kjær, Troels Wesenberg; Olsen, Niels Vidiendal; Krarup, Christian

    2014-01-01

    The local anaesthetic lidocaine is known to block voltage-gated Na+ channels (VGSCs), although at high concentration it was also reported to block other ion channel currents as well as to alter lipid membranes. The aim of this study was to investigate whether the clinical regional anaesthetic action of lidocaine could be accounted for solely by the block of VGSCs or whether other mechanisms are also relevant. We tested the recovery of motor axon conduction and multiple measures of excitability by ‘threshold-tracking’ after ultrasound-guided distal median nerve regional anaesthesia in 13 healthy volunteers. Lidocaine caused rapid complete motor axon conduction block localized at the wrist. Within 3 h, the force of the abductor pollicis brevis muscle and median motor nerve conduction studies returned to normal. In contrast, the excitability of the motor axons at the wrist remained markedly impaired as indicated by a 7-fold shift of the stimulus–response curves to higher currents with partial recovery by 6 h and full recovery by 24 h. The strength–duration properties were abnormal with markedly increased rheobase and reduced strength–duration time constant. The changes in threshold during electrotonus, especially during depolarization, were markedly reduced. The recovery cycle showed increased refractoriness and reduced superexcitability. The excitability changes were only partly similar to those previously observed after poisoning with the VGSC blocker tetrodotoxin. Assuming an unaltered ion-channel gating, modelling indicated that, apart from up to a 4-fold reduction in the number of functioning VGSCs, lidocaine also caused a decrease of passive membrane resistance and an increase of capacitance. Our data suggest that the lidocaine effects, even at clinical ‘sub-blocking’ concentrations, could reflect, at least in part, a reversible structural impairment of the axolemma. PMID:24710060

  5. Lengthened Cutaneous Silent Period in Fibromyalgia Suggesting Central Sensitization as a Pathogenesis.

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    Seol-Hee Baek

    Full Text Available The pathogenesis of fibromyalgia (FM has not been clearly elucidated, but central sensitization, which plays an important role in the development of neuropathic pain, is considered to be the main mechanism. The cutaneous silent period (CSP, which is a spinal reflex mediated by A-delta cutaneous afferents, is useful for the evaluation of sensorimotor integration at the spinal and supraspinal levels. To understand the pathophysiology of FM, we compared CSP patterns between patients with FM and normal healthy subjects. Twenty-four patients with FM diagnosed in accordance with the 1990 American College of Rheumatology classification system and 24 age- and sex-matched healthy volunteers were recruited. The CSP was measured from the abductor pollicis brevis muscle. Demographic data, number of tender points, and visual analog scale and FM impact questionnaire scores were collected. The measured CSP and clinical parameters of the patient and control groups were compared. In addition, possible correlations between the CSP parameters and the other clinical characteristics were analyzed. Mean CSP latencies did not differ between patients (55.50 ± 10.97 ms and healthy controls (60.23 ± 11.87 ms; p = 0.158, although the mean CSP duration was significantly longer in patients (73.75 ± 15.67 ms than in controls (63.50 ± 14.05 ms; p = 0.021. CSP variables did not correlate with any clinical variables. The significantly longer CSP duration in FM patients suggests central dysregulation at the spinal and supraspinal levels, rather than peripheral small fiber dysfunction.

  6. Lengthened Cutaneous Silent Period in Fibromyalgia Suggesting Central Sensitization as a Pathogenesis.

    Science.gov (United States)

    Baek, Seol-Hee; Seok, Hung Youl; Koo, Yong Seo; Kim, Byung-Jo

    2016-01-01

    The pathogenesis of fibromyalgia (FM) has not been clearly elucidated, but central sensitization, which plays an important role in the development of neuropathic pain, is considered to be the main mechanism. The cutaneous silent period (CSP), which is a spinal reflex mediated by A-delta cutaneous afferents, is useful for the evaluation of sensorimotor integration at the spinal and supraspinal levels. To understand the pathophysiology of FM, we compared CSP patterns between patients with FM and normal healthy subjects. Twenty-four patients with FM diagnosed in accordance with the 1990 American College of Rheumatology classification system and 24 age- and sex-matched healthy volunteers were recruited. The CSP was measured from the abductor pollicis brevis muscle. Demographic data, number of tender points, and visual analog scale and FM impact questionnaire scores were collected. The measured CSP and clinical parameters of the patient and control groups were compared. In addition, possible correlations between the CSP parameters and the other clinical characteristics were analyzed. Mean CSP latencies did not differ between patients (55.50 ± 10.97 ms) and healthy controls (60.23 ± 11.87 ms; p = 0.158), although the mean CSP duration was significantly longer in patients (73.75 ± 15.67 ms) than in controls (63.50 ± 14.05 ms; p = 0.021). CSP variables did not correlate with any clinical variables. The significantly longer CSP duration in FM patients suggests central dysregulation at the spinal and supraspinal levels, rather than peripheral small fiber dysfunction.

  7. Coil optimisation for transcranial magnetic stimulation in realistic head geometry.

    Science.gov (United States)

    Koponen, Lari M; Nieminen, Jaakko O; Mutanen, Tuomas P; Stenroos, Matti; Ilmoniemi, Risto J

    Transcranial magnetic stimulation (TMS) allows focal, non-invasive stimulation of the cortex. A TMS pulse is inherently weakly coupled to the cortex; thus, magnetic stimulation requires both high current and high voltage to reach sufficient intensity. These requirements limit, for example, the maximum repetition rate and the maximum number of consecutive pulses with the same coil due to the rise of its temperature. To develop methods to optimise, design, and manufacture energy-efficient TMS coils in realistic head geometry with an arbitrary overall coil shape. We derive a semi-analytical integration scheme for computing the magnetic field energy of an arbitrary surface current distribution, compute the electric field induced by this distribution with a boundary element method, and optimise a TMS coil for focal stimulation. Additionally, we introduce a method for manufacturing such a coil by using Litz wire and a coil former machined from polyvinyl chloride. We designed, manufactured, and validated an optimised TMS coil and applied it to brain stimulation. Our simulations indicate that this coil requires less than half the power of a commercial figure-of-eight coil, with a 41% reduction due to the optimised winding geometry and a partial contribution due to our thinner coil former and reduced conductor height. With the optimised coil, the resting motor threshold of abductor pollicis brevis was reached with the capacitor voltage below 600 V and peak current below 3000 A. The described method allows designing practical TMS coils that have considerably higher efficiency than conventional figure-of-eight coils. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. [Concurrence of myasthenia gravis, polymyositis, thyroiditis and eosinophilia in a patient with type B1 thymoma].

    Science.gov (United States)

    Inoue, Manabu; Kojima, Yasuhiro; Shinde, Akiyo; Satoi, Hitoshi; Makino, Fumi; Kanda, Masutarou; Shibasaki, Hiroshi

    2007-07-01

    We presented a 43-year-old Japanese woman who acutely developed weakness of all extremities and difficulty in swallowing and drooping of eyelids, characterized by easy fatigability at the end of December, 2005. On general physical examination, she had moderate goiter. No cervical lymphadenopathy, cardiac murmur, or skin rash was noted. Neurologically, she had blepharoptosis, more on the right, only in the upright position with easy fatigability and marked weakness in the neck flexor, trunk, and all limb muscles much more proximally than distally. She had neither muscular atrophy nor upper motor neuron sign. Laboratory data showed slight leukocytosis with eosinophilia (up to 31%), and serum creatine kinase was markedly increased to over 2,000 IU/l. TSH receptor antibody (11.9%) and anti-acetylcholine receptor antibody (46.6 nmol/L) were also increased. Edrophonium test was positive. Electrophysiologically, muscle evoked potentials by repetitive motor nerve stimulation showed 13% and 50% waning in abductor pollicis brevis and deltoid muscle, respectively, at low frequency and no waxing at high frequency. Needle EMG showed fibrillation potentials and positive sharp waves in proximal muscles. Polymyositis was diagnosed by muscle biopsy which showed infiltration of lymphocytes in the endomysium and around non-necrotic muscle fibers. Upper arm muscle MRI showed multifocal high signal intensity lesions on T2-weighted images which were likely related to myositis. This finding is atypical for polymyositis. X-ray and CT of chest showed a mass lesion in the left pulmonary hilum, which was histologically diagnosed as type B1 thymoma. Thus, the present case had myasthenia gravis, polymyositis, thyroidititis and eosinophilia associated with type B1 thymoma. After the thymectomy, corticosteroid administration and immunoadsorption therapy, clinical symptoms and all laboratory abnormalities markedly improved.

  9. Impairment of sensory-motor plasticity in mild Alzheimer's disease.

    Science.gov (United States)

    Terranova, Carmen; Carmen, Terranova; SantAngelo, Antonino; Antonino, Sant'Angelo; Morgante, Francesca; Francesca, Morgante; Rizzo, Vincenzo; Vincenzo, Rizzo; Allegra, Roberta; Roberta, Allegra; Arena, Maria Grazia; Grazia, Arena Maria; Ricciardi, Lucia; Lucia, Ricciardi; Ghilardi, Marie Felice; Felice, Ghilardi Maria; Girlanda, Paolo; Paolo, Girlanda; Quartarone, Angelo; Angelo, Quartarone

    2013-01-01

    Primary motor cortex (M1) is relatively spared in the early stages of Alzheimer's disease (AD). Aim of the present study was to investigate whether abnormal M1 synaptic plasticity is present at an early stage of AD. We employed an electrophysiological protocol, named rapid paired associative stimulation (rPAS), involving repetitive transcranial magnetic stimulation (rTMS) paired with electrical stimulation of the contralateral median nerve, that modifies corticospinal excitability and short latency afferent inhibition (SAI). We studied 10 patients with a diagnosis of probable mild AD according to the Mini Mental State Examination score (minimum 21) and 14 age-matched control subjects. Motor evoked potentials (MEP) amplitudes and short-afferent inhibition (SAI) were measured at baseline before and for up to 60 min after 5Hz-rPAS in abductor pollicis brevis (APB). rPAS consisted of 600 pairs of transcranial magnetic stimuli, at a rate of 5 Hz for 2 min, coupled with electrical median nerve stimulation preceding TMS over the contralateral M1 at an inter-stimulus interval of 25 ms. Baseline SAI was significantly reduced in AD patients. In the control subjects rPAS induced a significant increase in MEP amplitudes and a decrease of SAI in the APB muscle persistently for up to 1 h. Conversely 5Hz-rPAS did not induce any significant changes in MEP amplitudes and SAI in mild AD patients. Sensory-motor plasticity is impaired in the motor cortex of AD at an early stage of the disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. A local signature of LTP-like plasticity induced by repetitive paired associative stimulation.

    Science.gov (United States)

    Naro, Antonino; Russo, Margherita; AbdelKader, Mohamed; Manganotti, Paolo; Genovesi, Vincenzo; Marino, Marco; Rizzo, Vincenzo; Calabrò, Rocco Salvatore; Girlanda, Paolo; Quartarone, Angelo

    2015-03-01

    Repetitive paired associative stimulation (rPAS) repeatedly pairs electrical nerve stimulation (ENS) with transcranial magnetic stimulation (TMS) of the contralateral motor hand area (M1) at 5 Hz frequency. So far, there are only few studies concerning the effects of PAS on the modulation of EEG power. Hence, aim of the present study was to investigate rPAS long term after-effects on cortical excitability looking at EEG power spectra. In four experimental sessions, separated by 2 weeks interval, 12 awake subjects received rPAS of the right median nerve and left M1 at a fixed interval (ISI) of 25 ms (real condition), 5 Hz-TMS on left M1, 5 Hz-ENS, of the right median nerve, and rPAS with changing ISI (sham condition). We measured peak-to-peak MEP amplitude, evoked from the target muscle (right abductor pollicis brevis muscle) at rest and the absolute power (POW) in four frequency bands: α (8-12 Hz), β (13-30), θ (4-7) and δ (1-3), under rest conditions. All these parameters were evaluated in three detection blocks: baseline, immediately after and after 30' from the end of the conditioning protocol. Real rPAS induced a long-lasting homotopic cortical excitability modulation, as indexed by MEP amplitude increase, that was paralleled by a long-lasting reduction of α/β-POW and by a widespread θ-δ-POW modulation. rPAS applied over the sensory-motor cortex induced an LTP-like plasticity, as indexed by a robust reduction in the α/β POW positively correlated with the MEP amplitude increase. rPAS25ms may be a useful tool for motor neurorehabilitation promoting a sensory-motor coupling within β oscillations.

  11. Motor potentials evoked by paired cortical stimuli.

    Science.gov (United States)

    Inghilleri, M; Berardelli, A; Cruccu, G; Priori, A; Manfredi, M

    1990-01-01

    We recorded the motor evoked potentials (MEPs) from the abductor pollicis brevis muscle, after supramaximal electrical transcranial stimulation, and studied the effect of paired transcranial shocks with varying interstimulus time intervals, in 10 normal subjects, 4 patients with median nerve neuropathy and 2 patients with motoneurone disease. In relaxed muscles the amplitude of the MEP evoked by a single shock averaged 30% of the M wave. With intervals from 1 to 2.5 msec 2 shocks evoked one MEP far larger in size than the control MEP (70% of the M wave). With intervals of 10 msec and longer, the 2 shocks evoked 2 independent MEPs; the size of the MEP following the second shock (test) was inversely correlated with the size of the control MEP: the more the control MEP approached the size of the M wave, the smaller the test MEP. Single motor unit records showed that, in the normal subjects and patients with peripheral neuropathy, the same motor unit was activated either by the first or the second shock, whereas in the patients with motoneurone disease it fired twice. In active muscles, the control MEP averaged 70% of the M wave. With intervals of 10 msec and longer the test MEP was markedly suppressed; with 100 msec intervals it fully recovered. In relaxed muscles, by delivering a double shock at a 1.5 msec interval, thus evoking a large MEP, followed by a second double-shock, the test MEP was completely suppressed for a period of 20 msec; it began to recover at 50 msec intervals and fully recovered after 150 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players.

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    Raffaella Chieffo

    Full Text Available Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls, together with electromyographic recording of mirror movements (MMs to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH than on the non-dominant hemisphere (NDH. On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14 and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere.

  13. Motor Cortex Reorganization in Patients with Glioma Assessed by Repeated Navigated Transcranial Magnetic Stimulation-A Longitudinal Study.

    Science.gov (United States)

    Barz, Anne; Noack, Anika; Baumgarten, Peter; Seifert, Volker; Forster, Marie-Therese

    2018-04-01

    Evidence for cerebral reorganization after resection of low-grade glioma has mainly been obtained by serial intraoperative cerebral mapping. Noninvasively collected data on cortical plasticity in tumor patients over a surgery-free period are still scarce. The present study therefore aimed at evaluating motor cortex reorganization by navigated transcranial magnetic stimulation (nTMS) in patients after perirolandic glioma surgery. nTMS was performed preoperatively and postoperatively in 20 patients, separated by 26.1 ± 24.8 months. Further nTMS mapping was conducted in 14 patients, resulting in a total follow-up period of 46.3 ± 25.4 months. Centers of gravity (CoGs) were calculated for every muscle representation area, and Euclidian distances between CoGs over time were defined. Results were compared with data from 12 healthy individuals, who underwent motor cortex mapping by nTMS in 2 sessions. Preoperatively and postoperatively pooled CoGs from the area of the dominant abductor pollicis brevis muscle and of the nondominant leg area differed significantly compared with healthy individuals (P reorganization of all representation areas was observed in 3 patients, and a significant shift of hand representation areas was identified in further 3 patients. Complete functional recovery of postoperative motor deficits was exclusively associated with cortical reorganization. Despite the low potential of remodeling within the somatosensory region, long-term reorganization of cortical motor function can be observed. nTMS is best suited for a noninvasive evaluation of this reorganization. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Major motor-functional determinants associated with poor self-reported health-related quality of life in myasthenia gravis patients.

    Science.gov (United States)

    Cioncoloni, David; Casali, Stefania; Ginanneschi, Federica; Carone, Marisa; Veronica, Boni; Rossi, Alessandro; Giannini, Fabio

    2016-05-01

    Myasthenia gravis (MG) is an autoimmune neuromuscular disorder in which disabling muscle weakness may affect health-related quality of life (HRQoL). The aim of this study was to investigate which common motor-functional deficits and corresponding severity are most determinant of poor HRQoL in these patients. In 41 patients, the dichotomized first item of the Italian Myasthenia Gravis Questionnaire (IMGQ), categorizing patients who report "good" and "poor" HRQoL, was chosen as dependent-outcome variable. All items composing the myasthenia gravis-specific scale (MG-ADL), i.e. talking, chewing, swallowing, breathing, impairment of ability to brush teeth or comb hair, impairment of ability to rise from chair, double vision, and eyelid droop were acquired as independent variables and dichotomized. Stepwise backward LR multivariable logistic regression analysis was performed. In addition, the main characteristics of patients were compared. MG-ADL items "chewing" ≥1, i.e. "fatigue chewing solid food", and "breathing" ≥2, i.e. "shortness of breath at rest" proved to be significant determinants. Higher dose of corticosteroid therapy was significantly (p = 0.027; r s  = -0.35), correlated with poor HRQoL. At diagnosis, a decremental response to repetitive nerve stimulation (RNS) from the abductor pollicis brevis was significantly more frequent in patients with poor HRQoL. In conclusion, impaired "chewing" and "breathing" functions indicate the need for careful planning of rehabilitation, re-education and patient management. Moreover, decremental response to RNS at diagnosis may identify patients at risk for poor HRQoL.

  15. Thoracic limb morphology of the red panda (Ailurus fulgens evidenced by osteology and radiography

    Directory of Open Access Journals (Sweden)

    Modesta Makungu

    2015-02-01

    Full Text Available The red panda (Ailurus fulgens is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  16. Thoracic limb morphology of the red panda (Ailurus fulgens evidenced by osteology and radiography

    Directory of Open Access Journals (Sweden)

    Modesta Makungu

    2015-07-01

    Full Text Available The red panda (Ailurus fulgens is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  17. Thoracic limb morphology of the red panda (Ailurus fulgens) evidenced by osteology and radiography.

    Science.gov (United States)

    Makungu, Modesta; Groenewald, Hermanus B; Du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N

    2015-07-15

    The red panda (Ailurus fulgens) is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  18. Multicenter Survey of the Effects of Rehabilitation Practices on Pinch Force Strength After Tendon Transfer to Restore Pinch in Tetraplegia.

    Science.gov (United States)

    Johanson, M Elise; Jaramillo, Jeffrey P; Dairaghi, Christine A; Murray, Wendy M; Hentz, Vincent R

    2016-06-01

    To identify key components of conventional therapy after brachioradialis (BR) to flexor pollicis longus (FPL) transfer, a common procedure to restore pinch strength, and evaluate whether any of the key components of therapy were associated with pinch strength outcomes. Rehabilitation protocols were surveyed in 7 spinal cord injury (SCI) centers after BR to FPL tendon transfer. Key components of therapy, including duration of immobilization, participation, and date of initiating therapy activities (mobilization, strengthening, muscle reeducation, functional activities, and home exercise), were recorded by the patient's therapist. Pinch outcomes were recorded with identical equipment at 1-year follow-up. Seven SCI rehabilitation centers where the BR to FPL surgery is performed on a routine basis. Thirty-eight arms from individuals with C5-7 level SCI injury who underwent BR to FPL transfer surgery (N=34). Conventional therapy according to established protocol in each center. The frequency of specific activities and their time of initiation (relative to surgery) were expressed as means and 95% confidence intervals. Outcome measures included pinch strength and the Canadian Occupational Performance Measure (COPM). Spearman rank-order correlations determined significant relations between pinch strength and components of therapy. There was similarity in the key components of therapy and in the progression of activities. Early cast removal was associated with pinch force (Spearman ρ=-.40, P=.0269). Pinch force was associated with improved COPM performance (Spearman ρ=.48, P=.0048) and satisfaction (Spearman ρ=.45, P=.0083) scores. Initiating therapy early after surgery is beneficial after BR to FPL surgery. Postoperative therapy protocols have the potential to significantly influence the outcome of tendon transfers after tetraplegia. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Anatomical study of the motor branches of the median nerve to the forearm and guidelines for selective neurectomy.

    Science.gov (United States)

    Parot, Catalina; Leclercq, Caroline

    2016-07-01

    The median nerve is responsible for the motor innervation of most of the muscles usually involved in upper limb spasticity. Selective neurectomy is one of the treatments utilized to reduce spasticity. The purpose of this study was to describe the variations of the motor branches of the median nerve in the forearm and draw recommendations for an appropriate planning of selective neurectomy. The median nerve was dissected in the forearm of 20 fresh cadaver upper limbs. Measurements included number, origin, division, and entry point of each motor branch into the muscles. One branch for the pronator teres was the most common pattern. In 9/20 cases, it arose as a common trunk with other branches. A single trunk innervated the flexor carpi radialis with a common origin with other branches in 17/20 cases. Two, three or four branches innervated the flexor digitorum superficialis, the first one frequently through a common trunk with other branches. They were very difficult to identify unless insertions of pronator teres and flexor digitorum superficialis were detached. The flexor digitorum profundus received one to five branches and flexor pollicis longus one to two branches from the anterior interosseous nerve. There is no regular pattern of the motor branches of the median nerve in the forearm. Our findings differ in many points from the classical literature. Because of the frequency of common trunks for different muscles, we recommend the use of peroperative electrical stimulation. Selective neurotomy of flexor digitorum superficialis is technically difficult, because the entry point of some of their terminal branches occurs just below the arch and deep to the muscle belly.

  20. The range of excursion of flexor tendons in Zone V: a comparison of active vs passive flexion mobilisation regimes.

    LENUS (Irish Health Repository)

    Panchal, J

    1997-10-01

    A number of early postoperative mobilisation regimes have been developed in an attempt to increase tendon excursion and gliding and thereby reduce formation of adhesions following repair of flexor tendons. Early active flexion mobilisation regimes are becoming more popular, and have replaced early passive flexion regimes in many centres. The aim of the present study was: (a) to determine the range of excursion of flexor tendons in Zone V, and (b) to compare the excursion ranges between active (Belfast) and passive (modified Duran) flexion mobilisation regimes postoperatively. This was done (a) in two cadavers, and (b) in two patients intraoperatively, and postoperatively at 10 days, 3 weeks and 6 weeks. With passive flexion, the mean tendon excursion in Zone V in cadavers was 1 mm for flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons respectively. With simulated active flexion, the mean tendon excursion was 14 mm, 10 mm and 11 mm respectively. The mean tendon excursion in clinical cases intraoperatively following passive flexion was 2 mm for FDS, FDP and FPL respectively; following simulated active flexion it was 10 mm, 11 mm and 11 mm for FDS, FDP and FPL respectively. On the tenth day following repair, the mean excursions of FDS, FDP and FPL were 1 mm, 4 mm and 4 mm on passive flexion as compared to 3 mm, 10 mm and 12 mm on active flexion respectively. Three weeks postoperatively, the mean excursions of FDS, FDP and FPL tendons were 1 mm, 2 mm and 1 mm on passive flexion as compared to 5 mm, 15 mm on active flexion respectively. Six weeks postoperatively, the mean excursions of FDS, FDP and FPL tendons were 9 mm, 7 mm and 4 mm on passive flexion as compared to 12 mm, 33 mm and 20 mm on active flexion respectively. These results demonstrate an increased excursion of repaired flexor tendons in Zone V following an active flexion mobilisation regime as compared to a passive flexion mobilisation regime.

  1. Anatomical variants of lister's tubercle; A new morphological classification based on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Wan Ying; Chong, Le Roy [Dept. of Radiology, Changi General Hospital, Singapore (Singapore)

    2017-11-15

    Lister's tubercle is used as a standard anatomical landmark in hand surgery and arthroscopy procedures. In this study, we aimed to evaluate and propose a classification for anatomical variants of Lister's tubercle. Between September 2011 and July 2014, 360 MRI examinations for wrists performed using 1.5T scanners in a single institution were retrospectively evaluated. The prevalence of anatomical variants of Lister's tubercle based on the heights and morphology of its radial and ulnar peaks was assessed. These were classified into three distinct types: radial peak larger than ulnar peak (Type 1), similar radial and ulnar peaks (Type 2) and ulnar peak larger than radial peak (Type 3). Each type was further divided into 2 subtypes (A and B) based on the morphology of the peaks. The proportions of Type 1, Type 2, and Type 3 variants in the study population were 69.2, 21.4, and 9.5%, respectively. For the subtypes, the Type 1A variant was the most common (41.4%) and conformed to the classical appearance of Lister's tubercle; whereas, Type 3A and 3B variants were rare configurations (6.4% and 3.1%, respectively) wherein the extensor pollicis longus tendon coursed along the radial aspect of Lister's tubercle. Anatomical variations of Lister's tubercle have potential clinical implications for certain pathological conditions and pre-procedural planning. The proposed classification system facilitates a better understanding of these anatomical variations and easier identification of at-risk and rare variants.

  2. Wrist ultrasound examination – scanning technique and ultrasound anatomy. Part 2: Ventral wrist

    Directory of Open Access Journals (Sweden)

    Cyprian Olchowy

    2017-06-01

    Full Text Available Ultrasound imaging of the musculoskeletal system is an important element of the diagnostic and therapeutic protocol. Clinical decisions, including those regarding surgical procedures, are often based solely on ultrasound imaging. However, detailed knowledge on the anatomy and a correct scanning technique are crucial for an accurate diagnosis. Modern ultrasonographic equipment allows obtaining detailed anatomical images of muscle tendons, ligaments, nerves and vessels of the carpal area. Ventral wrist ultrasound is one of the most common diagnostic procedures in patients with suspected carpal tunnel syndrome. Ventral wrist evaluation is also often performed in patients with wrist pain of unclear etiology, rheumatic diseases, wrist injuries or symptoms of ulnar neuropathy. The aim of this paper is to present ultrasound images with corresponding anatomical schemes. The technique of ultrasound examination of the ventral wrist along with practical guidance to help obtain highly diagnostic images is also discussed. The present paper is the second part of an article devoted to ultrasound anatomy and wrist ultrasound technique – the part discussing the dorsal side of the wrist was published in the Journal of Ultrasonography, Vol. 15, No 61. The following anatomical structures should be visualized during an ultrasound examination of the ventral wrist, both in the carpal tunnel as well as proximally and distally to it: four flexor digitorum superficialis tendons, four flexor digitorum profundus tendons, flexor pollicis longus, flexor carpi radialis tendon, median nerve and flexor retinaculum; in the carpal tunnel as well as proximally and distally to it: the ulnar nerve, ulnar artery and veins; the tendon of the flexor carpi ulnaris muscle; carpal joints.

  3. The clinical effect of tendon repair for tendon spontaneous rupture after corticosteroid injection in hands

    Science.gov (United States)

    Lu, Hui; Yang, Hu; Shen, Hui; Ye, Ganmin; Lin, Xiang-Jin

    2016-01-01

    Abstract Corticosteroid injections for hand tendinitis can lead to a rare significant complication of tendon spontaneous rupture. However, only sporadic cases were reported in the literature before. This study was designed to gauge the clinical effect of tendon repair in patients of tendon spontaneous rupture after corticosteroid injection and analyze our experience. This was a retrospective observational study of 13 patients (8 women and 5 men) operated between July 2011 and December 2015 for tendon spontaneous rupture after corticosteroid injection. Demographic data, clinical features, imaging data, and surgical treatments were carefully reviewed. The average age was 52.308 ± 15.381 years (range 29–71). The average injection times were 2.538 ± 1.664 times (range 1–6). The average rupture time (after last injection) was 10.923 ± 9.500 weeks (range 3–32). Nine patients were treated by tendon suture (69% of cases), and 4 patients were treated by tendon grafting (31% of cases). All patients received follow-up in our outpatient clinic. The sites of the tendon rupture (15 tendons of 13 patients had involved) include extensor pollicis longus (6 tendons, 40% of cases), extensor digiti quinti and extensor digiti minimi (4 tendons, 27% of cases), ring finger of extensor digitorum communis (3 tendons, 20% of cases), and middle finger of extensor digitorum communis (2 tendons, 13% of cases). Two patients who had tendon adhesion (15% of cases) were treated by tendon release. One patient who had tendon rerupture (8% of cases) was treated by tendon grafting. No patient had complications of infections, vascular, or nerve injury. Tendon spontaneous rupture is a serious complication after corticosteroid injection for tendinitis. Rigid standard of corticosteroid injection is very important. Magnetic resonance imaging was contributory to preoperative assess tendon defect and can be used to monitor healing quality of tendons during the follow-up. PMID:27741145

  4. High-frequency submaximal stimulation over muscle evokes centrally generated forces in human upper limb skeletal muscles.

    Science.gov (United States)

    Blouin, Jean-Sébastien; Walsh, Lee D; Nickolls, Peter; Gandevia, Simon C

    2009-02-01

    Control of posture and movement requires control of the output from motoneurons. Motoneurons of human lower limb muscles exhibit sustained, submaximal activity to high-frequency electrical trains, which has been hypothesized to be partly triggered by monosynaptic Ia afferents. The possibility to trigger such behavior in upper limb motoneurons and the potential unique role of Ia afferents to trigger such behavior remain unclear. Subjects (n = 9) received high-frequency trains of electrical stimuli over biceps brachii and flexor pollicis longus (FPL). We chose to study the FPL muscle because it has weak monosynaptic Ia afferent connectivity and it is involved in fine motor control of the thumb. Two types of stimulus trains (100-Hz bursts and triangular ramps) were tested at five intensities below painful levels. All subjects exhibited enhanced torque in biceps and FPL muscles after both types of high-frequency train. Torques also persisted after stimulation, particularly for the highest stimulus intensity. To separate the evoked torques that resulted from a peripheral mechanism (e.g., muscle potentiation) and that which resulted from a central origin, we studied FPL responses to high-frequency trains after complete combined nerve blocks of the median and radial nerves (n = 2). During the blocks, high-frequency trains over the FPL did not yield torque enhancements or persisting torques. These results suggest that enhanced contractions of central origin can be elicited in motoneurons innervating the upper limb, despite weak monosynaptic Ia connections for FPL. Their presence in a recently evolved human muscle (FPL) indicates that these enhanced contractions may have a broad role in controlling tonic postural outputs of hand muscles and that they may be available even for fine motor activities involving the thumb.

  5. New postcranial fossils of Australopithecus afarensis from Hadar, Ethiopia (1990-2007).

    Science.gov (United States)

    Ward, Carol V; Kimbel, William H; Harmon, Elizabeth H; Johanson, Donald C

    2012-07-01

    Renewed fieldwork at Hadar, Ethiopia, from 1990 to 2007, by a team based at the Institute of Human Origins, Arizona State University, resulted in the recovery of 49 new postcranial fossils attributed to Australopithecus afarensis. These fossils include elements from both the upper and lower limbs as well as the axial skeleton, and increase the sample size of previously known elements for A. afarensis. The expanded Hadar sample provides evidence of multiple new individuals that are intermediate in size between the smallest and largest individuals previously documented, and so support the hypothesis that a single dimorphic species is represented. Consideration of the functional anatomy of the new fossils supports the hypothesis that no functional or behavioral differences need to be invoked to explain the morphological variation between large and small A. afarensis individuals. Several specimens provide important new data about this species, including new vertebrae supporting the hypothesis that A. afarensis may have had a more human-like thoracic form than previously appreciated, with an invaginated thoracic vertebral column. A distal pollical phalanx confirms the presence of a human-like flexor pollicis longus muscle in A. afarensis. The new fossils include the first complete fourth metatarsal known for A. afarensis. This specimen exhibits the dorsoplantarly expanded base, axial torsion and domed head typical of humans, revealing the presence of human-like permanent longitudinal and transverse arches and extension of the metatarsophalangeal joints as in human-like heel-off during gait. The new Hadar postcranial fossils provide a more complete picture of postcranial functional anatomy, and individual and temporal variation within this sample. They provide the basis for further in-depth analyses of the behavioral and evolutionary significance of A. afarensis anatomy, and greater insight into the biology and evolution of these early hominins. Copyright © 2011

  6. Can Physical Examination Create a Stener Lesion?

    Science.gov (United States)

    Lankachandra, Manesha; Eggers, John P; Bogener, James W; Hutchison, Richard L

    2017-09-01

    The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint. Visual examination was performed to assess the presence of a Stener lesion. No Stener lesion was created in any position as long as the fascial origin of the ulnar sagittal band at the adductor pollicis longus remained intact. After creating a defect in the ulnar sagittal band, a Stener lesion was created in two specimens, but only when the thumb was flexed and supinated. Pronation provided more stability, and supination provided less stability, with one or both components cut, especially when testing at 30° of flexion. Compared to both components cut without flexion or rotation, there was a statistically significant difference in angulation with the 30 degrees of MCP joint flexion in both neutral rotation in supination. Performing a physical examination to assess the amount of instability of an ulnar collateral ligament injury did not create a Stener lesion if the exam was performed in a controlled, gentle manner with the thumb held without rotation. If the thumb is held in neutral rotation during the exam, an iatrogenic Stener lesion should not be created.

  7. Drill Penetration Injury to Extensor Tendons: A Biomechanical Analysis.

    Science.gov (United States)

    Mahylis, Jared M; Burwell, Anora K; Bonneau, Laura; Marshall, Lynn M; Mirarchi, Adam J

    2017-05-01

    Little is known about extensor tendon failure following drill injury at the time of volar plate fixation. Our goals were to analyze extensor tendon injury following simulated drill penetration, and change in tendon displacement during cyclic loading following simulated drill penetration injury. Extensor pollicis longus (EPL) and extensor carpi radialis brevis (ECRB) tendons were harvested from 9 fresh frozen cadaveric arms. Eighteen EPL and 18 ECRB samples were created from harvested tendons. Drill penetration injury was performed in either a continuous or an oscillating mode. Injured tendons were subjected to 1200 cycles at 1- to 15-kg cyclic load at a frequency of 1 Hz, and analyzed for failure at drill sites and change in displacement throughout the testing cycle. Ten EPL samples and 16 ECRB samples completed testing without failure. Tendon type (ECRB, EPL), mode of injury (continuous, oscillating), and location (proximal, distal) did not affect tendon displacement during loading. A single EPL tendon failed following continuous drill penetration injury. Extensor carpi radialis brevis samples had a mean change in displacement of 2.8 (standard deviation [SD]: 1.5 mm) and 5.9 mm (SD: 4.7 mm) for oscillating and continuous modes, respectively. Six EPL samples had a mean change in displacement of 4.7 (SD: 2.7 mm) and 4.3 mm (SD: 1.8 mm) for oscillating and continuous modes, respectively. Complete extensor tendon failure due to drill penetration was rare. Drill mode did not affect the degree of elongation. Increasing cyclic loading of extensor tendons after drill injury caused modest extensor tendon elongation.

  8. Long Volar Plating for Metadiaphyseal Fractures of Distal Radius: Study Comparing Minimally Invasive Plate Osteosynthesis versus Conventional Approach.

    Science.gov (United States)

    Pire, Emilie; Hidalgo Diaz, Juan José; Salazar Botero, Santiago; Facca, Sybille; Liverneaux, Philippe A

    2017-08-01

    Background  Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Materials and Methods  Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2). In group 1, a long volar plate was inserted under pronator quadratus through a 15- to 30-mm distal incision then fixed to the epiphysis of the distal radius. Then, through a 15- to 30-mm proximal incision, the plate was fixed to the diaphysis of the radius, thus reducing the fracture. Results  In group 1, mean distal incision size was 23.5 and 16.9 mm for proximal one. Mean total scar size (sum of both distal and proximal incisions) was 40.0 mm in group 1 and 84.1 mm in group 2. Mean tourniquet time was 58.4 minutes in group 1 and 68.9 minutes in group 2. At latest follow-up, no significant difference was noted in both the groups concerning pain, quick-DASH score, grip strength, ROM, and radiologic data. One extensor pollicis longus rupture treated by tendon transfer was done in group 1. Conclusion  The MIPO technique for metadiaphyseal fractures of the distal radius by long volar plating has cosmetic and economic advantages compared with the conventional approach. Conversion to conventional approach is possible at any time in case of technical difficulties. Level of Evidence  III.

  9. Detections of Screw Penetration during Volar Plating for Distal Radius Fractures.

    Science.gov (United States)

    Cha, Soo Min; Shin, Hyun Dae

    2017-11-01

    Background  We evaluated the detection for screw penetration on the dorsal cortex of the radius in serial oblique, dorsal tangential, and radial groove radiographic views in volar plating fixation. Materials and Methods  Eight screw positions were set in each of the four cadaveric radii. Screw 1 was placed in the styloid subregion, whereas screws 2 and 3 were placed just proximal to the styloid and were defined for the radial region of the radius. Screws 4 (distal to the extensor pollicis longus [EPL] groove), 5 (the distal half of the groove), and 6 (the proximal half of the groove) were placed in the central region of the radius. Screws 7 (just medial to the groove) and 8 (sigmoid notch subregion) were positioned in the ulnar region of the radius. The screws were overlengthened by 1 and 2 mm and were evaluated in three radiographic views. Results  Penetrations in the radial region were fully visible in supinated oblique views with 1- and 2-mm overlengthened screws. The penetration of screw 4 was clearly observable over a considerable range of views. However, the 1-mm penetration of screw 5 was not detectable at any angle of projection. Detection of the ulnar region screw was the most difficult among the three regions with oblique views. In the dorsal tangential view, the 1-mm penetration of screw 4 was not observed in any of the four radii, but the penetration of screw 5 was detectable in all the radii. The screws 2, 3, 5, 7, and 8 were readily detectable. The screw 4 was barely seen in the radial groove view, while the screws 5 and 6 were readily detectable. Conclusion/Clinical Relevance  Appropriate combinations of these well-known radiological views are essential for the overall detection of penetrated screws during plating in distal radius fractures.

  10. Different sensitivity of miniature endplate currents of the rat extensor digitorum longus, soleus and diaphragm muscles to a novel acetylcholinesterase inhibitor C-547

    Czech Academy of Sciences Publication Activity Database

    Petrov, K. A.; Kovyazina, I. V.; Zobov, V. V.; Bukharaeva, E. A.; Nikolsky, E. E.; Vyskočil, František

    2006-01-01

    Roč. 55, č. 5 (2006), s. 585-589 ISSN 0862-8408 R&D Projects: GA AV ČR(CZ) IAA5011411; GA MŠk(CZ) LC554; GA ČR(CZ) GA305/02/1333 Institutional research plan: CEZ:AV0Z50110509 Keywords : acetylcholine * anticholinesterase Subject RIV: ED - Physiology Impact factor: 2.093, year: 2006

  11. PET/CT imaging in polymyalgia rheumatica: praepubic 18F-FDG uptake correlates with pectineus and adductor longus muscles enthesitis and with tenosynovitis

    Directory of Open Access Journals (Sweden)

    Rehak Zdenek

    2017-01-01

    Full Text Available The role of 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT is increasing in the diagnosis of polymyalgia rheumatica (PMR, one of the most common inflammatory rheumatic diseases. In addition to other locations, increased 18F-FDG accumulation has been detected in the praepubic region in some patients. However, a deeper description and pathophysiological explanation of this increased praepubic accumulation has been lacking. The aim of the presented study is to confirm a decrease in praepubic 18F-FDG accumulation in response to therapy and to describe potential correlations to other 18F-FDG PET/CT scan characteristics during the course of disease. As a secondary objective, we describe the pathological aspects of the observed praepubic 18F-FDG uptake.

  12. The Effect of Increasing Age on the Concentric and Eccentric Contractile Properties of Isolated Mouse Soleus and Extensor Digitorum Longus Muscles.

    Science.gov (United States)

    Hill, Cameron; James, Rob S; Cox, Val M; Tallis, Jason

    2017-12-09

    There is currently a limited amount of literature investigating the age-related changes in eccentric muscle function in vitro. The present study uniquely uses the work loop technique, to better replicate in vivo muscle function, in the assessment of the age and muscle-specific changes in acute and sustained concentric and eccentric power and recovery. Whole soleus or EDL muscles were isolated from 10-week and 78-week old mice, and acute and sustained concentric and eccentric work loop power assessed. Despite an age-related increase in body and muscle mass, peak absolute power for both muscles was unaffected by age. Peak concentric power normalised to muscle mass declined significantly for each muscle, whilst peak normalised eccentric power declined only for soleus. Fatigue resistance and recovery for the soleus did not differ between age or contraction type. Older EDL was less resistant to concentric fatigue, but was better able to withstand sustained eccentric activity than young EDL. We have shown that age-related changes in muscle quality are more limited for eccentric function than concentric function. A greater bodily inertia is likely to further reduce in vivo locomotor performance in older animals. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Rare Giant Cell Tumor of the Distal Flexor Digitorum Longus Tendon Sheath and Early Diagnosis with Use of Magnetic Resonance Imaging.

    Science.gov (United States)

    Levi, Michael; Crafton, Jordan

    2017-07-01

    Giant-cell tumor of the tendon sheath (GCT-TS) is an uncommon occurrence for a foot and ankle surgeon. However, there is a need to recognize the symptoms of typical and atypical presentations of this pathology. These benign neoplasms are recognized clinically as a soft-tissue mass that is usually painless and palpable. The foot and ankle account for only 3% to 5% of all GCT-TS in the body, with most being located in the hand. Giant cell tumor in the tendon sheath occurring in the foot and ankle is usually encountered on the lateral ankle and dorsum of the foot, occupying the extensor tendons. Additionally, it is commonly misdiagnosed clinically. This case study illustrates how early use of magnetic resonance imaging decreased patient morbidity with early recognition and excision of GCT-TS.

  14. 3D Visualization and Measurement of Capillaries Supplying Metabolically Different Fiber Types in the Rat Extensor Digitorum Longus Muscle During Denervation and Reinnervation

    Czech Academy of Sciences Publication Activity Database

    Janáček, Jiří; Čebašek, V.; Kubínová, Lucie; Ribarič, S.; Eržen, I.

    2009-01-01

    Roč. 57, č. 5 (2009), s. 437-447 ISSN 0022-1554 R&D Projects: GA MŠk(CZ) LC06063; GA MŠk(CZ) MEB090606; GA AV ČR(CZ) IAA100110502 Institutional research plan: CEZ:AV0Z50110509 Keywords : capillaries * denervation * muscle fiber types Subject RIV: ED - Physiology Impact factor: 2.372, year: 2009

  15. Fiber type composition of unoperated rat soleus and extensor digitorum longus muscles after unilateral isotransplantation of a foreign muscle in long-term experiments

    Czech Academy of Sciences Publication Activity Database

    Soukup, Tomáš; Smerdu, V.; Zachařová, Gisela

    2009-01-01

    Roč. 58, č. 2 (2009), s. 253-262 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA304/05/0327; GA ČR(CZ) GA304/08/0256; GA MŠk(CZ) LC554 Grant - others:EC(XE) LSH-CT-2004-511978 Institutional research plan: CEZ:AV0Z50110509 Keywords : muscle transplantations * muscle fiber types * myosin heavy chains Subject RIV: ED - Physiology Impact factor: 1.430, year: 2009

  16. Armed Forces Institute of Regenerative Medicine Annual Report 2011

    Science.gov (United States)

    2012-01-01

    muscle, the extensor digitorum longus (EDL) muscle, and the extensor hallicus longus (EHL) muscle. All three muscles are innervated by the common... extensor digitorum longus our science for their healing Appendix A A-2 D D e-film... digitorum longus (EDL) muscles were removed from a rat model and assigned to treatment groups: no treatment, needle injection, saline injec- tion

  17. Incidental tenosynovial huge cell tumors of the flexor hallucis longus muscle: seldom differential diagnosis of metabolic lesions using F18-FDG PET/CT; Inzidenteller tenosynovialer Riesenzelltumor des Musculus flexor hallucis longus. Seltene Differenzialdiagnose stoffwechselaktiver Laesionen in der F-18-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Koestner, W.; Daemmrich, M.; Derlin, T.

    2016-03-15

    Tenosynovial huge cell tumors are seldom benign tumors in extremities originating from bone joint synovia and tendon sheats. In F18-FDG PET/CT imaging the tenosynovial huge cell tumors show increased metabolic activity and can trigger false diagnoses.

  18. Postoperative Physical Therapy Management of Tendon Transfer for Digital/Wrist Extension Due to Multifocal Motor Neuropathy.

    Science.gov (United States)

    Volpe, Steve

    2016-12-01

    Study Design Case report. Background Multifocal motor neuropathy is a progressive motor nerve disorder characterized by muscle weakness in the extremities. Muscle imbalance and weakness can become so severe that the involved extremity can be rendered nonfunctional. The purpose of this case report is to describe the physical therapy postoperative management of a patient who underwent a multiple tendon transfer to correct the loss of digital/wrist extension of the right upper extremity. Case Description A 38-year-old woman with a medical diagnosis of multifocal motor neuropathy, which caused muscle imbalance and weakness in the right hand, underwent a multiple tendon transfer to correct the loss of digit and wrist extension. The pronator teres was transferred and attached to the extensor carpi radialis longus and brevis. The palmaris longus was transferred and attached to the extensor pollicis longus. The flexor carpi radialis was transferred and attached to the extensor digitorum communis. The patient underwent static and dynamic splinting and a modified tendon transfer protocol starting at 3 weeks and ending at 16 weeks postsurgery. The patient attended therapy 1 to 3 times a week, depending on protocol stage and need for skilled therapy intervention. Outcomes Patient-reported outcome measures included the Disabilities of the Arm, Shoulder and Hand (DASH) survey to monitor the return of function and the numeric pain-rating scale to assess pain. At the initial evaluation (3 weeks postsurgery), the patient's DASH score was 87.5 and her pain score was 7/10. At discharge (16 weeks postsurgery), the patient's DASH score was 37.5 and her pain score was 0/10. Strength impairment was monitored with hydraulic hand dynamometers and manual muscle testing. At discharge, her hand grip strength was 4.5 kg, her key pinch strength was 4.1 kg, and her 3-jaw pinch strength was 2.3 kg. Manual muscle testing grades were 5/5 for elbow extension/flexion, 4/5 for forearm pronation

  19. Function after removal of various hip and thigh muscles for extirpation of tumors.

    Science.gov (United States)

    Markhede, G; Stener, B

    1981-08-01

    Forty-six patients who had undergone excision of one or more well defined hip and/or thigh muscles because of a soft-tissue tumor or a tumoriform lesion were investigated with respect to the function of the operated limb and the isometric and isokinetic strength of the affected motion or motions, relative to the non-operated side (percentage). Hip flexion: Loss of the iliopsoas caused slight impairment of function. The flexion strength decreased with increasing flexion of the hip joint. Loss of the rectus femoris reduced the isometric strength by 37 and the isokinetic strength by 17 per cent. Hip abduction: The strength reduction was only about 50 per cent and the impairment of function only slight or moderate even in patients with extensive loss of abductor muscles. Hip adduction: Removal of all three prime adductors (longus, brevis, magnus) caused a strength reduction of about 70 per cent but the impairment of function was only slight or moderate. Hip extension: Loss of the gluteus maximus caused only a small strength reduction and no impairment or only slight impairment of function. Significant strength reduction was only seen when all hamstrings had been removed. Knee extension: Loss of one, two, and three of the quadriceps muscles reduced the isometric strength by 22, 33, and 55 per cent, respectively. The isokinetic strength was reduced somewhat more. The strength reduction usually had to exceed 50 per cent to cause more than slight impairment of function. Knee flexion: Loss of the semitendinosus, the biceps femoris, and all the hamstrings reduced the isometric strength by 24, 28, and 67 per cent, respectively. The isokinetic strength was reduced somewhat less. Loss of one of the hamstrings usually caused no impairment of function whereas loss of all three resulted in moderate impairment of function.

  20. Navigated transcranial magnetic stimulation for glioma removal: prognostic value in motor function recovery from postsurgical neurological deficits.

    Science.gov (United States)

    Takakura, Tomokazu; Muragaki, Yoshihiro; Tamura, Manabu; Maruyama, Takashi; Nitta, Masayuki; Niki, Chiharu; Kawamata, Takakazu

    2017-10-01

    OBJECTIVE The aim of the present study was to evaluate the usefulness of navigated transcranial magnetic stimulation (nTMS) as a prognostic predictor for upper-extremity motor functional recovery from postsurgical neurological deficits. METHODS Preoperative and postoperative nTMS studies were prospectively applied in 14 patients (mean age 39 ± 12 years) who had intraparenchymal brain neoplasms located within or adjacent to the motor eloquent area in the cerebral hemisphere. Mapping by nTMS was done 3 times, i.e., before surgery, and 1 week and 3 weeks after surgery. To assess the response induced by nTMS, motor evoked potential (nTMS-MEP) was recorded using a surface electromyography electrode attached to the abductor pollicis brevis (APB). The cortical locations that elicited the largest electromyography response by nTMS were defined as hotspots. Hotspots for APB were confirmed as positive responsive sites by direct electrical stimulation (DES) during awake craniotomy. The distances between hotspots and lesions (D HS-L ) were measured. Postoperative neurological deficits were assessed by manual muscle test and dynamometer. To validate the prognostic value of nTMS in recovery from upper-extremity paresis, the following were investigated: 1) the correlation between D HS-L and the serial grip strength change, and 2) the correlation between positive nTMS-MEP at 1 week after surgery and the serial grip strength change. RESULTS From the presurgical nTMS study, MEPs from targeted muscles were identified in 13 cases from affected hemispheres. In one case, MEP was not evoked due to a huge tumor. Among 9 cases from which intraoperative DES mapping for hand motor area was available, hotspots for APB identified by nTMS were concordant with DES-positive sites. Compared with the adjacent group (D HS-L motor recovery at 1 week, 3 weeks, and 3 months after surgery (r = 0.87, 0.88, and 0.77, respectively). CONCLUSIONS Navigated TMS is a useful tool for identifying motor eloquent

  1. Magnetic versus electrical stimulation in the interpolation twitch technique of elbow flexors.

    Science.gov (United States)

    Lampropoulou, Sofia I; Nowicky, Alexander V; Marston, Louise

    2012-01-01

    The study compared peripheral magnetic with electrical stimulation of the biceps brachii m. (BB) in the single pulse Interpolation Twitch Technique (ITT). 14 healthy participants (31±7 years) participated in a within-subjects repeated-measures design study. Single, constant-current electrical and magnetic stimuli were delivered over the motor point of BB with supramaximal intensity (20% above maximum) at rest and at various levels of voluntary contraction. Force measurements from right elbow isometric flexion and muscle electromyograms (EMG) from the BB, the triceps brachii m. (TB) and the abductor pollicis brevis m. (APB) were obtained. The twitch forces at rest and maximal contractions, the twitch force-voluntary force relationship, the M-waves and the voluntary activation (VA) of BB between magnetic and electrical stimulation were compared. The mean amplitude of the twitches evoked at MVC was not significantly different between electrical (0.62 ± 0.49 N) and magnetic (0.81 ± 0.49 N) stimulation (p > 0.05), and the maximum VA of BB was comparable between electrical (95%) and magnetic (93%) stimulation (p > 0. 05). No differences (p >0.05) were revealed in the BB M-waves between electrical (13.47 ± 0.49 mV.ms) and magnetic (12.61 ± 0.58 mV.ms) stimulation. The TB M-waves were also similar (p > 0.05) but electrically evoked APB M-waves were significantly larger than those evoked by magnetic stimulation (p twitch-voluntary force relationship over the range of MVCs was best described by non-linear functions for both electrical and magnetic stimulation. The electrically evoked resting twitches were consistently larger in amplitude than the magnetically evoked ones (mean difference 3.1 ± 3.34 N, p twitch amplitude by 6.5 ± 6.2 N (p < 0.05). The fundamental similarities in voluntary activation assessment of BB with peripheral electrical and magnetic stimulation point towards a promising new application of peripheral magnetic stimulation as an alternative to the

  2. Domiciliary VR-Based Therapy for Functional Recovery and Cortical Reorganization: Randomized Controlled Trial in Participants at the Chronic Stage Post Stroke.

    Science.gov (United States)

    Ballester, Belén Rubio; Nirme, Jens; Camacho, Irene; Duarte, Esther; Rodríguez, Susana; Cuxart, Ampar; Duff, Armin; Verschure, Paul F M J

    2017-08-07

    Most stroke survivors continue to experience motor impairments even after hospital discharge. Virtual reality-based techniques have shown potential for rehabilitative training of these motor impairments. Here we assess the impact of at-home VR-based motor training on functional motor recovery, corticospinal excitability and cortical reorganization. The aim of this study was to identify the effects of home-based VR-based motor rehabilitation on (1) cortical reorganization, (2) corticospinal tract, and (3) functional recovery after stroke in comparison to home-based occupational therapy. We conducted a parallel-group, controlled trial to compare the effectiveness of domiciliary VR-based therapy with occupational therapy in inducing motor recovery of the upper extremities. A total of 35 participants with chronic stroke underwent 3 weeks of home-based treatment. A group of subjects was trained using a VR-based system for motor rehabilitation, while the control group followed a conventional therapy. Motor function was evaluated at baseline, after the intervention, and at 12-weeks follow-up. In a subgroup of subjects, we used Navigated Brain Stimulation (NBS) procedures to measure the effect of the interventions on corticospinal excitability and cortical reorganization. Results from the system's recordings and clinical evaluation showed significantly greater functional recovery for the experimental group when compared with the control group (1.53, SD 2.4 in Chedoke Arm and Hand Activity Inventory). However, functional improvements did not reach clinical significance. After the therapy, physiological measures obtained from a subgroup of subjects revealed an increased corticospinal excitability for distal muscles driven by the pathological hemisphere, that is, abductor pollicis brevis. We also observed a displacement of the centroid of the cortical map for each tested muscle in the damaged hemisphere, which strongly correlated with improvements in clinical scales. These

  3. MAGNETIC VERSUS ELECTRICAL STIMULATION IN THE INTERPOLATION TWITCH TECHNIQUE OF ELBOW FLEXORS

    Directory of Open Access Journals (Sweden)

    Sofia I. Lampropoulou

    2012-12-01

    Full Text Available The study compared peripheral magnetic with electrical stimulation of the biceps brachii m. (BB in the single pulse Interpolation Twitch Technique (ITT. 14 healthy participants (31±7 years participated in a within-subjects repeated-measures design study. Single, constant-current electrical and magnetic stimuli were delivered over the motor point of BB with supramaximal intensity (20% above maximum at rest and at various levels of voluntary contraction. Force measurements from right elbow isometric flexion and muscle electromyograms (EMG from the BB, the triceps brachii m. (TB and the abductor pollicis brevis m. (APB were obtained. The twitch forces at rest and maximal contractions, the twitch force-voluntary force relationship, the M-waves and the voluntary activation (VA of BB between magnetic and electrical stimulation were compared. The mean amplitude of the twitches evoked at MVC was not significantly different between electrical (0.62 ± 0.49 N and magnetic (0.81 ± 0.49 N stimulation (p > 0.05, and the maximum VA of BB was comparable between electrical (95% and magnetic (93% stimulation (p > 0. 05. No differences (p >0.05 were revealed in the BB M-waves between electrical (13.47 ± 0.49 mV.ms and magnetic (12.61 ± 0.58 mV.ms stimulation. The TB M-waves were also similar (p > 0.05 but electrically evoked APB M-waves were significantly larger than those evoked by magnetic stimulation (p < 0.05. The twitch-voluntary force relationship over the range of MVCs was best described by non-linear functions for both electrical and magnetic stimulation. The electrically evoked resting twitches were consistently larger in amplitude than the magnetically evoked ones (mean difference 3.1 ± 3.34 N, p < 0.05. Reduction of the inter-electrodes distance reduced the twitch amplitude by 6.5 ± 6.2 N (p < 0.05. The fundamental similarities in voluntary activation assessment of BB with peripheral electrical and magnetic stimulation point towards a promising

  4. Rapid-rate paired associative stimulation of the median nerve and motor cortex can produce long-lasting changes in motor cortical excitability in humans.

    Science.gov (United States)

    Quartarone, Angelo; Rizzo, Vincenzo; Bagnato, Sergio; Morgante, Francesca; Sant'Angelo, Antonino; Girlanda, Paolo; Siebner, Hartwig Roman

    2006-09-01

    Repetitive transcranial magnetic stimulation (rTMS) or repetitive electrical peripheral nerve stimulation (rENS) can induce changes in the excitability of the human motor cortex (M1) that is often short-lasting and variable, and occurs only after prolonged periods of stimulation. In 10 healthy volunteers, we used a new repetitive paired associative stimulation (rPAS) protocol to facilitate and prolong the effects of rENS and rTMS on cortical excitability. Sub-motor threshold 5 Hz rENS of the right median nerve was synchronized with submotor threshold 5 Hz rTMS of the left M1 at a constant interval for 2 min. The interstimulus interval (ISI) between the peripheral stimulus and the transcranial stimulation was set at 10 ms (5 Hz rPAS10ms) or 25 ms (5 Hz rPAS25ms). TMS was given over the hot spot of the right abductor pollicis brevis (APB) muscle. Before and after rPAS, we measured the amplitude of the unconditioned motor evoked potential (MEP), intracortical inhibition (ICI) and facilitation (ICF), short- and long-latency afferent inhibition (SAI and LAI) in the conditioned M1. The 5 Hz rPAS25ms protocol but not the 5 Hz rPAS10ms protocol caused a somatotopically specific increase in mean MEP amplitudes in the relaxed APB muscle. The 5 Hz rPAS25ms protocol also led to a loss of SAI, but there was no correlation between individual changes in SAI and corticospinal excitability. These after-effects were still present 6 h after 5 Hz rPAS25ms. There was no consistent effect on ICI, ICF and LAI. The 5 Hz rENS and 5 Hz rTMS protocols failed to induce any change in corticospinal excitability when given alone. These findings show that 2 min of 5 Hz rPAS25ms produce a long-lasting and somatotopically specific increase in corticospinal excitability, presumably by sensorimotor disinhibition.

  5. Muscle Moment Arms and Sensitivity Analysis of a Mouse Hindlimb Musculoskeletal Model (Open Access Publisher’s Version)

    Science.gov (United States)

    2016-05-12

    digitorum longus EDL Leg 0.0005 0.0029 0.0016 Pedal 0.0135 0.0019 0.0001 Extensor hallucis longus EHL Leg 0.0004 0.0042 0.0004 Pedal 0.0093... Extensor digitorum longus EDL Ankle dorsiflexors 0.368 0.00635 0.02378 12.39 Extensor hallucis longus EHL Ankle dorsiflexors 0.069 0.00593 0.01793 9.56... extensor hallucis longus (EHL) had the greatest peak ankle flexion moment arm (0.88 mm at 14 o), with TA and M. extensor digitorum longus

  6. Associação entre o consumo energético e proteico e a espessura do músculo adutor do polegar em pacientes em hemodiálise = Association between energy and protein intake and the adductor pollicis muscle thickness in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Machado, Alisson Diego

    2017-01-01

    Full Text Available Introdução: A desnutrição energético-proteica é frequente em pacientes com doença renal crônica em hemodiálise e medidas alternativas para a avaliação do estado nutricional e do consumo alimentar podem ser empregadas na prática clínica. Objetivo: Avaliar a associação entre o consumo energético e proteico e a espessura do músculo adutor do polegar em pacientes em hemodiálise. Materiais e Métodos: Foi realizado um estudo transversal com 33 pacientes com doença renal crônica em hemodiálise. Foi aplicado um questionário para a identificação do perfil sociodemográfico dos pacientes. A ingestão de energia e de proteínas foi avaliada pela aplicação de dois recordatórios de 24 horas. A espessura do músculo adutor do polegar foi aferida com auxílio de um adipômetro. A associação entre as variáveis foi avaliada por meio de testes paramétricos, análise de correlação, regressão linear e curva ROC. Resultados: A média de idade da amostra em estudo correspondeu a 68,0 anos, sendo 54,5% do sexo masculino. Pacientes com idade inferior a 60 anos e do sexo masculino apresentaram uma maior espessura do músculo adutor do polegar (p=0,01. Não houve associação entre a espessura do músculo adutor do polegar e o consumo energético e proteico. A medida também não é capaz de indicar quais pacientes apresentam uma maior ingestão de energia e proteínas. Conclusão: Em pacientes com doença renal crônica em hemodiálise não houve associação entre o consumo energético e proteico e a espessura do músculo adutor do polegar e nem eficácia da medida em predizer uma maior ingestão de energia e proteínas

  7. Extramuscular myofascial force transmission within the rat anterior tibial compartment: Proximodistal differences in muscle force

    NARCIS (Netherlands)

    Huijing, P.A.J.B.M.; Baan, G.C.

    2001-01-01

    Intramuscular connective tissues are continuous to extramuscular connective tissues. If force is transmitted there, differences should be present between force at proximal and distal attachments of muscles. Extensor digitorum longus (EDL), tibialis anterior (TA), and extensor hallucis longus muscles

  8. Extramuscular myofascial force transmission within the rat anterior tibial compartment: Proximo-distal differences in muscle force

    NARCIS (Netherlands)

    Huijing, P.A.J.B.M.; Baan, G.C.

    2001-01-01

    Intramuscular connective tissues are continuous to extramuscular connective tissues. If force is transmitted there, differences should be present between force at proximal and distal attachments of muscles. Extensor digitorum longus (EDL), tibialis anterior (TA), and extensor hallucis longus muscles

  9. Outcome of early active mobilization after flexor tendons repair in zones II-V in hand

    Directory of Open Access Journals (Sweden)

    Saini Narender

    2010-01-01

    Full Text Available Background: The functional outcome of a flexor tendon injury after repair depends on multiple factors. The postoperative management of tendon injuries has paved a sea through many mobilization protocols. The improved understanding of splinting techniques has promoted the understanding and implication of these mobilization protocols. We conducted a study to observe and record the results of early active mobilization of repaired flexor tendons in zones II-V. Materials and Methods: 25 cases with 75 digits involving 129 flexor tendons including 8 flexor pollicis longus (FPL tendons in zones II-V of thumb were subjected to the early active mobilization protocol. Eighteen (72% patients were below 30 years of age. Twenty-four cases (96% sustained injury by sharp instrument either accidentally or by assault. Ring and little finger were involved in 50% instances. In all digits, either a primary repair (n=26 or a delayed primary repair (n=49 was done. The repair was done with the modified Kessler core suture technique with locking epitendinous sutures with a knot inside the repair site, using polypropylene 3-0/4-0 sutures. An end-to-end repair of the cut nerves was done under loupe magnification using a 6-0/8-0 polyamide suture. The rehabilitation program adopted was a modification of Kleinert′s regimen, and Silfverskiold regimen. The final assessment was done at 14 weeks post repair using the Louisville system of Lister et al. Results: Eighteen of excellent results were attributed to ring and little fingers where there was a flexion lag of < 1 cm and an extension lag of < 15o. FPL showed 75% (n=6 excellent flexion. 63% (n=47 digits showed excellent results whereas good results were seen in 19% (n=14 digits. Nine percent (n=7 digits showed fair and the same number showed poor results. The cases where the median (n=4 or ulnar nerve (n=6 or both (n=3 were involved led to some deformity (clawing/ape thumb at 6 months postoperatively. The cases with digital

  10. Endoscopic Repair of a Gluteus Medius Tear at the Musculotendinous Junction

    Science.gov (United States)

    Yanke, Adam B.; Hart, Michael A.; McCormick, Frank; Nho, Shane J.

    2013-01-01

    Abductor tendon tears are an increasingly recognized clinical entity in patients with lateral thigh pain and weakness. These “rotator cuff tears of the hip” typically result from chronic, nontraumatic rupture of the anterior fibers of the gluteus medius. Although the abductor tendon typically tears from the osseous insertion, the case discussed here ruptured at the musculotendinous junction. This is the first report of this abductor tear subtype and its endoscopic repair. PMID:23875152

  11. The Effect of Acute Renal Failure on Muscle Protein Turnover in the Rat and Implications for Therapy.

    Science.gov (United States)

    1983-06-15

    and extensor digitorum longus ; Ŗ. To devise a therapeutic regimen to reduce muscle protein catabo- lism and enhance muscle protein synthesis A. Goals...Degredation .... 18 6. Soleus: Muscle Protein Synthesis and Degradation ...20 7. Extensor Digitorum Longus : Muscle Protein Synthesis and Degradation... Extensor Digitorum Longus : Protein Degradation and Synthesis ........................................ 23 V. The Effect of an IV Solution of Hypertonic

  12. Proximo-distal organization and fibre type regionalization in rat hindlimb muscles

    NARCIS (Netherlands)

    Wang, LC; Kernell, D

    Five muscles of the rat's lower hindlimb were compared with regard to their histochemical fibre type distribution at seven different proximo-distal levels. The muscles were: extensor digitorum longus (ED), flexor digitorum and hallucis longus (FD), gastrocnemius medialis (GM), peroneus longus (PE)

  13. Levels of myosin heavy chain mRNA transcripts and protein isoforms in the fast extensor digitorum longus muscle of 7-month-old rats with chronic thyroid status alterations

    Czech Academy of Sciences Publication Activity Database

    Vadászová, Adriana; Hudecová, S.; Križanová, O.; Soukup, Tomáš

    2006-01-01

    Roč. 55, č. 6 (2006), s. 707-710 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA304/05/0327 Grant - others:VEGA(SK) 2/4106; NATO(XE) 979876; SAV(SK) APVT-51-027404; MYORES(XE) 511978 Institutional research plan: CEZ:AV0Z50110509 Keywords : myosin heavy chain isoforms * thyroid hormones * muscle differentiation Subject RIV: ED - Physiology Impact factor: 2.093, year: 2006

  14. Effects of beta-hydroxy-beta-methylbutyrate (HMB) on the expression of ubiquitin ligases, protein synthesis pathways and contractile function in extensor digitorum longus (EDL) of fed and fasting rats.

    Science.gov (United States)

    Gerlinger-Romero, Frederico; Guimarães-Ferreira, Lucas; Yonamine, Caio Yogi; Salgueiro, Rafael Barrera; Nunes, Maria Tereza

    2018-03-01

    Beta-hydroxy-beta-methylbutyrate (HMB), a leucine metabolite, enhances the gain of skeletal muscle mass by increasing protein synthesis or attenuating protein degradation or both. The aims of this study were to investigate the effect of HMB on molecular factors controlling skeletal muscle protein synthesis and degradation, as well as muscle contractile function, in fed and fasted conditions. Wistar rats were supplied daily with HMB (320 mg/kg body weight diluted in NaCl-0.9%) or vehicle only (control) by gavage for 28 days. After this period, some of the animals were subjected to a 24-h fasting, while others remained in the fed condition. The EDL muscle was then removed, weighed and used to evaluate the genes and proteins involved in protein synthesis (AKT/4E-BP1/S6) and degradation (Fbxo32 and Trim63). A sub-set of rats were used to measure in vivo muscle contractile function. HMB supplementation increased AKT phosphorylation during fasting (three-fold). In the fed condition, no differences were detected in atrogenes expression between control and HMB supplemented group; however, HMB supplementation did attenuate the fasting-induced increase in their expression levels. Fasting animals receiving HMB showed improved sustained tetanic contraction times (one-fold) and an increased muscle to tibia length ratio (1.3-fold), without any cross-sectional area changes. These results suggest that HMB supplementation under fasting conditions increases AKT phosphorylation and attenuates the increased of atrogenes expression, followed by a functional improvement and gain of skeletal muscle weight, suggesting that HMB protects skeletal muscle against the deleterious effects of fasting.

  15. Comparison of two rocuronium bromide doses in adult and elderly ...

    African Journals Online (AJOL)

    evoked muscle tension and neuromuscular paralysis extension were expressed by strength of contraction of adductor pollicis, in response to a direct stimulation of the ulnar nerve (TOF). Results The results showed that in elderly patients the effect ...

  16. Intermittent Cold Exposure Causes a Muscle-Specific Shift in the Fiber Type Composition in Rats

    Science.gov (United States)

    1993-01-01

    exposure on the fiber type composition of the predominantly type I soleus and the predominantly type lIb extensor digitorum longus (EDL) muscles of rats...the predominantly type Ilb extensor digitorum longus (EDL) muscles of rats. Cold exposure was accomplished by submerg- position would occur in rats if...were killed with an over- dose of pentobarbital sodium (Nembutal). The soleus "* -4 and extensor digitorum longus (EDL. muscles were ex- cised

  17. A Standardized Rat Model of Volumetric Muscle Loss Injury for the Development of Tissue Engineering Therapies

    Science.gov (United States)

    2012-12-01

    Fig. 1D). Then, at the demarcated middle third the TA muscle, the TA and extensor digitorum longus (EDL) mus- cles were bluntly separated and the medial...0.05). VML, volumetric muscle loss; BW, body weight; MW, muscle weight; TA, tibialis anterior; EDL, extensor digitorum longus ; Po, peak iso- metric...tenotomy of the extensor digito- rum longus muscle (Ablation). abcLetters indicate that the value is significantly different from any different letter

  18. An Autologous Muscle Tissue Expansion Approach for the Treatment of Volumetric Muscle Loss

    Science.gov (United States)

    2015-07-01

    DOI: 10.1089/ biores.2015.0009. Abbreviations Used ANOVA¼ analysis of variance ECM¼ extracellular matrix EDL¼ extensor digitorum longus TA¼ tibialis...muscle VML injury VML was surgically created in similar fashion to that previously reported.2,13,17 The TA and underlying ex- tensor digitorum longus ...made at the antero-lateral aspect of the ankle and the distal EDL muscle tendon and extensor hallicus longus muscle was isolated and severed above the

  19. Does Current Army Physical Fitness Training Doctrine Adequately Prepare Soldiers for War?

    Science.gov (United States)

    2010-06-11

    longus (H) biceps femorus(TH) brachialis(A) infraspinatus(B) adductor magnus(TH) gastrocnemius(LL) extensor digitorum (A) levator scapulae(B...quinti pedis(LL) infraspinatus(B) adductor longus (TH) adductor magnus(TH) latissimus dorsi(B) extensor digitorum (LL) biceps femoris(TH) quadratus...externus(TR) erector spinae(TR) adductor longus (TH) biceps femoris(TH) transversus abdominus(TR) latissimus dorsi(B) extensor digitorum (LL

  20. Adductor policis muscle: a new anthropometric parameter

    Directory of Open Access Journals (Sweden)

    Lameu Edson Braga

    2004-01-01

    Full Text Available PURPOSE: To measure the thickness of adductor pollicis muscle in healthy adults. This measurement will be used as a nutritional anthropometric parameter in further studies. SUBJECTS AND METHOD: Four hundred and twenty-one healthy adults were studied, 209 men and 212 women, with ages ranging from 18 to 87 years, living in Rio de Janeiro. The adductor pollicis muscle was also studied in the human anatomy lab as well as in normal healthy volunteers using CAT scans and nuclear magnetic resonance imaging to ensure that only the adductor pollicis was included in measurement of muscle thickness with a Lange caliper. To standardize the measurement, the methodology was detailed, with subjects sitting with the dominant hand dangling over the homolateral thigh and the elbow bent at approximately a 90° angle. The Lange caliper was applied at a pressure of 10 g/mm², pinching the adductor pollicis muscle at the vertex of an imaginary angle between the thumb and the index finger. The average of 3 consecutive measurements was considered to be the muscle thickness. RESULTS: This study provides the first estimates of adductor pollicis thickness in normal healthy subjects as an anthropometric parameter. The normal values in the dominant hand for men were 12.5 ± 2.8 mm (mean ± SD, median 12 mm, and for women were 10.5 ± 2.3 mm, median 10 mm.

  1. Tarsal tunnel syndrome in patients with rheumatoid arthritis ...

    African Journals Online (AJOL)

    Ibrahim Khalil Ibrahim

    2013-01-10

    Jan 10, 2013 ... Tendon girth swelling altered echogenicity of flexor hallucis longus tendon, flexor digitorum longus tendon, and the tibialis posterior tendon. Signs of plan- tar fasciitis (edema and increased thickness of plantar fascia). 5. Results. Thirty rheumatoid arthritis patients having pain and/or burn- ing sensation in ...

  2. Myofascial force transmisison between antagonistic rat lower limb muscles: effects of single muscle or muscle group lengthening

    NARCIS (Netherlands)

    Meijer, Hanneke J.M; Rijkelijkhuizen, Josina M.; Huijing, P.A.J.B.M.

    2007-01-01

    Effects of lengthening of the whole group of anterior crural muscles (tibialis anterior and extensor hallucis longus muscles (TA + EHL) and extensor digitorum longus (EDL)) on myofascial interaction between synergistic EDL and TA + EHL muscles, and on myofascial force transmission between anterior

  3. Muscle force is determined also by muscle relative position: isolated effects

    NARCIS (Netherlands)

    Maas, Huub; Baan, Guus C.; Huijing, P.A.J.B.M.

    2004-01-01

    Effects on force of changes of the position of extensor digitorum longus muscle (EDL) relative to surrounding tissues were investigated in rat. Connective tissue at the muscle bellies of tibialis anterior (TA), extensor hallucis longus (EHL) and EDL was left intact, to allow myofascial force

  4. Compartmental fasciotomy and isolating a muscle from neighbouring muscles interfere with extramuscular myofascial force transmission within the rat anterior tibial compartment.

    NARCIS (Netherlands)

    Huijing, P.A.J.B.M.; Maas, H.; Baan, G.C.

    2003-01-01

    Muscles within the anterior crural compartment (extensor digitorum longus, EDL; tibialis anterior, TA; and extensor hallucis longus, EHL) and within the peroneal compartment were excited simultaneously and maximally. All muscles were kept at constant length with the exception of EDL, for which

  5. Histologic Changes as Indicators of Carcinogenicity of Tungsten Alloy in Rodents

    Science.gov (United States)

    2008-01-01

    prevents compensatory hypertrophy of overloaded mouse extensor digitorum longus muscle. J Appl Physiol, 73(6), 2538-2543. Schenck, N. L., & Kronman...Faulkner JA, Niemeyer JH, Maxwell LC & White TP. (1980). Contractile properties of transplanted extensor digitorum longus muscle of the cat. Journal of

  6. Nerve Regeneration in Vitro: Comparative Effects of Direct and Induced Current and NGF. Appendix.

    Science.gov (United States)

    1985-11-26

    stimulation on the denervated extensor digitorum longus muscle of the rabbit. Acta Neurol. Scandinav. j, 521-528 Nix, W. A. and Hope, H. C. (1983...peroneal nerve of the rabbit. Stimulation of the external digitorum longus muscle with 10- 12 Hz for 8 hr/day via implanted electrodes into the muscle

  7. Transplantation of Devitalized Muscle Scaffolds is Insufficient for Appreciable De Novo Muscle Fiber Regeneration After Volumetric Muscle Loss Injury

    Science.gov (United States)

    2014-10-10

    minced muscle grafts were shown to support de novo skeletal muscle regeneration. For instance, devitalized whole extensor digitorum longus (EDL) muscle...antero- lateral aspect of the ankle, and the distal EDL muscle tendon and extensor hallicus longus (EHL) muscle was isolated and severed above the

  8. Development of Non-Hormonal Steroids for the Treatment of Duchenne Muscular Dystrophy

    Science.gov (United States)

    2013-02-01

    were conducted on the extensor digitorum longus muscle of the right hindlimb of the mdx mouse as described previously (Spurney et al., 2011). Results...increases functional mouse limb strength. Evaluating muscle strength of isolated muscles ex vivo, extensor digitorum longus (EDL) muscles showed a

  9. Mechanism of Action of Botulinum Neurotoxin and Overview of Medical Countermeasures for Intoxication

    Science.gov (United States)

    2008-01-01

    a recent study from our laboratory, TVL was injected locally in the rat extensor digitorum longus (EDL) muscle 30 min before a local injection of 0.6...1996. Effect of 3,4-diaminopyridine on rat extensor digitorum longus muscle paralyzed by local injection of botulinum neurotoxin. Toxieon 34:237-249

  10. Myofascial force transmission between antagonistic rat lower limb muscles: Effects of single muscle or muscle group lengthening.

    NARCIS (Netherlands)

    Meijer, H.J.M.; Rijkelijkhuizen, J.M.; Huijing, P.A.J.B.M.

    2007-01-01

    Effects of lengthening of the whole group of anterior crural muscles (tibialis anterior and extensor hallucis longus muscles (TA + EHL) and extensor digitorum longus (EDL)) on myofascial interaction between synergistic EDL and TA + EHL muscles, and on myofascial force transmission between anterior

  11. Multiple Arterial Variations in the Right Upper Limb | Vaseethan ...

    African Journals Online (AJOL)

    Anatomy Journal of Africa ... (6) The SUA coursed superficial to the flexor muscles in the forearm and passed superficial to the flexor retinaculum to form incomplete superficial palmar arch (SPA) (7) The SPA gave off three common palmar digital arteries and a common trunk for radialis indicis and princeps pollicis arteries.

  12. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 9990 ...

    African Journals Online (AJOL)

    Prof Kakande

    mobilization of this flap. It provided adequate and reliable coverage of the soft tissue defect at the first web space leaving a minor defect that was grafted8. The thumb commonly receives its blood supply from the princeps pollicis artery which usually a terminal branch of the radial artery after giving off the deep arch and.

  13. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 9990 ...

    African Journals Online (AJOL)

    Prof Kakande

    It provided adequate and reliable coverage of the soft tissue defect at the first web space leaving a minor defect that was grafted8. The thumb commonly receives its blood supply from the princeps pollicis artery which usually a terminal branch of the radial artery after giving off the deep arch and its branch to the index finger ...

  14. Similar effects of cooling and fatigue on eccentric and concentric force-velocity relationships in human muscle

    NARCIS (Netherlands)

    De Ruiter, C J; De Haan, A

    The purpose of this study was to investigate the effects of muscle temperature and fatigue during stretch (eccentric) and shortening (concentric) contractions of the maximally electrically activated human adductor pollicis muscle. After immersion of the lower arm in water baths of four different

  15. CT-based analysis of muscle volume and degeneration of gluteus medius in patients with unilateral hip osteoarthritis.

    Science.gov (United States)

    Momose, Takako; Inaba, Yutaka; Choe, Hyonmin; Kobayashi, Naomi; Tezuka, Taro; Saito, Tomoyuki

    2017-11-15

    The gluteus medius (GMED) affects hip function as an abductor. We evaluated muscle volume and degeneration of the GMED by using CT-based analysis and assessed factors that affect hip abductor strength in patients with unilateral hip osteoarthritis (OA). We examined clinical and imaging findings associated with hip abductor strength in consecutive 50 patients with unilateral hip OA. Hip abductor muscle strength and Harris hip score (HHS) were assessed. Leg length discrepancy (LLD) and femoral offset were assessed using X-ray; CT assessment was employed for volumetric and qualitative GMED analysis. Volumetric analysis involved measurement of cross sectional area (CSA) and three-dimensional (3D) muscle volume. CT density was measured for the qualitative assessment of GMED degeneration with or without adjustment using a bone mineral reference phantom. Hip abductor muscle strength on the affected side was significantly lower than that on the contralateral healthy side and positively correlated with overall score and score for limping of gait of HHS, demonstrating the importance of hip abductor strength for normal hip function. A significant correlation was found between CSA and 3D muscle volume, unadjusted CT density and adjusted CT density, and hip abductor strength and these CT measurements. Multiple linear regression analysis demonstrated that 3D muscle volume, adjusted CT density, and LLD are independent factors affecting hip abduction. 3D measurement of muscle volume and adjusted CT density more accurately reflect quantity and the GMED quality than do conventional assessments. Increase in muscle volume, recovery of muscle degeneration, and correction of LLD are important for improving limping in patients with hip OA.

  16. Muscle Moment Arms and Sensitivity Analysis of a Mouse Hindlimb Musculoskeletal Model

    Science.gov (United States)

    2016-05-12

    anterior TA Leg 0.0007 0.0025 0.0001 Pedal 0.0008 0.0000 0.0006 Extensor digitorum longus EDL Leg 0.0005 0.0029 0.0016 Pedal 0.0135 0.0019 0.0001...0.00 Tibialis anterior TA Ankle dorsiflexors 2.422 0.00490 0.01180 16.58 Extensor digitorum longus EDL Ankle dorsiflexors 0.368 0.00635 0.02378 12.39...moment arm (0.88 mm at 14 o), with TA and M. extensor digitorum longus (EDL) showing similarly shaped curves but lower peaks. M. medial gastrocnemius (MG

  17. Prevention and Treament of Botulism

    Science.gov (United States)

    2014-01-01

    preparations. Toxicon 33:527-537 Adler M, MacDonald DA, Sellin LC, Parker GW (1996) Effect of 3,4-diaminopyridine on rat extensor digitorum longus muscle...have demonstrated that injection of the insulin-like growth factor I (IGF-1) in BoNT/ A-paralyzed rat extensor digit arum longus (EDL) muscles led to...0.25 ’ii) c Q,) 1- 0.00 ~ ta Q,) Q. 30 d after BoNT 327 1 U BoNT/A - +IGF Fig. 13.3 Extensor digitorom longus (EDL) muscles were

  18. Plantar pain is not always fasciitis

    Directory of Open Access Journals (Sweden)

    N. Romano

    2017-12-01

    Full Text Available The case is described of a patient with chronic plantar pain, diagnosed as fasciitis, which was not improved by conventional treatment. Magnetic resonance imaging revealed flexor hallucis longus tenosynovitis, which improved after local glucocorticoid injection.

  19. Conference Support - Surgery in Extreme Environments - Center for Surgical Innovation

    Science.gov (United States)

    2007-01-01

    represent the first survival surgery during space flight. This included exposure and injection of the soleus and extensor digitorum longus ; perfusion...abscess Incision and drainage of thrombosed external hemorrhoid Repair of Extensor Tendon Extremity splinting Needle decompression of pneumothorax

  20. Effect of hindlimb suspension and clenbuterol treatment on polyamine levels in skeletal muscle

    Science.gov (United States)

    Abukhalaf, Imad K.; von Deutsch, Daniel A.; Wineski, Lawrence E.; Silvestrov, Natalia A.; Abera, Saare A.; Sahlu, Sinafikish W.; Potter, David E.; Thierry-Palmer, M. (Principal Investigator)

    2002-01-01

    Polyamines are unbiquitous, naturally occurring small aliphatic, polycationic, endogenous compounds. They are involved in many cellular processes and may serve as secondary or tertiary messengers to hormonal regulation. The relationship of polyamines and skeletal muscle mass of adductor longus, extensor digitorum longus, and gastrocnemius under unloading (hindlimb suspension) conditions was investigated. Unloading significantly affected skeletal muscle polyamine levels in a fiber-type-specific fashion. Under loading conditions, clenbuterol treatment increased all polyamine levels, whereas under unloading conditions, only the spermidine levels were consistently increased. Unloading attenuated the anabolic effects of clenbuterol in predominately slow-twitch muscles (adductor longus), but had little impact on clenbuterol's action as a countermeasure in fast- twitch muscles such as the extensor digitorum longus. Spermidine appeared to be the primary polyamine involved in skeletal muscle atrophy/hypertrophy. Copyright 2002 S. Karger AG, Basel.

  1. Vascularization and anatomical model of the mesotendons of the extensor digitorum and extensor indicis muscles.

    OpenAIRE

    Zbrodowski, A; Gajisin, S; Grodecki, J

    1980-01-01

    In ten human hands the mesotendons of m. extensor digitorum longus and m. extensor indicis have been examined and described in detail. The various sources of their blood supplies have also been demonstrated and described.

  2. Role of the AMPKgamma3 isoform in hypoxia-stimulated glucose transport in glycolytic skeletal muscle

    DEFF Research Database (Denmark)

    Deshmukh, Atul S; Glund, Stephan; Tom, Robby Z

    2009-01-01

    in hypoxia-mediated energy status signaling and glucose transport in fast-twitch glycolytic extensor digitorum longus (EDL) muscle from AMPKgamma3-knockout (KO) mice and wild-type mice. Although hypoxia increased glucose transport (P

  3. Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Joo, Kyung Bin; Lee, Kyu Hoon; Uhm, Wan Sik

    2011-01-01

    Retropharyngeal calcific tendinitis is defined as inflammation of the longus colli muscle and is caused by the deposition of calcium hydroxyapatite crystals, which usually involves the superior oblique fibers of the longus colli muscle from C1-3. Diagnosis is usually made by detecting amorphous calcification and prevertebral soft tissue swelling on radiograph, CT or MRI. In this report, we introduce a case of this disease which was misdiagnosed as a retropharyngeal tuberculous abscess, or a muscle strain of the ongus colli muscle. No calcifications were visible along the vertical fibers of the longus colli muscle. The lesion was located anterior to the C4-5 disc, in a rheumatoid arthritis patient with atlantoaxial subluxation. Calcific tendinitis of the longus colli muscle at this location in a rheumatoid arthritis patient has not been reported in the English literature.

  4. Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Joo, Kyung Bin; Lee, Kyu Hoon; Uhm, Wan Sik [Hanyang University Hospital, Seoul (Korea, Republic of)

    2011-08-15

    Retropharyngeal calcific tendinitis is defined as inflammation of the longus colli muscle and is caused by the deposition of calcium hydroxyapatite crystals, which usually involves the superior oblique fibers of the longus colli muscle from C1-3. Diagnosis is usually made by detecting amorphous calcification and prevertebral soft tissue swelling on radiograph, CT or MRI. In this report, we introduce a case of this disease which was misdiagnosed as a retropharyngeal tuberculous abscess, or a muscle strain of the ongus colli muscle. No calcifications were visible along the vertical fibers of the longus colli muscle. The lesion was located anterior to the C4-5 disc, in a rheumatoid arthritis patient with atlantoaxial subluxation. Calcific tendinitis of the longus colli muscle at this location in a rheumatoid arthritis patient has not been reported in the English literature.

  5. Does anterior knee pain severity and function relate to the frontal plane projection angle and trunk and hip strength in women with patellofemoral pain?

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; Carvalho E Silva, Ana Paula de Moura Campos; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2015-07-01

    The aim of the present study was to determine the relationship between knee pain severity and function with the frontal plane projection angle (FPPA) and trunk and hip peak torque (PT) in women with patellofemoral pain (PFPS). Twenty-two women with PFPS were assessed. Knee pain severity (KPS) was assessed with an 11-point visual analog scale and function with an Anterior Knee Pain Scale. The FPPA was recorded with a digital camera. PT of extensors, abductors, and the lateral rotators of hip and lateral core stability were measured with a handheld dynamometer. FPPA was the only predictor for the KPS. Regarding predictors of function, PT of lateral core stability and the extensor and abductor of the hip explained 41.4% of the function. Increase in FPPA was associated with greater KPS, and the lowest PT of lateral core stability, hip abductors, and extensors was associated with lower function in women with PFPS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Myopathic Alterations in Extraocular Muscle of Rats Subchronically Fed Pyridostigmine Bromide

    Science.gov (United States)

    1990-01-01

    pre- soleus and extensor digitorum longus , the myopathy exposure antidote for nerve poisons that irreversibly consists of large diameter vacuoles in...By transmission electron microscopy, 35- diaphragm, extensor digitorum longus and soleusrat EoM Bny tranpsiss i lectons icroscopymuscles of the rat...end plates of rat soleus and extensor muscles. Macmillan Pub. Co., New York, p. 123. Exp. Neurol. 89: 96-114. Fcesion ’or INTIS CRA& VIC TAD El U d’-OU

  7. Maintenance of Glucose Homeostasis Through Acetylation of the Metabolic Transcriptional Coactivator PGC1-alpha

    Science.gov (United States)

    2011-02-01

    incubation of rat extensor digitorum longus (EDL) muscle with a high glucose medium (25 vs. 6 or 0 mM) for 4 h diminished AMPK activity without changing the...hindlimb muscles after a single AICAR injection. PGC-1a acetylation was markedly reduced by AICAR in extensor digitorum longus (EDL) and gastrocnemius...tein substrate affinity [20]. Similar effects of resveratrol were observed in C2C12 cells and incubated rat extensor digitorum lon- gus (EDL) muscle

  8. Botulinum Toxin

    Science.gov (United States)

    2009-01-01

    show inconsistent and erroneous results. In vivo experiments using the rat extensor digitorum longus (EDL) muscle assay showed sensitivities of rat... digitorum longus muscle paralyzed by local injection of botulinum neurotoxin. Toxicon 34: 237--49. Amon, S. (1995). Botulism as an intestinal...BoNT -induced paralysis. References Adler, M., MacDonald, D.A., Sellin, L.C., Parker, G.W. (1996). Effect of 3,4-diaminopyridine on rat extensor

  9. Role of adenosine 5'-monophosphate-activated protein kinase in interleukin-6 release from isolated mouse skeletal muscle

    DEFF Research Database (Denmark)

    Glund, Stephan; Treebak, Jonas Thue; Long, Yun Chau

    2009-01-01

    -type mice was also incubated with the AMPK activator A-769662. Incubation of mouse glycolytic extensor digitorum longus and oxidative soleus muscle for 2 h was associated with profound IL-6 mRNA production and protein release, which was suppressed by AICAR (P ... KO mice and their respective wild-type littermates (P extensor digitorum longus, was reduced 45% by A-769662. Our results on basal...

  10. [Open repair of gluteus medius and minimus tendons tears with double-row technique : Clinical and radiological results].

    Science.gov (United States)

    Schröder, J H; Geßlein, M; Schütz, M; Perka, C; Krüger, D

    2018-01-11

    Operative refixation is a new therapeutic option in cases of failed conservative treatment for trochanteric pain syndrome (TPS) and lesions of the hip abductors in magnetic resonance imaging (MRI). Evaluation of the clinical and radiological results after open gluteus medius and minimus tendon reconstruction with a double-row technique was carried out. Patients with failed conservative treatment for TPS and confirmed lesions of the hip abductors in MRI were treated by open hip abductor tendon reconstruction with a double-row technique. The patients were evaluated preoperatively and postoperatively (minimum follow-up 12 months) using the modified Harris hip score (mHHS) and a subjective score (subjective hip value, SHV). Preoperative and postoperative MRI evaluation included measurement of hip abductor muscle diameter and cross-sectional area as well as fatty degeneration. In this study 12 consecutive cases of open reconstruction of the hip abductor tendons were included. There was a significant improvement in the mHHS. In one case the patient showed an atraumatic rupture in the proximal anchor row. The MRI showed a significant improvement in muscle diameter and cross-sectional area for the gluteus medius muscle of the affected and the contralateral side, while the degree of fatty degeneration did not improve. The fatty degeneration showed a significant correlation with the postoperative results in the mHHS and the SHV. Operative reconstruction of lesions in the hip abductor tendons is a therapy option with significant improvement of patient satisfaction and functional scores as well as muscle diameter and cross-sectional area for the gluteus medius. The degree of fatty degeneration and possible differential diagnoses need to be taken into consideration.

  11. Comparison of anterior gluteus medius fiber activation during general exercises and PNF exercises.

    Science.gov (United States)

    Ju, Sung-Kwang; Yoo, Won-Gyu

    2017-03-01

    [Purpose] This study compared the activation of anterior gluteus medius fibers during general exercises and proprioceptive neuromuscular facilitation exercises. [Subjects and Methods] The study enrolled 15 healthy adults. The participants performed general hip abductor strengthening exercises and proprioceptive neuromuscular facilitation exercises; during both types of exercise, electromyography activity was recorded. [Results] Greater anterior gluteus medius fiber activation was observed during the proprioceptive neuromuscular facilitation exercises compared with the general hip abductor strengthening exercises. The anterior gluteus medius fibers exhibited greater activity during pattern 2 exercises compared with any other type of exercise. [Conclusion] The results suggest that pattern 2 exercises can selectively activate anterior gluteus medius fibers.

  12. Qualitative Neuromuscular Monitoring: How to Optimize the Use of a Peripheral Nerve Stimulator to Reduce the Risk of Residual Neuromuscular Blockade.

    Science.gov (United States)

    Thilen, Stephan R; Bhananker, Sanjay M

    This review provides recommendations for anesthesia providers who may not yet have quantitative monitoring and sugammadex available and thus are providing care within the limitations of a conventional peripheral nerve stimulator (PNS) and neostigmine. In order to achieve best results, the provider needs to understand the limitations of the PNS. The PNS should be applied properly and early. All overdosing of neuromuscular blocking drugs should be avoided and the intraoperative neuromuscular blockade should be maintained only as deep as necessary. The adductor pollicis is the gold standard site and must be used for the pre-reversal assessment, also when the ulnar nerve and thumb were not accessible intraoperatively. Spontaneous recovery should be maximized and neostigmine should be administered after a TOF count of 4 has been confirmed at the adductor pollicis. Extubation should not occur within 10 min after administration of an appropriate dose of neostigmine.

  13. Arterial anatomy of the thumb.

    Science.gov (United States)

    Ames, E L; Bissonnette, M; Acland, R; Lister, G; Firrell, J

    1993-08-01

    The anatomical literature has indicated that the arterial supply to the thumb comes from the princeps pollicis artery. However, this simplified description does not often correlate with intraoperative findings. The purpose of this study was to investigate and clarify this important area of anatomy by dissection of fresh cadaver hands. 40 dissections were completed on 35 intravascularly injected and five non-injected hands. Five patterns were identified. The most common pattern showed both a superficial and deep vessel to the first web space in 54% of specimens. Dominant vessels included the superficial palmar branch of the radial artery in 8%, first palmar metacarpal artery in 18% and dorsal metacarpal artery in 8%. Only three specimens correlated with the textbook description. We conclude that the term "princeps pollicis" is actually a misnomer.

  14. Diagnostic value of magnetic resonance imaging of the ankle joint - visualization of ligaments and tendons by standard slice orientations; Die diagnostische Wertigkeit der Magnetresonanztomographie des oberen Sprunggelenks - Darstellung von Baendern und Sehnen in den Standardschichtorientierungen

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, R.J. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Siewert, C. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Maeurer, J. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Vogl, T.J. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Suedkamp, N. [Klinik fuer Unfall- und Wiederherstellungschirurgie, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany)

    1996-01-01

    We sought to evaluate the capability of high field strength MRI in depicting clinically important tendons and ligaments of the ankle joint using slice orientations parallel to the standard space directions without angulation. Patients (65) whose ankle joint complaints were not sufficiently clarified by conventional radiology sphere underwent MRI using plain T{sub 1}-weighted spin echo sequences. Tendons and ligaments were classified by three independent radiologists with regard to their perceptibility on images of the different slice orientations. Good perceptibility of at least two-thirds of each structure was observed with the possibility for a decision regarding continuity or rupture of the remaining part was given most frequently in the following slice orientations: Axially for the tendons of peroneus longus, peroneus brevis, tibialis posterior, flexor digitorum longus, flexor hallucis longus, tibialis anterior, extensor digitorum longus, and extensor hallucis longus muscles, and for the calcanear tendor (each over 94% of cases), anterior (68%) talofibular ligament, deltoid (77%), anterior (63%), and posterior (72%) tibiofibular ligaments and coronally for the calcaneofibular (39%) and posterior talofibular ligaments (70%). The sagittal orientation was never the favored one. Thus in most cases tendons and ligaments of the ankle joint can be sufficiently visualized by non-angulated spin echo sequences in standard slice orientations if the examination is performed in at least two slice directions. [Deutsch] Studienziel: Bewertung der Darstellungsqualitaet von klinisch bedeutsamen Sehnen- und Bandstrukturen im Bereich des oberen Sprunggelenks in Hochfeld-MRT-Aufnahmen bei Schichtorientierung parallel zu den Standardraumebenen ohne Angulierung. Material und Methodik: Bei Verwendung nativer T{sub 1}-gewichteter Spinechosequenzen wurden 65 Patienten mit konventionell-radiologisch nicht ausreichend abgeklaerten Beschwerden im oberen Sprunggelenkbereich untersucht und

  15. Intraoperative neuromuscular monitoring site and residual paralysis.

    Science.gov (United States)

    Thilen, Stephan R; Hansen, Bradley E; Ramaiah, Ramesh; Kent, Christopher D; Treggiari, Miriam M; Bhananker, Sanjay M

    2012-11-01

    Residual paralysis is common after general anesthesia involving administration of neuromuscular blocking drugs (NMBDs). Management of NMBDs and reversal is frequently guided by train-of-four (TOF) monitoring. We hypothesized that monitoring of eye muscles is associated with more frequent residual paralysis than monitoring at the adductor pollicis. This prospective cohort study enrolled 180 patients scheduled for elective surgery with anticipated use of NMBDs. Collected variables included monitoring site, age, gender, weight, body mass index, American Society of Anesthesiologists physical status class, type and duration of surgery, type of NMBDs, last and total dose administered, TOF count at time of reversal, dose of neostigmine, and time interval between last dose of NMBDs to quantitative measurement. Upon postanesthesia care unit admission, we measured TOF ratios by acceleromyography at the adductor pollicis. Residual paralysis was defined as a TOF ratio less than 90%. Multivariable logistic regression was used to account for unbalances between the two groups and to adjust for covariates. 150 patients received NMBDs and were included in the analysis. Patients with intraoperative TOF monitoring of eye muscles had significantly greater incidence of residual paralysis than patients monitored at the adductor pollicis (P paralysis was observed in 51/99 (52%) and 11/51 (22%) of patients, respectively. The crude odds ratio was 3.9 (95% CI: 1.8-8.4), and the adjusted odds ratio was 5.5 (95% CI: 2.1-14.5). Patients having qualitative TOF monitoring of eye muscles had a greater than 5-fold higher risk of postoperative residual paralysis than those monitored at the adductor pollicis.

  16. Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

    OpenAIRE

    Man, W. D-C.; Hopkinson, N.S.; Harraf, F.; Nikoletou, D.; Polkey, M. I.; Moxham, J.

    2005-01-01

    Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and fibre type distribution to the quadriceps, although they remain active in COPD. Cough gastric pre...

  17. [Wound repair and functional reconstruction of high-voltage electrical burns in wrists].

    Science.gov (United States)

    Shen, Y M; Ma, C X; Qin, F J; Zhang, C; Wang, C; Hu, X H

    2017-12-20

    Objective: To explore the methods and effects of wound repair and functional reconstruction of high-voltage electrical burns in wrists. Methods: From January 2009 to June 2016, 71 patients with high-voltage electrical burns in wrists were hospitalized, with 118 wrist wounds including 21 of type Ⅰ, 69 of type Ⅱ, 9 of type Ⅲ, and 19 of type Ⅳ. According to the wrist injuries, different surgical operations were performed. Forearm amputation was conducted in 20 wrists with necrosis in the distal end. On the basis of fasciotomy for decompression, early debridement was performed on the other 98 wrist wounds. After debridement, wounds with area ranging from 10 cm×7 cm to 30 cm×18 cm were repaired with tissue flaps with abundant blood supply. Thirty-two wounds were repaired with pedicled groin flaps, 11 wounds with pedicled paraumbilical flaps, 3 wounds with pedicled anterolateral thigh island flaps, 9 wounds with combined abdominal axial pattern flaps, 37 wounds with free skin flaps or myocutaneous flaps, and 6 wounds with flow-through descending branch of lateral femoral circumflex artery flaps, with tissue flap area ranging from 12 cm×8 cm to 34 cm×20 cm. Ulnar artery or radial artery vascular reconstruction was performed in 20 wrist wounds. Forty-one donor sites were sutured directly, while 14 were closed by thin split-thickness skin grafts from same-side thighs, and 43 were closed by thin split-thickness skin grafts from opposite-side thighs. Fifty-three wrist wounds were performed with tendon and nerve repair surgery, of which 20 were performed with simple tendon and nerve release surgery. Flexor digitorum profundus tendons and (or) flexor pollicis longus tendons were reconstructed with autologous or allogeneic tendon transplantation in 33 wrist wounds, and the median nerve was repaired with sural nerve graft in 21 wrist wounds. In 6 to 24 months after the last operation, tendon function of 53 wrist wounds which had tendon repair was evaluated with finger

  18. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    Science.gov (United States)

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  19. Frontal plane kinematics in walking with moderate hip osteoarthritis: stability and fall risk

    NARCIS (Netherlands)

    Lin, X.B.; Meijer, O.G.; Lin, J.H.; Wu, W.H.; Lin, X.C.; Liang, B.W.; van Dieen, J.H.; Bruijn, S.M.

    2015-01-01

    Background Hip abductor weakness and unilateral pain in patients with moderate hip osteoarthritis may induce changes in frontal plane kinematics during walking that could affect stability and fall risk. Methods In 12 fall-prone patients with moderate hip osteoarthritis, 12 healthy peers, and 12

  20. Implementation of the Parental Kidnaping Prevention Act of 1980. Oversight Hearing before the Subcommittee on Crime of the Committee on the Judiciary, House of Representatives, Ninety-Seventh Congress, First Session (September 24, 1981).

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on the Judiciary.

    This hearing was convened to inquire into the Department of Justice's compliance with the intent of Congress as expressed in section 10 of the Parental Kidnaping Prevention Act of 1980. The primary purpose of section 10(a) of the act was to involve federal authorities in helping state law enforcement agencies locate and apprehend abductor parents.…