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Intraoperative assessment of wrist extensor muscle force
L S Mendelson1, P H Peckham, A A Freehafer
1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.
The Journal of Hand Surgery
|November 1, 1988
Summary
This study introduces a new method to measure wrist extensor muscle strength before tendon transfer surgery in spinal cord injury patients. This ensures adequate wrist function is preserved after restoring hand grasp.
Area of Science:
- Orthopedic Surgery
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Spinal cord injury at the C6 level often requires tendon transfer surgery using radial wrist extensors to restore hand grasp.
- Preserving remaining wrist function is critical, necessitating accurate preoperative assessment of muscle strength.
Purpose of the Study:
- To develop and validate an in situ method for quantitatively measuring the strength of individual wrist extensor muscles during tendon transfer surgery.
- To predict postoperative wrist function and ensure sufficient residual strength after tendon transection.
Main Methods:
- Developed an in situ technique using buckle transducers placed on the tendons of extensor carpi radialis brevis and longus.
- Measured individual muscle strength during voluntary and electrically stimulated wrist extension.
- Analyzed the strength of the extensor carpi radialis brevis to assess remaining wrist extension torque.
Main Results:
- Successfully measured simultaneous strength of individual wrist extensor muscles in situ.
- Demonstrated the ability to quantitatively assess the contribution of each muscle to wrist extension torque.
- Provided a method to evaluate the adequacy of remaining wrist extension after potential tendon transfer.
Conclusions:
- The developed in situ method accurately measures the force of voluntarily activated muscles with long tendons.
- This technique is crucial for predicting postoperative function and preventing devastating loss of wrist function in spinal cord injury patients undergoing tendon transfer.
- Enables informed surgical decisions to optimize hand grasp restoration while preserving essential wrist stability.