Importance of Electromyography in the Reconstructive Surgery of the Upper Extremity

Czech version

Authors: I. Čižmář ¹; E. Ehler ²; J. Dufek ¹; P. Přikryl ¹
Authors‘ workplace: Traumatologické oddělení, LF UP a FN Olomouc ¹; Neurologická klinika FZS UPa a Pardubické krajské nemocnice, a. s. ²
Published in: Cesk Slov Neurol N 2014; 77/110(1): 100-103
Category: Short Communication

Overview

Aim of the study:
Muscle-tendon transfers are used as part of a complex approach in management of spasticity. The aim of the study was to highlight varied activation of individual muscles in a spastic upper extremity, and to emphasise that it is absolutely necessary to implement a functional EMG assessment before each reconstructive intervention.

Methodology:
Between 2009 and 2012, a group of 17 patients with spasticity of the upper limb was scheduled for surgical reconstruction of the forearm. The mean age of the group was 34 (7–71) years, the mean duration of spastic deformity was 11 (3–24) years. Activity level of the muscles with respect to the position of the hand, involvement when gripping and releasing the grip was assessed using EMG. The aim of the surgery was to eliminate symptoms of spastic forearm muscles during volitional movement of the hand.

Results:
While in a healthy person, forearm muscles are agonistic or synergistic to a specific acral movements, the same muscles showed antagonistic muscle properties in 17% (nine muscles) of the 52 examined muscles of patients with the spastic syndrome. In half of the patients (53%), at least one muscle with antagonistic muscle characteristics – a reverse muscle – was present.

Conclusion:
During hand movement, there are significant differences between patients in how spastic muscles are activated, depending on individual movement patterns. Functional assessment of muscles before reconstructive surgery using EMG provides the necessary information on how to utilize spasticity symptoms (contraction, synkinesis) effectively to achieve a positive effect on the function of the hand grip.

Key words:
elasticity – functional electromyography – upper extremity – tendon transfer

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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