Fiber length variability within the flexor carpi ulnaris and flexor carpi radialis muscles: implications for surgical tendon transfer. 2004

Jan Fridén, and Richard M Lovering, and Richard L Lieber
Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.

OBJECTIVE The purpose of this study was to understand the detailed architectural properties of the human flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) muscles and their implications for tendon transfer surgery. METHODS Muscle fiber length was measured in 6 separate regions of the FCU and FCR from 10 cadaveric specimens. Sarcomere length was measured by laser diffraction for normalization. Moment arms were estimated by measuring tendon excursion with respect to joint angle. The position of entry of the motor nerve branches into each muscle also was measured to establish limits for the safe length of muscle mobilization. RESULTS Muscle fiber length varied significantly along both the FCU and FCR. Fiber length variability in the FCU was twice that of the FCR. Although the average fiber length for both muscles across all regions was similar (62.6 +/- 2.1 mm for the FCR and 63.1 +/- 4.0 mm for the FCU), the proximal fibers of the FCU were longer compared with the proximal fibers of the FCR and the distal fibers of the FCU were shorter compared with the distal fibers of the FCR. The 99% confidence interval for the second nerve branch entry into the muscles was located approximately 69 mm distal to the medial epicondyle for the FCU and approximately 73 mm distal for the FCR. CONCLUSIONS These data show different designs of both the FCU and the FCR. The functional significance of fiber length variability is not clear but imply that, when used in tendon transfer, the properly mobilized FCU has a much greater excursion.

UI MeSH Term Description Entries
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D005542 Forearm Part of the upper extremity in humans and primates extending from the ELBOW to the WRIST. Antebrachium,Antebrachiums,Forearms
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013709 Tendon Transfer Surgical procedure by which a tendon is incised at its insertion and placed at an anatomical site distant from the original insertion. The tendon remains attached at the point of origin and takes over the function of a muscle inactivated by trauma or disease. Tendon Transfers,Transfer, Tendon,Transfers, Tendon
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular
D016001 Confidence Intervals A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable. Confidence Interval,Interval, Confidence,Intervals, Confidence
D048430 Cell Shape The quality of surface form or outline of CELLS. Cell Shapes,Shape, Cell,Shapes, Cell
D018482 Muscle, Skeletal A subtype of striated muscle, attached by TENDONS to the SKELETON. Skeletal muscles are innervated and their movement can be consciously controlled. They are also called voluntary muscles. Anterior Tibial Muscle,Gastrocnemius Muscle,Muscle, Voluntary,Plantaris Muscle,Skeletal Muscle,Soleus Muscle,Muscle, Anterior Tibial,Muscle, Gastrocnemius,Muscle, Plantaris,Muscle, Soleus,Muscles, Skeletal,Muscles, Voluntary,Skeletal Muscles,Tibial Muscle, Anterior,Voluntary Muscle,Voluntary Muscles
D018485 Muscle Fibers, Skeletal Large, multinucleate single cells, either cylindrical or prismatic in shape, that form the basic unit of SKELETAL MUSCLE. They consist of MYOFIBRILS enclosed within and attached to the SARCOLEMMA. They are derived from the fusion of skeletal myoblasts (MYOBLASTS, SKELETAL) into a syncytium, followed by differentiation. Myocytes, Skeletal,Myotubes,Skeletal Myocytes,Skeletal Muscle Fibers,Fiber, Skeletal Muscle,Fibers, Skeletal Muscle,Muscle Fiber, Skeletal,Myocyte, Skeletal,Myotube,Skeletal Muscle Fiber,Skeletal Myocyte

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