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Effect of muscle tension during tendon transfer on sarcomerogenesis in a rabbit model
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy. Department of Orthopaedics, Uppsala University, Uppsala, Sweden.
Responsible organisation
2000 (English)In: Journal of Hand Surgery-American Volume, ISSN 0363-5023, E-ISSN 1531-6564, Vol. 25, no 1, 138-143 p.Article in journal (Refereed) Published
Abstract [en]

Sarcomere number change was investigated in an animal model of tendon transfer. In 9 adult New Zealand white rabbits, the flexor digitorum longus muscle was cut distally and transferred and woven into the tibialis anterior tendon. Ankles were then immobilized for 3 weeks in 75 degrees flexion. Transferred flexor digitorum longus muscles were harvested and complete architectural analysis was performed. Sarcomere lengths were measured using laser diffraction. Serial sarcomere number in transferred flexor digitorum longus fibers was a strong function of the sarcomere length at the time of transfer. A highly significant negative correlation between these 2 parameters was approximated by a linear relationship. Based on this finding, we conclude that serial sarcomere number is significantly affected by the degree of stretch during the transfer itself. This could easily compromise the purpose of surgical tendon transfer by reducing the procedure to little more than a tenodesis.

Place, publisher, year, edition, pages
Philadelphia: Saunders Elsevier, 2000. Vol. 25, no 1, 138-143 p.
Keyword [en]
muscle, sarcomere length, passive tension, tendon transfer, sarcomerogenesis
National Category
Orthopedics Surgery
URN: urn:nbn:se:umu:diva-3247DOI: 10.1053/jhsu.2000.jhsu025a0138ISI: 000085004500020OAI: diva2:141768
Available from: 2009-03-26 Created: 2009-03-26 Last updated: 2016-08-26Bibliographically approved
In thesis
1. Tendon transfer mechanics and donor muscle properties: implications in surgical correction of upper limb muscle imbalance
Open this publication in new window or tab >>Tendon transfer mechanics and donor muscle properties: implications in surgical correction of upper limb muscle imbalance
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Tendon transfer surgery is used to improve the hand function of patients with nerve injuries, spinal cord lesions, cerebral palsy (CP), stroke, or muscle injuries. The tendon of a muscle, usually with function opposite that of the lost muscle function, is transferred to the tendon of the deficient muscle. The aim is to balance the wrist and fingers to achieve better hand function.

The position, function, and length at which the donor muscle is sutured is essential for the outcome for the procedure. In these studies the significance of the transferred muscle’s morphology, length and apillarization was investigated using both animal and human models. Immunohistochemical, biochemical, and laser diffraction techniques were used to examine muscle structure.

In animal studies (rabbit), the effects of immobilization and of tendon transfers at different muscle lengths were analyzed. Immobilization of highly stretched muscles resulted in fibrosis and aberrant regeneration. A greater pull on the tendon while suturing a tendon transfer resulted in larger sarcomere lengths as measured in vivo. On examination of the number of sarcomeres per muscle fiber and the sarcomere lengths after 3 weeks of immobilization and healing time, we found a cut-off point up to which the sarcomerogenesis was optimal. Transfer at too long sarcomere lengths inhibited adaptation of the muscle to its new length, probably resulting in diminished function.

In human studies we defined the sarcomere lengths of a normal human flexor carpi ulnaris muscle through the range of motion, and then again after a routinely performed tendon transfer to the finger extensor. A calculated model illustrated that after a transfer the largest force was predicted to occur with the wrist in extension.

Morphological studies of spastic biceps brachii muscle showed, compared with control muscle, smaller fiber areas and higher variability in fiber size. Similar changes were also found in the more spastic wrist flexors comparing with wrist extensors in children with CP. In flexors, more type 2B fibers were found. These observations could all be due to the decreased use in the spastic limb, but might also represent a specific effect of the spasticity.

In children and adults with spasticity very small fibers containing developmental myosin were present in all specimens, while none were found in controls. These fibers probably represent newly formed fibers originating from activated satellite cells. Impaired supraspinal control of active motion as well as of spinal reflexes, both typical of upper motor syndrome, could result in minor eccentric injuries of the muscle, causing activation of satellite cells.

Spastic biceps muscles had fewer capillaries per cross-sectional area compared to age-matched controls, and also a smaller number of capillaries around each fiber. Nevertheless, the number of capillaries related to the specific fiber area was normal, and hence the spastic fibers are sufficiently supplied with capillaries.

This study shows that the length of the muscle during tendon transfer is crucial for optimization of force output. Laser diffraction can be used for accurate measurement of sarcomere length during tendon transfer surgery. Wrist flexor muscles have more morphological alterations typical of spasticity compared to extensors.

Place, publisher, year, edition, pages
Integrativ medicinsk biologi, 2003. 43 p.
laser diffraction, sarcomere length, tendon transfer, spasticity, muscle morphology, myosin heavy chain, capillary, rabbit, human, cerebral palsy, stroke
National Category
Medical and Health Sciences
Research subject
urn:nbn:se:umu:diva-167 (URN)91-7305-300-X (ISBN)
Public defence
Available from: 2009-05-25 Created: 2004-12-22 Last updated: 2011-11-21Bibliographically approved

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