Beredjiklian Pedro K, Kachooei Amir R, Gallant Greg, Abboudi Jack, Kwok Moody, Takei Robert, Hotchkiss Robert N
Rothman Orthopedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Rothman Orthopedic Institute, Adventhealth, Orlando, FL, USA.
Arch Bone Jt Surg. 2023;11(6):398-403. doi: 10.22038/ABJS.2023.64666.3105.
This study examines the pattern of muscular contraction and the intensity of this contraction of the biceps and triceps following elbow surgery.
We performed a prospective electromyographic study of 16 patients undergoing 19 surgical procedures on the elbow joint. We measured the resting EMG signal intensity of the biceps and triceps of the operated and the normal sides at 90 degrees. We then calculated the peak EMG signal intensity during passive elbow flexion and extension of the operated side.
Seventeen of 19 elbows (89%) displayed a co-contraction pattern of the biceps and triceps near the end of flexion and extension during the passive range of motion. The co-contraction pattern was observed near the end of the range of motion in both flexion and extension. In addition to the observed co-contraction patterns, we detected higher contraction intensities for the biceps and triceps muscles in all patients in both flexion and extension for the elbows, which had been treated surgically. Further analysis suggests an inverse correlation between the biceps contraction intensity and the arc of motion measured at the latest follow-up.
The co-contraction pattern and increased contraction intensity of periarticular muscle groups may result in internal splinting mechanisms, contributing to the development of elbow joint stiffness, which is frequently observed following elbow surgery.
本研究探讨肘部手术后肱二头肌和肱三头肌的肌肉收缩模式及其收缩强度。
我们对16例接受19项肘关节手术的患者进行了前瞻性肌电图研究。我们在90度时测量了手术侧和正常侧肱二头肌和肱三头肌的静息肌电图信号强度。然后计算了手术侧被动肘关节屈伸过程中的肌电图信号峰值强度。
在19个肘部中,有17个(89%)在被动活动范围内屈伸接近结束时出现肱二头肌和肱三头肌的共同收缩模式。在屈伸活动范围接近结束时均观察到共同收缩模式。除了观察到的共同收缩模式外,我们还检测到所有接受手术治疗的肘部患者在屈伸时肱二头肌和肱三头肌的收缩强度更高。进一步分析表明,肱二头肌收缩强度与最后一次随访时测量的运动弧呈负相关。
关节周围肌肉群的共同收缩模式和增加的收缩强度可能导致内部夹板机制,促进肘关节僵硬的发展,这在肘部手术后经常观察到。