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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 6, 856-859.
doi: 10.1302/0301-620X.85B6.14071  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Biomechanical effects of dissecting flexor carpi ulnaris

M. Kreulen, MD, Plastic Surgeon; and M. J. C. Smeulders, MSc, Human Movement Scientist

Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands.

J. J. Hage, PhD, Plastic Surgeon

Department of Plastic and Reconstructive Surgery, Antoni van Leeuwenhoek Ziekenhuis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.

P. A. Huijing, PhD, Human Movement Scientist

Instituut voor Fundamentele en Klinische Bewegingswetenschappen, Vrije Universiteit, Van de Boechorststraat 9, 1081 BT Amsterdam, The Netherlands.

Correspondence should be sent to Dr M. Kreulen.

Our aim was to determine whether the length and function of the flexor carpi ulnaris muscle were affected by separating it from its soft tissue connections. We measured the length of flexor carpi ulnaris before and after its dissection in ten patients with cerebral palsy. After tenotomy, tetanic contraction shortened the muscle by a mean of 8 mm. Subsequent dissection to separate it from all soft tissue connections, resulted in a further mean shortening of 17 mm (p < 0.001). This indicated that the dissected connective tissue had been strong enough to maintain the length of the contracting muscle. Passive extension of the wrist still lengthened the muscle after tenotomy, whereas this excursion significantly decreased after subsequent dissection.

We conclude that the connective tissue envelope, which may be dissected during tendon transfer of flexor carpi ulnaris may act as a myofascial pathway for the transmission of force. This may have clinical implications for the outcome after tendon transfer.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General