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Results for “LEG LENGTHENING”

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PubMed1997

Electrophysiologic evaluation of neuromuscular functions during limb lengthening by callus distraction.

We investigated the effects of different rates and extents of lengthening on the affected nerves and muscles in callus distraction, in a rabbit tibial model. Electrophysiologic evaluations measuring the motor nerve conduction velocity of the peroneal and tibial nerves, and compound muscle action potentials of the anterior tibialis and gastrocnemius muscle were performed sequentially on rabbits whose left legs were lengthened at different rates and to different extents over a 5-month period after surgery. We found that neuropathies of the peroneal nerves developed earlier and were more severe than those of tibial nerves, especially when the rate of lengthening was over 2 mm per day, or when the extent of lengthening was over 20% of the leg length at a lengthening rate of 1 mm per day. When the nerve damage was mild, there was a slow recovery of nerve function with time. The anterior tibialis muscle exhibited earlier and more severe damage than the gastrocnemius muscle during lengthening, especially when the rate of lengthening was over 2 mm per day, or when the extent of lengthening was over 20% of leg length. Elevated serum creatine kinase levels also indicated muscle damage after lengthening, especially in cases of high lengthening rates and long extent of lengthening. We conclude that nerves and muscles may have the same optimal rate of lengthening as bones, (1 mm per day). However, the extent of lengthening still has a limit of 20% or less of the total leg length. Electrophysiologic evaluation measuring the motor nerve conduction velocity and compound muscle action potential can serve as a tool for early detection and for long-term monitoring of neurologic dysfunction.

Action Potentials↗
PubMedDate not supplied

[Regenerative myogenesis of the leg muscles during experimental lengthening].

Regenerative myogenesis of an extremity regenerating by bilocal distraction osteosynthesis according to Ilizarov has been studied by light end electron microscopy. During the osteosynthesis, the action of the factor of mechanical tension is observed. Muscles elongate because myogenic cells incorporate into muscular fibers in the area of their attachment to dense connective tissues. The data obtained confirm the role of mechanical tension in spatial organization of cells, in morphogenetic and formation processes.

Animals↗
PubMed2000

Gait and electromyographic analysis of patients recovering after limb-saving surgery.

OBJECTIVE: Control of gait after limb-saving surgery.Design. Case series study. BACKGROUND: At the moment little is known about adaptations in patients' gait after limb-saving surgery. METHODS: Nineteen patients who underwent limb-saving surgery at least 1 yr earlier and 10 normal subjects were studied during treadmill walking. The main outcome measures were walking speed, step parameters and angular displacement of both legs and EMG of the biceps femoris, rectus femoris and medial gastrocnemius in the affected leg. RESULTS: Preferred walking speed in the patients was lower than in the controls (0.7 versus 1.1 m/s). Furthermore, stance phase of the non-affected leg was lengthened. All patients showed reduced stance phase knee flexion in the affected leg, while during the swing phase no difference was seen. The EMG signals of the rectus femoris and biceps femoris show changes, which are related to the location of surgery. CONCLUSIONS: The results showed that the gait pattern of the patients differed compared to normal gait. The reduced stance phase knee flexion in the hip group is based on a high degree of co-contraction between quadriceps and hamstring activity, while in the knee group this is based on the quadriceps avoidance pattern. The finding that there is still side-to-side asymmetry indicates that there is no complete reorganisation following the massive loss of input and output of the leg. It is possible that some reprogramming of the locomotor process occur. RELEVANCE: Gait and electromyographic analysis are essential for the quantitative assessments of the functional outcome in this type of surgery.

Adult↗
PubMed1991

Methodology for restoring functional leg length in revision total hip arthroplasty.

Functional leg length was measured in 30 patients before and after revision total hip arthroplasty. The authors emphasize the importance of preoperative planning, and determination of adjustment of the leg length should be aimed at a balanced attitude of the entire pelvis and lower back. In order to correct the length inequality, the leg was lengthened in the revision in 25 cases, left unchanged in 2 cases, and shortened in 3 cases. The mean functional leg-length inequality was 13 mm before operation and 4 mm after operation. The mean radiographic inequality between the upper surfaces of the iliac crest was 13 mm before operation and 9 mm after operation. The side operated was more often functionally shorter than the other side before operation, and longer than the other side after operation. The authors emphasize the importance of functional leg length in revision hip arthroplasty. The functional length discrepancy can be corrected in revision, but there appears to be a risk of overlengthening.

Aged↗
PubMed2005

Anabolic signaling and protein synthesis in human skeletal muscle after dynamic shortening or lengthening exercise.

We hypothesized a differential activation of the anabolic signaling proteins protein kinase B (PKB) and p70 S6 kinase (p70(S6K)) and subsequent differential stimulation of human muscle protein synthesis (MPS) after dynamic shortening or lengthening exercise. Eight healthy men [25 +/- 5 yr, BMI 26 +/- 3 kg/m(-2) (means +/- SD)] were studied before and after 12 min of repeated stepping up to knee height, and down again, while carrying 25% of their body weight, i.e., shortening exercise with the "up" leg and lengthening exercise with contralateral "down" leg. Quadriceps biopsies were taken before and 3, 6, and 24 h after exercise. After exercise, over 2 h before the biopsies, the subjects ingested 500 ml of water containing 45 g of essential amino acids and 135 g of sucrose. Rates of muscle protein synthesis were determined via incorporation over time of [1-(13)C]leucine (<or=6 h after exercise) or [1-(13)C]valine (21-24 h after exercise) and phosphorylation of signaling proteins by Western analysis. PKB and p70(S6K) phosphorylation increased approximately 3-fold after 3 h and remained elevated at 6 and 24 h. After exercise, rates of myofibrillar and sarcoplasmic protein synthesis were unchanged over the period including exercise and 3 h of recovery but had increased significantly at 6 (approximately 3.0- and 2.4-fold, respectively) and 24 h (approximately 3.2- and 2.0-fold, respectively), independently of the mode of exercise. Short-term dynamic exercise in either shortening or lengthening mode increases MPS at least as much as resistance exercise and is associated with long-term activation of PKB and p70(S6K).

Adult↗