By Raoul Tubiana, Alain Gilbert, Caroline Leclercq, René Malek
This textbook stands out as the definitive learn of the surgical administration of muscular defects and neurbiologcial issues of the higher extremity. The lead editor has dedicated an entire life to surgical procedure of the hand adn top extremity, and he attracts the following on his own sequence and event
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Extra resources for Restoration of Function in Upper Limb Paralyses and Muscular Defects
All kinds of injuries to motor neurons have consequences on motor function. EMG is the recording with a needle electrode of the electrical activity of motor units in a muscle. The electrode (concentric needle) records the electrical activity derived from the action potentials of the muscle fibers that are firing singly or in groups near to it. This activity is named motor unit potentials (MUPs). This electrical activity induces the contraction of muscle fibers. Thus, electromyography is a useful tool to study the extent of nerve trauma.
From the forearm to the hand a complete lesion of the nerve gives the same palsies. What is peculiar is the frequency of nerve compression at different levels: • Between the two heads of the pronator teres or under the arch of the flexor digitorum sublimis. 2 Sensitive terminal branch of the radial nerve. (A) Radial sensitive branch and (B) digital collateral nerve from the median nerve. • More distally compression at the carpal tunnel is very frequent and generates acroparesthesia at night, hypesthesia at the hand, and in severe cases a thenar muscle paralysis.
However, communication with the patient remains essential, as it is often possible to have an opinion based on reality and intensity of a pain described by the patient. Functional assessment After the analytic evaluation it is possible to determine the therapeutic indications. If one admits that the paralysis is definitive, its consequences on the life of the patient must be determined. The investigation is necessarily undertaken within a limited space of time and this adds to the difficulties to appreciate exactly what can be proposed to improve function.