Paralysis Research Today is a free monthly online journal that collates and summarizes the latest research about Paralysis, including details on treatment, diagnosis, facial paralysis, sleep paralysis.

Flexor carpi ulnaris tendon transfer to the split brachioradialis tendon to restore supination in paralytic forearms.

Anderson GA, Thomas BP, Pallapati SC

Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India. andersongeorge@hotmail.com

Inability to actively supinate the forearm makes common activities of daily living and certain vocational activities awkward or impossible to perform. A total of 11 patients with deficient supination of the arm underwent transfer of the tendon of flexor carpi ulnaris to the split tendon of brachioradialis with its bony insertion into the radial styloid left intact. Active supination beyond neutral rotation was a mean of 37.2 degrees (25 degrees to 49.5 degrees ) at a minimum follow-up of three years, representing a significant improvement (95% confidence interval 25 to 50, p < 0.001). Functional evaluation of the hand after this transfer showed excellent and good results in ten patients and fair in one. The split tendon of brachioradialis as an insertion for transfer of the flexor carpi ulnaris appears to provide adequate supination of the forearm without altering the available pronation and avoids the domination of wrist extension sometimes associated with transfers of the flexor carpi ulnaris to the radial extensors of the wrist.

Published 4 February 2010 in J Bone Joint Surg Br, 92(2): 230-4.
Full-text of this article is available online (may require subscription).

Articles on Paralysis published 4 February 2010:

Severe rotational deformity, quadriparesis and respiratory embarrassment due to osteomyelitis at the occipito-atlantoaxial junction.   J Bone Joint Surg Br, 92(2): 286-8.

We present the case of an 83-year-old man who developed quadriparesis and respiratory embarrassment following osteomyelitis at the occipito-atlantoaxial junction. He had developed an abscess at this site after an earlier urinary infection with methicillin-resistant staphylococcus aureus. Stabilisation of the neck and antibiotic therapy led to an almost complete neurological recovery without recourse to anterior surgery. [Abstract] [Full-text]

Articles on Paralysis published 3 February 2010:

The outcomes of dynamic procedures for blink restoration in pediatric facial paralysis.   Plast Reconstr Surg, 125(2): 629-44.

BACKGROUND: Surgical planning aims to restore coordinated eyelid function. Although achieving voluntary eye closure is one of the primary goals, it cannot guarantee return of involuntary blink. Restoration of the afferent pathway of the reflex is a prerequisite, but successful coordination of the reflex components and restoration of their time-related function are also required. METHODS: A retrospective review of 49 patients who underwent dynamic procedures for blink restoration was performed. ... [Abstract] [Full-text]

Articles on Paralysis published 29 January 2010:

Physical findings and sonography of hemiplegic shoulder in patients after acute stroke during rehabilitation.   J Rehabil Med, 42(1): 21-6.

OBJECTIVE: Physical and sonographic evaluation of hemiplegic shoulder in patients after acute stroke and correlation between the physical/sonographic findings and early-onset hemiplegic shoulder pain. DESIGN: Cross-sectional study. SUBJECTS: Fifty-seven patients after stroke with hemiplegic shoulder. METHODS: Subjects were assigned to poor motor function and good motor function groups according to the Brunnström motor recovery stages of hemiplegic shoulder. Physical findings and sonography of ... [Abstract] [Full-text]

Articles on Paralysis published 26 January 2010:

Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications.   Laryngoscope, 120(2): 319-25.

OBJECTIVES/HYPOTHESIS: To identify contemporary indications, treatment principles, technique, injection materials, complications, and success rates of vocal fold injection augmentation. STUDY DESIGN: Multi-institutional retrospective review. METHODS: Records of patients undergoing injection augmentation at seven university medical centers from July 2007 through June 2008 were reviewed for information regarding diagnosis, unilateral or bilateral injection, route of injection, anesthesia, ... [Abstract] [Full-text]

Functional modulation of satellite cells in long-term denervated human laryngeal muscle.   Laryngoscope, 120(2): 353-8.

OBJECTIVES/HYPOTHESIS: To evaluate the effects of long-term denervation on satellite cells (SCs) as myogenic stem cells in human posterior cricoarytenoid (PCA) muscle. STUDY DESIGN: Histological investigation of SCs and quantitative assessment of myoD and myogenin, which are two key myogenic regulatory factors. METHODS: According to the course of denervation, denervated PCA muscles of 58 patients who suffered from traumatic unilateral vocal cord paralysis were divided into four groups: group A ... [Abstract] [Full-text]

Laryngeal neuropathy of Charcot-Marie-Tooth disease: further observations and novel mutations associated with vocal fold paresis.   Laryngoscope, 120(2): 291-6.

OBJECTIVES/HYPOTHESIS: To describe and define laryngeal neuropathy in Charcot-Marie-Tooth (CMT) disease. STUDY DESIGN/METHODS: Retrospective record review from a university laryngology practice. RESULTS: Four adult CMT patients presented with laryngeal symptoms. Three patients exhibited bilateral vocal fold palsy, in each case with more severe hypomobility on the left. One case exhibited an isolated left vocal fold palsy. All patients complained of hoarseness and stridor, three had dyspnea, two ... [Abstract] [Full-text]

Electromyographic laryngeal synkinesis alters prognosis in vocal fold paralysis.   Laryngoscope, 120(2): 285-90.

OBJECTIVES/HYPOTHESIS: Synkinesis, or misdirected reinnervation, is likely a confounder when predicting return of function of an immobile vocal fold. Currently, no information exists on the incidence of synkinesis in unilateral vocal fold immobility (UVFI) or the effect synkinesis has on prognosis and treatment. Our objective was to examine a vocal fold adductor synkinesis screening protocol using diagnostic laryngeal electromyography (LEMG). We aim to determine the effect of synkinesis on ... [Abstract] [Full-text]

High-resolution entrainment mapping of gastric pacing: a new analytical tool.   Am J Physiol Gastrointest Liver Physiol, 298(2): G314-21.

Gastric pacing has been investigated as a potential treatment for gastroparesis. New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This study introduces high-resolution (HR) "entrainment mapping" for the analysis of gastric pacing and presents four demonstrations. Gastric pacing was initiated in a porcine model (typical ... [Abstract] [Full-text]

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