Follow-up motion laboratory analysis for patients with spastic hemiplegia due to cerebral palsy: analysis of the flexor carpi ulnaris firing pattern before and after tendon transfer surgery.
OBJECTIVE
To compare the preoperative and postoperative pattern of firing of the flexor carpi ulnaris (FCU) in a grasp and release functional activity for children treated with an FCU to extensor carpi radialis brevis tendon transfer for wrist flexion deformity associated with spastic hemiplegia from cerebral palsy.


METHODS
Seven children, evaluated by a preoperative EMG video analysis and treated with an FCU to extensor carpi radialis brevis transfer, had a follow-up postoperative EMG/video motion laboratory analysis at an average follow-up of 3.5 years (range, 1.0-6.8 years). Each preoperative and postoperative EMG/video was reviewed for the task of lifting heavy cans, as described by Jebson et al. The EMG activity of the FCU was described as active or relaxed during grasp and during release.


RESULTS
Preoperatively, the most common pattern was to activate the FCU during grasp and to relax the FCU during release (4 patients). Postoperatively, 6 patients activated the FCU during grasp and relaxed the FCU during release; 1 patient activated the FCU during both grasp and release.


CONCLUSIONS
Of the 7 patients studied, the FCU changed phase from preoperative to postoperative in only 1. This study concludes that most commonly the FCU does not predictably change phase when transferred from a position of wrist flexion to wrist extension.


METHODS
Therapeutic IV.
Van Heest
Ann
A
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55454, USA. vanhe003@umn.edu
Stout
Jean
J
Wervey
Roy
R
Garcia
Louis
L
D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D015331:Cohort Studies; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006429:Hemiplegia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007753:Laboratories; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D012720:Severity of Illness Index; D013647:Task Performance and Analysis; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome; D014741:Video Recording; D014955:Wrist Joint / Q000601:surgery