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Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 35 - 35
1 Mar 2006
Adamczyk G Kostera-Pruszczyk A Chomicki-Bindas P
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Introduction: Conventional nerve conduction studies localize the lesion of a nerve and can disclose the degree of focal conduction block or pinpoint the region of focal slowing, giving complementary information about the character of the lesion. In a group of active population transient disturbances during physical efforts are commonly observed.

Aim: To precise the evolution with time of EMG recordings of the median nerve in common sport-specific positions.

Material and methods: 20 healthy volunteers and 12 symptomatic patients (persons with a conduction block were excluded from the study). Conventional EMG of median nerve was performed, than a “reversed Phalen” position kept for 30 min, and consequent measurements in 5 min periods were performed.

Results: In 20% of asymptomatic patients a significant decrease of sensory nerve action potential was recorded after 20 min of observation, while 100% of symptomatic in daily living and negative in conventional EMG studies developed a severe decrease of conduction and blocks after 15 min. These symptoms recuperated after 5 min in functional wrist position. We proposed to these patients a neuromobilisation physiotherapy program, that clinically diminished their complaints.

Conclusions: EMG shows a 97–100% diagnostic specificity and sensitivity. It might be a functional test helping to distinguish a group of risk of development of carpal tunnel syndrome with exercises. This method is useful among patients with functional disturbances due to joint instability or repetitive motions in sports.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 133 - 133
1 Mar 2006
Adamczyk G Kostera-Pruszczyk A Czyrny Z Chomicki-Bindas P
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Introduction: The presence of atypical muscle groups especially in sportsmen population is one of the causes of ulnar nerve entrapmnet. To treat this problem a close cooperation in between neurophysiologist, US-diagnost, surgeon and physiotherapist is mandatory. The inching (short segment study – SSS) of the peripheral nerves was introduced for testing the ulnar neuropathy at the elbow (UNE). The conventional fractionated ulnar nerve conduction studies localize the lesion only approximately to the elbow region, should be followed by inching of the ulnar nerve at the elbow. Dynamic, functional US also precise the character and localise the lesion and region of mechanical obstacles for the nerve. These methods can disclose the degree of focal conduction block or pinpoint the region of focal slowing, giving complementary information about the character of the lesion and help to choose a therapy by neuromobilisation or operative treatment.

Aim: To compare results of SSS and US with intraoperative observations in a group of 24 patients operated due to peripheral neuropathy.

Results: US and SSS shows a 97–100% diagnostic specificity and sensitivity These methods are also useful among patients with functional disturbances due to joint instability or presence of abnormal muscle groups like the anconeus epitrochlearis muscle, additional triceps aponeurosis or abnormality of the medial head of triceps brachii.

Conclusions: Precise diagnosis helps to choose optimal therapy of UNE directed at the specific site of involvement. In our observations muscular pathology is responsible for UNE in about 40% of cases among sportsmen.