Gastrosoleus kas fonksiyonu üzerine tibial uzatmanın etkileri: Elektrofizyolojik çalışma
Amaç: Deneysel tibial uzatma sırasında gastrosoleus kas grubunda gerilmeye bağlı meydana gelen kas kasılma kuvvetlerindeki değişiklikler elektrofizyolojik olarak değerlendirildi. Çalışma planı: Ağırlıkları 600-800 gr arasında değişen 22 kobay (guinea pig) üzerinde distraksiyon histiogenezi uygulandı. Kobayların sağ tibialarına, semisürküler eksternal fiksatör uygulanmasından sonra osteotomi yapıldı ve latent periyot beklenmeden 15 gün boyunca günde iki kez 0.25 mm hızla distraksiyon gerçekleştirildi. Hayvanlar rastgele iki gruba ayrıldı. Bir gruba eksternal fiksatöre sabitlenen ve plantar fleksiyonu engelleyen ayak pedalı eklendi. Kontrol grubundaki deneklerin ayak bilek hareketleri serbest bırakıldı. Distraksiyonun 5, 10 ve 15. günlerinde posterior tibial sinir, sinir uyarıcısı ile sabit frekansta uyarıldı. Gastrosoleus kas kontraksiyonları elektriksel uyarım çeviricisi ile ölçülerek kaydedildi. Sonuçlar: Beşinci günde, deney grubunda ölçülen ortalama kas kasılma kuvvetleri kontrol grubuna göre anlamlı derecede yüksek bulundu (p
The effect of tibial lengthening on gastrosoleus muscle function: An electrophysiological study
Objectives: We evaluated the changes in electrophysiological characteristics of the contraction forces of the gastrosoleus complex due to stretching in experimental tibial lengthening. Methods: Distraction histiogenesis was performed in 22 guinea pigs weighing 600 to 800 g. Following the application of a semicircular external fixator and right tibial osteotomy, distraction was applied at a rate of 0.25 mm two times a day for 15 days without a latency period. The animals were random- ized to two groups. In the study group, a foot plate preventing ankle plantar flexion was affixed to the external fixator, while ankle motions were unrestricted in the control group. On days 5, 10, and 15, the posterior tibial nerve was stimulated with a nerve stimulator at a constant frequency. Gastrosoleus muscle contractions were measured with a transducer and contraction forces were recorded. Results: On day 5, muscle contraction forces measured in the study group were much higher than the control group (p<0.05). On day 10, however, muscle contraction forces showed a rapid decline in the study group and, at the end of the study, muscle contraction forces decreased by 81% compared to the base- line values (p<0.05). Yet, throughout the study period, muscle contraction forces were always higher than the control group (p<0.05). In addition, the rate of the decrease in muscle strength slowed down after day 10 in the study group, and gastrosoleus function and strength were much better preserved. Equinus de- formity developed progressively in the ankles of the control animals whose muscle contraction forces also showed significant decreases during the experiment (p<0.05). Conclusion: In clinical applications of tibial lengthening, the strength of the gastrosoleus complex should be preserved to prevent equines deformity and maintain ankle functions. This can be achieved through gradual stretching of the muscle during distraction. If there is shortening before surgery or muscle stiffness is expected during lengthening, measures should be taken before distraction osteogenesis and muscle length should be preserved.
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