Wednesday, June 16, 2010

"All muscles are not created equal"

"All muscles are not created equal" with respect to muscle fiber number and orientation. Similarly, it is clear that the musculoskeletal system tailors a particular muscle "design" to satisfy a particular need. However, it is not clear to what degree architecture is adaptable. This would be an extremely important factor in surgical procedures where a muscle of one architectural design was required to perform a substitute function for a muscle of a different architectural design. Could the new muscle adequately perform the task? Would it "adapt" to the new required function? These questions are currently unanswerable for at least two reasons: first the architecture of the upper extremity muscles involved in tendon transfers is not known and, second, the extent of muscle adaptation following transfer has not been studied. There are many surgeons all over the world who are aware of the fact that we do not yet have "the cure" for spinal cord injury and that we have to refine, develop and most importantly, make available the surgical reconstructions that we currently do have at hand. There are so many persons living with tetraplegia who can benefit from surgical reconstruction today and we need to promote and support this type of science much more and spread the service that exists. Patients, physiatrists and surgeons need to enhance the pressure on lobby groups to reach further with existing, well-documented procedures to improve function and abilities of the upper extremities in individuals with spinal cord injuries.
This spinal cord injured man had no function whatsoever on left side before having surgical reconstruction of triceps and grip in a single-step operation. Function and performance is shown 10 months after surgery.

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