Intraoperative muscle measurements reveal a relationship between contracture formation and muscle remodeling

Eva Pontén, Stefan Gantelius, Richard L. Lieber*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Children with cerebral palsy often have spasticity of both the extensors and flexors, but how and why a flexion contracture of the wrist will develop during growth is not thoroughly understood. In order to understand the muscle adaptations that occur during contracture formation, the relationship between intraoperative sarcomere length and the extent of contracture was measured in 23 children (average age, 14.3 ± 2.9 years) undergoing tendon transfers involving the flexor carpi ulnaris (FCU) or extensor carpi radialis brevis (ECRB) muscles. For both ECRB and FCU, sarcomere lengths measured intraoperatively were longer compared to sarcomere lengths predicted from a regression relationship obtained from "control" patients with radial nerve injury (P < 0.001). The most interesting aspect of the long FCU sarcomere lengths measured was that there was a highly significant correlation between the degree of contracture formation and intraoperative sarcomere length (r2 = 0.5, P < 0.005). These data clearly show that greater contracture severity is associated with longer intraoperative FCU sarcomere length. No such correlation was observed for the ECRB. The data suggest that the clinical presentation of the contracture is related to degree of FCU, but not ECRB adaptation, to the central nervous system lesion.

Original languageEnglish (US)
Pages (from-to)47-54
Number of pages8
JournalMuscle and Nerve
Issue number1
StatePublished - Jul 2007


  • Contracture
  • Muscle remodeling
  • Sarcomere length
  • Skeletal-muscle contracture
  • Spasticity
  • Surgical deformities

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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