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Journal of Hand Surgery (European Volume)
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Articles

Subscapularis Muscle Mechanics in Children with Obstetric Brachial Plexus Palsy

F. EINARSSON
T. HULTGREN
B. -O. LJUNG
E. RUNESSON
J. FRIDÉN

From the Department of Hand Surgery and Orthopedics, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden and Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Hand Surgery, Stockholm, Sweden

Correspondence: Fredrik Einarsson, MD, Department of Orthopaedics, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital/Östra, S-416 85 Göteborg, Sweden. Tel.: +46 31 343 6836; fax: +46 31 343 4092. E-mail: fredrik.einarsson{at}vgregion.se.

This study investigates the passive mechanical properties of the subscapularis muscle in children with a contracture as a result of obstetrical brachial plexus palsy. Muscle biopsies were harvested from nine children undergoing open surgery for shoulder contracture. Passive mechanical testing of single cells and muscle bundles was performed. Corresponding comparisons were made using muscle biopsies from seven healthy controls. Single muscle fibres from patients with obstetric brachial plexus palsy displayed a shorter slack sarcomere length, linear deformation of the fibre within a wider zone of sarcomere length and a greater relative increase in stiffness compared with muscle bundles.

We conclude that secondary changes in muscle fibre properties will occur as a result of a longstanding lack of sufficient passive stretch, leading to compensatory changes in the extracellular matrix. These results suggest the presence of a dynamic feedback system constituting a muscle-to-extracellular matrix communication interface.

Key Words: obstetric brachial plexus palsy • human • subscapularis • sarcomere • extracellular matrix

Journal of Hand Surgery (European Volume), Vol. 33, No. 4, 507-512 (2008)
DOI: 10.1177/1753193408090764
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 J Bone Joint Surg BrHome page
J. A. Bertelli
Lengthening of subscapularis and transfer of the lower trapezius in the correction of recurrent internal rotation contracture following obstetric brachial plexus palsy
J Bone Joint Surg Br, July 1, 2009; 91-B(7): 943 - 948.
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