This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by WRIGHT, T. W.
Right arrow Articles by COWIN, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by WRIGHT, T. W.
Right arrow Articles by COWIN, D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery 78:1897-1903 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Excursion and Strain of the Median Nerve*

THOMAS W. WRIGHT, M.D.{dagger}, FRANK GLOWCZEWSKIE, JR., B.A.{dagger}, DONNA WHEELER, PH.D.{dagger}, GARY MILLER, PH.D.{dagger} and DAVID COWIN, B.A.{dagger}, GAINESVILLE, FLORIDA

Investigation performed at the University of Florida, Gainesville

Five fresh-frozen transthoracic cadaver specimens (ten upper extremities) were dissected in order to measure excursion and strain of the median nerve at the wrist and the elbow in association with different positions of the shoulder, elbow, wrist, and fingers. The relationships between motions of the joints and excursion and strain at the wrist and the elbow as well as between excursion and strain were also determined. When the wrist was moved from 60 degrees of extension to 65 degrees of flexion, the median nerve at the wrist underwent a mean total excursion of 19.6 millimeters (9.2 ± 1.38 millimeters [mean and standard deviation] in extension and 10.4 ± 1.50 millimeters in flexion). The change in strain was not measurable secondary to nerve-wrinkling. Motion of the fingers from hyperextension to full flexion caused a mean total excursion of 9.7 millimeters (6.3 ± 1.31 millimeters in hyperextension and 3.4 ± 1.04 millimeters in flexion) and a change in strain of 19.0 per cent. This change in strain became more pronounced when the wrist and the fingers moved in synergy. Such strain, if constant, has been shown to decrease microvascular perfusion and nerve conduction in rabbits. With motion of the shoulder, the mean total excursion of the median nerve at the elbow was 9.1 millimeters (4.4 ± 1.64 millimeters in abduction and 4.7 ± 1.81 millimeters in adduction) and the change in strain was 13.3 per cent. With motion of the elbow, the mean total excursion was 12.3 millimeters (12.3 ± 4.20 millimeters in flexion and zero millimeters in the resting position) and the change in strain was not measurable because of the wrinkle effect in flexion. With motion of the wrist, the mean total excursion was 5.6 millimeters (4.3 ± 1.95 millimeters in extension and 1.25 ± 0.81 millimeters in flexion) and the change in strain was 14.8 per cent. With motion of the fingers, the mean total excursion was 3.4 millimeters (2.6 ± 1.13 millimeters in hyperextension and 0.80 ± 0.92 millimeter in flexion) and the change in strain was 10.3 per cent. Motion of the wrist and the fingers induced profound excursion of the median nerve at the wrist, whereas motion of the shoulder and the elbow induced marked excursion of the median nerve at the elbow. These excursions were much more pronounced when a number of joints were moved in a composite manner. Any factor that might limit normal excursion, such as scarring, could induce strains that could adversely affect the function of the median nerve. The finding that the position and movement of the limb had a profound effect on excursion and strain of the median nerve at the wrist and the elbow may aid in the understanding of the pathophysiology of median-nerve neuropathy.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
P. J. O'Neill, B. G. Parks, R. Walsh, L. M. Simmons, and S. D. Miller
Excursion and Strain of the Superficial Peroneal Nerve During Inversion Ankle Sprain
J. Bone Joint Surg. Am., May 1, 2007; 89(5): 979 - 986.
[Abstract] [Full Text] [PDF]

Home page
 ptjournalHome page
K. S Topp and B. S Boyd
Structure and Biomechanics of Peripheral Nerves: Nerve Responses to Physical Stresses and Implications for Physical Therapist Practice
Physical Therapy, January 1, 2006; 86(1): 92 - 109.
[Abstract] [Full Text] [PDF]

Home page
 ptjournalHome page
A. E Barr and M. F Barbe
Pathophysiological Tissue Changes Associated With Repetitive Movement: A Review of the Evidence
Physical Therapy, February 1, 2002; 82(2): 173 - 187.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
R. H. GELBERMAN, K. YAMAGUCHI, S. B. HOLLSTIEN, S. S. WINN, F. P. HEIDENREICH JR., R. R. BINDRA, P. HSIEH, and M. J. SILVA
Changes in Interstitial Pressure and Cross-Sectional Area of the Cubital Tunnel and of the Ulnar Nerve with Flexion of the Elbow. An Experimental Study in Human Cadavera
J. Bone Joint Surg. Am., April 1, 1998; 80(4): 492 - 501.
[Abstract] [Full Text]