Nerve Injury Management - Part 1-Dr. Lieber - Nerve Injury Management

Dr. Lieber - Nerve Injury Management - Part 1

Pdf Summary

This document summarizes a presentation by Richard L. Lieber on skeletal muscle design in consideration for tendon transfers. Lieber emphasizes the importance of muscle architecture, specifically the orientation of muscle fibers, in determining whole muscle function. He explains that muscle force is proportional to the physiological cross-sectional area and that muscle excursion is proportional to fiber length. Lieber also discusses the longitudinal pennate and multipennate muscle architectures commonly found in the upper extremities. He presents data on various transfers to restore thumb flexion and illustrates the sarcomere length-tension relationship. Additionally, Lieber explores the design of the posterior deltoid and its application to upper extremity surgery. He examines the postoperative care and protective measures taken to ensure successful outcomes, including the use of armrests and electric wheelchairs. The document includes postoperative X-rays and measurements of muscle-tendon unit elongation over time. Lieber concludes that understanding skeletal muscle architecture and operating range can inform surgical approaches and provide innovative alternatives to restore function. The work presented was supported by various grants from the National Institutes of Health and the Department of Veterans Affairs.

Keywords

skeletal muscle design

tendon transfers

muscle architecture

whole muscle function

fiber length

upper extremities

thumb flexion

postoperative care

surgical approaches

restore function