Nerve injuries are a common complication of upper extremities fractures. Especially the long arm nerves are prone to injuries. After such an injury the muscles are denervated. Fortunately, if nerves are injured but the continuity of the nerve shed is intact a regeneration by spreading of the axonal fibres starts early after the injury and finally a new neuromuscular connection – a neuromuscular endplate- is reestablished. Till today it is unknown whether the newly formed neuro-muscular endplate is functional equivalent to the original. During the last years a new technic became routinely available in paediatric neurology to study the neuro-muscular endplate: stimulated single-fibre-EMG. This technic allows a precise and objective assessment of the neuro-muscular connection. At our hospital we care together with our colleagues from the paediatric surgery department for children with fractures and nerve injuries. During the last years we have adopted the technique of single fibre EMG and included it into our clinical repertoire for traumatic nerve injuries.
It has been previously hypothesis that the newly formed neuromuscular endplate is not as reliable as the original one. This fact would have major clinical implications for the support and training after nerval injuries. To address this question, we have set up this pilot project to conduct routine measurements of the recovering nerve using single fibre-EMG. Our preliminary data shows, that these measurements can be reliable conducted in the pediatric population and we are now in the process of applying for ethical approval to analyse a larger cohort.
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