Intercostal nerve electrodiagnostic testing in rib fractures.

electromyography intercostal nerve rib fracture ultrasound

Journal

Muscle & nerve
ISSN: 1097-4598
Titre abrégé: Muscle Nerve
Pays: United States
ID NLM: 7803146

Informations de publication

Date de publication:
24 Jul 2024
Historique:
revised: 07 07 2024
received: 09 12 2023
accepted: 14 07 2024
medline: 24 7 2024
pubmed: 24 7 2024
entrez: 24 7 2024
Statut: aheadofprint

Résumé

Intercostal nerve injury can occur after rib fractures, resulting in denervation of the abdominal musculature. Loss of innervation to the rectus abdominis and intercostal muscles can cause pain, atrophy, and eventual eventration, which may be an underrecognized and thus undertreated complication of rib fractures. We investigated the clinical utility of intercostal nerve electrodiagnostic testing following rib fractures to diagnose and localize nerve injury at levels T7 and below. Five patients with displaced bicortical rib fractures involving the 7th-11th ribs and clinical eventration of the ipsilateral abdominal wall underwent intercostal nerve conduction studies (NCS) and needle electromyography (EMG) on the affected side. EMG of the rectus abdominis and intercostal muscles was performed with ultrasound guidance, and ultrasound measurements of rectus abdominis thickness were obtained to assess for atrophy. Average patient age was 59.4 years and average body mass index (BMI) was 31.5 kg/m Intercostal electrodiagnostic studies can diagnose and localize intercostal nerve damage after displaced rib fractures. Musculoskeletal ultrasound can be used to diagnose and quantify rectus abdominis atrophy and to accurately and safely guide needle EMG to the intercostal and rectus abdominis muscles.

Identifiants

pubmed: 39045878
doi: 10.1002/mus.28211
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 Wiley Periodicals LLC.

Références

Rogers FB, Larson NJ, Rhone A, Amaya D, Olson‐Bullis BA, Blondeau BX. Comprehensive review of current pain management in rib fractures with practical guidelines for clinicians. J Intensive Care Med. 2023;38(4):327‐339. doi:10.1177/08850666221148644
Pieracci FM, Leasia K, Bauman Z, et al. A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, NONFLAIL fracture patterns (Chest Wall injury society NONFLAIL). J Trauma Acute Care Surg. 2020;88(2):249‐257. doi:10.1097/TA.0000000000002559
Antonescu I, Baird R. Paralysis of the rectus abdominis muscle after video‐assisted thoracoscopic surgery for recurrent spontaneous pneumothorax. J Pediatr Surg. 2011;46(12):2397‐2400. doi:10.1016/j.jpedsurg.2011.06.022
Lee JH, Lee SS. Rectus abdominis muscle atrophy after thoracotomy. Yeungnam Univ J Med. 2020;37(2):133‐135. doi:10.12701/yujm.2019.00381
Cho HM, Sim HJ, Kim DH, Lim MH, Lee SK. Paralysis of the rectus abdominis muscle after a video‐assisted thoracoscopic surgery. Ann Thorac Cardiovasc Surg. 2018;24(1):40‐42. doi:10.5761/atcs.cr.17‐00103
Blondeel N, Vanderstraeten GG, Monstrey SJ, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction. Br J Plast Surg. 1997;50(5):322‐330. doi:10.1016/s0007‐1226(97)90540‐3
Futter CM, Webster MH, Hagen S, Mitchell SL. A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap. Br J Plast Surg. 2000;53(7):578‐583. doi:10.1054/bjps.2000.3427
Hamdi M, Weiler‐Mithoff EM, Webster MH. Deep inferior epigastric perforator flap in breast reconstruction: experience with the first 50 flaps. Plast Reconstr Surg. 1999;103(1):86‐95. doi:10.1097/00006534‐199901000‐00015
Vandevoort M, Vranckx JJ, Fabre G. Perforator topography of the deep inferior epigastric perforator flap in 100 cases of breast reconstruction. Plast Reconstr Surg. 2002;109(6):1912‐1918. doi:10.1097/00006534‐200205000‐00021
Atisha D, Alderman AK. A systematic review of abdominal wall function following abdominal flaps for postmastectomy breast reconstruction. Ann Plast Surg. 2009;63(2):222‐230. doi:10.1097/SAP.0b013e31818c4a9e
Grevious MA, Cohen M, Shah SR, Rodriguez P. Structural and functional anatomy of the abdominal wall. Clin Plast Surg. 2006;33(2):169‐179. doi:10.1016/j.cps.2005.12.005
Hellinger A, Roth I, Biber FC, Frenken M, Witzleb S, Lammers BJ. Surgical anatomy of the abdominal wall. Chirurg. 2016;87(9):724‐730. doi:10.1007/s00104‐016‐0257‐3
Stecco C, Azzena GP, Macchi V, et al. Rectus abdominis muscle innervation: an anatomical study with surgical implications in diep flap harvesting. Surg Radiol Anat. 2018;40(8):865‐872. doi:10.1007/s00276‐017‐1944‐6
Kudzinskas A, Cunha B. Anatomy, anterolateral abdominal wall nerves. StatPearls. StatPearls Publishing; 2024.
Pradhan S, Taly A. Intercostal nerve conduction study in man. J Neurol Neurosurg Psychiatry. 1989;52(6):763‐766. doi:10.1136/jnnp.52.6.763
Fahmy E, Zakaria A, Amer H, Nada M. Diabetic truncal neuropathy: early detection by intercostal nerve conduction studies. Egypt J Neurol Psych Neurosurg. 2009;46(2):431‐443.
Heckmatt JZ, Dubowitz V, Leeman S. Detection of pathological change in dystrophic muscle with B‐scan ultrasound imaging. Lancet. 1980;1(8183):1389‐1390. doi:10.1016/s0140‐6736(80)92656‐2
Rai R, Azih LC, Iwanaga J, et al. Tendinous inscriptions of the rectus abdominis: a comprehensive review. Cureus. 2018;10(8):e3100. doi:10.7759/cureus.3100
Meenakshi S, Manjunath K. The tendinous intersections of rectus abdominis muscle. J Mahatma Gandhi Inst Med Sci. 2008;13(1):34‐39.
Butensky AM, Gruss LP, Gleit ZL. Flank pseudohernia following posterior rib fracture: a case report. J Med Case Reports. 2016;10(1):273. doi:10.1186/s13256‐016‐1054‐9
Dobradin A, Bello J. Clinicoradiological diagnosis of cough‐induced intercostal hernia. J Surg Tech Case Rep. 2013;5(2):106‐108. doi:10.4103/2006‐8808.128754
Connery A, Mutvalli E. Cough‐induced abdominal intercostal hernia. JRSM Short Rep. 2010;1(3):23. doi:10.1258/shorts.2010.010029

Auteurs

Kristen Gambardella (K)

College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

Cody Ashy (C)

Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

Dane Daley (D)

Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

Evert Eriksson (E)

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Matthew Sherrier (M)

Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

Classifications MeSH