Results: 3D MRI generates high-resolution axial andtransverse images of DRG. Volumetric quantif i -cation was precise (intra-observer coeff i cient ofvariation ¼ 3.8%), highly repeatable (9% variability)and sensitive (mean 15.0% volume reduction in axoto-mised ganglia detected with signif i cance: Po0.01 versusnon-axotomized contralateral ganglia, Po0.01 versuscontrol group). MRI showed strong correlation withstereological measures of volume loss (r ¼ 0.90,Po0.001), which in turn correlates well with neuronloss (r ¼ 0.75, Po0.05). MRI similarly exhibited directcorrelation with neuron loss (r ¼ 0.67, Po0.05) withconsistent agreement.Conclusion: MRI volumetric quantif i cation of DRG is avalid measure of neuron loss in vivo. As a prelude toneuroprotective trials, studies have begun to develop thetechnique in human subjects as a non-invasive, objectivemeasure of neuronal death after nerve trauma.10.1016/j.jhsb.2006.03.06610.8 ENHANCED SENSORY RECOVERY AFTERMEDIAN NERVE REPAIR INDUCED BY ARTIFICIALSENSIBILITY USING THE SENSOR GLOVE SYSTEMG. Lundborg and B. Rose´ nMalmo University Hospital, Malmo, SwedenBackground: The result from median nerve repair inadult patients is often disappointing with inferiorrecovery of tactile discrimination of the hand. Onereason may be the rapid cortical reorganization whichoccurs after nerve injury as a result of arrested sensoryinf l ow.Aims: To preserve the cortical hand representationduring the initial denervation period by providingartif i cial sensibility based on cortical audio-tactileinteraction.Materials and methods: In a prospective randomizedmulticentre study we investigated the effectiveness ofartif i cial sensibility in the early denervation periodfollowing median nerve repair. The Model Instrumentfor Outcome after Nerve Repair was used for follow-upat 3, 6 and 12 months. Thirty patients with mediannerve repair were randomised to either early use of aSensor Glove System (an ‘‘acoustic’’ glove providedwith miniature microphones at f i nger tip levels trans-mitting the friction sound, associated with touch,to earphones) or conventional training. 26 of the initial30 patients completed the study. Fourteen patients(mean age 35 years) used the Sensor Glove Systemfrom the f i rst postoperative week and duringthe f i rst three postoperative months. Twelve patients(mean age 33 years) had conventional training. After3 months all patients received conventional sensoryre-education.Results and conclusion: The recovery of functionalsensibility was signif i cantly better in the artif i cialsensibility group. This highlights the importance of thetiming of onset of sensory re-education after nerverepair, and emphasizes the importance of afferentfeedback from a denervated hand very early inrehabilitation process–long before reinnervation of thehand has started. This may hypothetically help tomaintain the cortical hand representation during theearly denervation period.10.1016/j.jhsb.2006.03.06710.9 COMMON SPORT SPECIFIC WRIST POSI-TIONS CAN INDUCE CHANGES IN ‘‘FUNCTIONAL’’EMG RECORDING OF THE MEDIAN NERVE—IMPLICATIONS FOR DIAGNOSTICS AND TREAT-MENTG. Adamczyk 1 , A. Kostera-Pruszczyk 2 andP. Chomicki-Bindas 11 Carolina Medical Center, Warsaw, Poland;2 Medical University, Warsaw, PolandBackground: Conventional nerve conduction studieslocalize the lesion of a nerve and can disclose the degreeof focal conduction block or pinpoint the region of focalslowing, giving complementary information about thecharacter of the lesion. In a group of an activepopulation transient disturbances during physical ef-forts are commonly observed.Aim: To precise the evolution with time of EMGrecordings of the median nerve in common sport-specif i cpositions.Material and methods: Twenty healthy volunteers and 20symptomatic patients (persons with a conduction blockwere excluded from the study). Conventional EMG of themedian nerve was performed, followed by a ‘‘reversedPhalen’’ position kept for 30 minutes, and consecutivelymeasurements in 5 minutes periods were performed.Results: In 20% of asymptomatic patients, a signif i cantdecrease of sensory nerve action potential was recordedafter 20 minutes of observation, while in 100% ofsymptomatic patients in daily life with negative symp-toms in conventional EMG studies developed a severedecrease of conduction and blocks after 15 minute-s.These symptoms recuperated after 5 minute in func-tional wrist position. We proposed to these patients aneuromobilization physiotherapy program that clini-cally diminished their complaints.Conclusions: EMG shows a 97–100% diagnostic speci-f i city and sensitivity. It might be a functional testhelping to distinguish a group atrisk of developingacarpal tunnel syndrome with exercises. This method isuseful among patients with functional disturbances dueto joint instability or repetitive motions in sports.10.1016/j.jhsb.2006.03.068ARTICLE IN PRESSTHE JOURNAL OF HAND SURGERY VOL. 31B No. S1 JUNE 2006 50
