Extramuscular myofascial force transmission: experiments and finite element modeling.

The specific purpose of the present study was to show that extramuscular myofascial force transmission exclusively has substantial effects on muscular mechanics. Muscle forces exerted at proximal and distal tendons of the rat extensor digitorium longus (EDL) were measured simultaneously, in two conditions (1) with intact extramuscular connections (2) after dissecting the muscles' extramuscular connections to a maximum extent without endangering circulation and innervation (as in most in situ muscle experiments). A finite element model of EDL including the muscles' extramuscular connections was used to assess the effects of extramuscular myofascial force transmission on muscular mechanics, primarily to test if such effects lead to distribution of length of sarcomeres within muscle fibers. In condition (1), EDL isometric forces measured at the distal and proximal tendons were significantly different (F(dist) > F(prox), DeltaF approximates maximally 40% of the proximal force). The model results show that extramuscular myofascial force transmission causes distributions of strain in the fiber direction (shortening in the proximal, lengthening in the distal ends of fibers) at higher lengths. This indicates significant length distributions of sarcomeres arranged in series within muscle fibers. Stress distributions found are in agreement with the higher distal force measured, meaning that the muscle fiber is no longer the unit exerting equal forces at both ends. Experimental results obtained in condition (2) showed no significant changes in the length-force characteristics (i.e., proximo-distal force differences were maintained). This shows that a muscle in situ has to be distinguished from a muscle that is truly isolated in which case the force difference has to be zero. We conclude that extramuscular myofascial force transmission has major effects on muscle functioning.

The mechanical properties of intact and traumatized epidural catheters.

UNLABELLED: Comparative data on the mechanical properties of epidural catheters used clinically are not available. We performed a controlled laboratory investigation to assess the mechanical performance of three different intact or traumatized catheter types (Polyurethane, clear nylon, and radiopaque nylon catheters, designed for 18-gauge Tuohy needles). We studied a control (intact) and two trauma groups (needle bevel and surgical blade). Catheters were loaded to their breaking points by using a Lloyd LS500 material testing machine (Lloyd, Southampton, UK). Maximal load and extension values before breakage were measured, and modulus of elasticity and toughness values were calculated. Intact polyurethane catheters did not break within the limits of the experimental study (extension up to 3 times the original length of a specimen). The toughness values obtained from polyurethane and clear nylon catheters were significantly higher than those for the radiopaque catheters in intact specimens (P < 0.05). In the traumatized groups, polyurethane catheters had the highest toughness values (P < 0.05). Modulus of elasticity values were higher in both control and trauma groups of the radiopaque catheters when compared with the polyurethane and clear nylon catheters, which indicates a higher stiffness to elastic deformation (P < 0.05). In conclusion, polyurethane catheters are the most durable catheter type to tensile loading, either intact or traumatized. Mechanical properties can be used to predict complications related to the clinical use of these catheters. IMPLICATIONS: Using a computer-assisted material testing machine, we studied the mechanical properties of three different types of epidural catheters, either intact or traumatized, in a blinded, controlled study. This information may be vital to clinicians who implant epidural catheters by helping them choose a catheter that has the lowest probability of failure.