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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(5):980-985.
The Optimal Measurement of Across Elbow Segment in Ulnar Motor Conduction Study.
Paik, Nam Jong , Han, Tai Ryoon , Lee, In Sik
Department of Rehabilitation Medicine, Seoul National University College of Medicine.
척골신경의 분절별 운동 신경 전도 검사시 이상적인 주관절 구간의 거리 측정
백남종, 한태륜, 이인식
서울대학교 의과대학 재활의학교실
Abstract

Objective
There is a room for considerable error in the measurement of across-elbow conduction velocity due to the different possible positions of the elbow and the difficulty in measuring distance accurately. We propose a technique for the measurement of conduction velocity through the elbow segment in a fully flexed elbow position with the arm abducted at 90o.


Method
We assumed 'ideal' across-elbow segmental conduction velocity is the mean of the forearm and arm segmental conduction velocities, and established an optimal deflection point at the elbow, which best reflects the ideal conduction velocity in normal healthy subjects. Five deflection points were examined at the elbow. Segmental conduction velocities of across-elbow segments were calculated at each of these points, using the sum of the linear distances from each point to the proximal above-elbow cathode stimulation site and to the distal below-elbow cathode stimulation site.


Results
The optimal deflection point was the midpoint between the epicondyle and the olecranon in an arm abducted 90o and elbow fully flexed position.


Conclusion
Our data suggests that an across-elbow segment velocity lower than 54.2 m/sec, or a difference of more than 11.6 m/sec between the across-elbow and forearm segments is to be considered abnormal. The lower limit values expressed as mean - 2 S.D. for absolute across-elbow segmental conduction velocity and relative velocity difference between the across- elbow segment and forearm segments at other possible deflection points of the elbow were also calculated.

Key Words: Ulnar nerve conduction study, Ulnar neuropathy, Elbow, Segmental nerve conduction study, Normal data


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