{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:19:11Z","timestamp":1780319951256,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five patients with displaced bicortical rib fractures involving the 7th\u201311th 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Average patient age was 59.4\u2009years and average body mass index (BMI) was 31.5\u2009kg\/m<jats:sup>2<\/jats:sup>. Intercostal NCS and EMG were able to reliably diagnose and localize intercostal nerve damage after rib fractures. Ultrasound demonstrated an average rectus abdominis transverse cross\u2010sectional thickness of 0.534\u2009cm on the affected side, compared with 1.024\u2009cm on the non\u2010affected side.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28211","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T10:40:11Z","timestamp":1721817611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intercostal nerve electrodiagnostic testing in rib fractures"],"prefix":"10.1002","author":[{"given":"Kristen","family":"Gambardella","sequence":"first","affiliation":[{"name":"College of Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cody","family":"Ashy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dane","family":"Daley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0617-2264","authenticated-orcid":false,"given":"Matthew","family":"Sherrier","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/08850666221148644"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002559"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.06.022"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.12701\/yujm.2019.00381"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.cr.17\u201000103"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0007\u20101226(97)90540\u20103"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.2000.3427"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010199901000\u201000015"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010200205000\u201000021"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31818c4a9e"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2005.12.005"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00104\u2010016\u20100257\u20103"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276\u2010017\u20101944\u20106"},{"key":"e_1_2_11_15_1","volume-title":"StatPearls","author":"Kudzinskas A","year":"2024"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.6.763"},{"issue":"2","key":"e_1_2_11_17_1","first-page":"431","article-title":"Diabetic truncal neuropathy: early detection by intercostal nerve conduction studies","volume":"46","author":"Fahmy E","year":"2009","journal-title":"Egypt J Neurol Psych Neurosurg"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(80)92656\u20102"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.3100"},{"issue":"1","key":"e_1_2_11_20_1","first-page":"34","article-title":"The tendinous intersections of rectus abdominis muscle","volume":"13","author":"Meenakshi S","year":"2008","journal-title":"J Mahatma Gandhi Inst Med Sci"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256\u2010016\u20101054\u20109"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/2006\u20108808.128754"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1258\/shorts.2010.010029"}],"container-title":["Muscle &amp; 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