Analysis of shoulder abduction by dynamic shoulder radiograph following suprascapular nerve repair in brachial plexus injury

Shimoe, Takashi; Doi, Kazuteru; Madura, Tomas; Kumar, Kannan Karuppiah; Montales, Tristram D.; Hattori, Yasunori; Sakamoto, Sotetsu; Yukata, Kiminori; Yoshida, Munehito

doi:10.1016/j.jos.2017.05.009

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Dynamic shoulder radiography (DSR) was used to investigate the individual component angles of glenohumeral joint and scapulothoracic joint motion in shoulder abduction 16 , 17 (Fig. 2 ).…”

Section: Methodsmentioning

confidence: 99%

Midterm Outcomes of Surgical Reconstruction and Spontaneous Recovery of Upper-Extremity Paralysis Following Acute Flaccid Myelitis

Doi,

Hattori,

Sakamoto

et al. 2024

JBJS Open Access

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Background: Acute flaccid myelitis (AFM) is a disabling, poliomyelitis-like illness that mainly affects children. Although various surgical interventions are performed for intractable paralysis due to AFM, the timing of surgery and its long-term outcomes have yet to be established, especially for shoulder reconstruction. This study aimed to analyze the midterm outcomes of nonsurgically and surgically treated upper-extremity AFM and the factors influencing shoulder functional outcomes after surgical reconstruction. Methods: We retrospectively examined 39 patients with AFM in 50 upper extremities between 2011 and 2019. The degree of spontaneous recovery of completely paralyzed muscles was evaluated at a median of 3, 6, and 37 months after the onset of paralysis. Twenty-seven patients with 29 extremities underwent surgery involving nerve transfer, muscle-tendon transfer, or free muscle transfer for shoulder, elbow, and hand reconstruction. Results: Patients with complete paralysis of shoulder abduction at 6 months did not show later recovery. Twenty-two patients with 24 extremities underwent shoulder surgery, and all but 1 were followed for at least 24 months after surgery. Although postoperative shoulder abduction recovery was similar between transfer of the spinal accessory nerve and of the contralateral C7 nerve root to the suprascapular nerve, the outcomes obtained with spinal accessory nerve transfer had more variability, likely related to latent spinal accessory nerve paralysis, shoulder instability related to pectoralis major paralysis, and the type of paralysis. Shoulder abduction recovery was also greatly affected by scapulothoracic joint movement. In contrast, the outcomes of the elbow flexion and hand reconstructions were more consistent and acceptable. Conclusions: All patients had loss of shoulder abduction, and restoration of shoulder function was less predictable and depended on the quality of the donor nerves and recovery of the synergistic muscles. Strict donor nerve selection and additional nerve transfer for shoulder reconstruction are imperative for satisfactory outcomes. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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“…Dynamic shoulder radiography (DSR) was used to investigate the individual component angles of glenohumeral joint and scapulothoracic joint motion in shoulder abduction 16 , 17 (Fig. 2 ).…”

Section: Methodsmentioning

confidence: 99%

Midterm Outcomes of Surgical Reconstruction and Spontaneous Recovery of Upper-Extremity Paralysis Following Acute Flaccid Myelitis

Doi,

Hattori,

Sakamoto

et al. 2024

JBJS Open Access

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“…However, from a biomechanical perspective, the SSN may undergo dynamic entrapment due to scapular movement. 13 Therefore, even if there is no evidence of nerve entrapment on radiological or electromyography studies with the scapula in a neutral position, the SSN may still be susceptible to entrapment during scapular movement if the notch is stenotic due to TSL ossification. 14 While the possibility of dynamic SSN entrapment is recognized, its patho-mechanics remain poorly understood because no biomechanical data on this topic have been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Does the Suprascapular Nerve Move within the Suprascapular Notch? Biomechanical Perspective Using the Finite Element Method

Yoo¹,

Jang

Kim

et al. 2022

Yonsei Med J

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Purpose We aimed to analyze changes in suprascapular nerve (SSN) position within the suprascapular notch during in vivo shoulder abduction. Materials and Methods Three-dimensional models of the shoulder complex were constructed based on magnetic resonance imaging of the brachial plexus (BP-MR) in a patient diagnosed with SSN dysfunction but normal scapular movement. Using BP-MR in neutral position and computed tomography data on shoulder abduction, shoulder abduction was simulated as the transition between two positions of the shoulder complex with overlapping of a neutral and abducted scapula. SSN movement during abduction was evaluated using the finite element method. Contact stress on the SSN was measured in the presence and absence of the transverse scapular ligament (TSL). Results In the neutral position, the SSN ran almost parallel to the front of the TSL until entering the suprascapular notch and slightly contacted the anterior-inferior border of the TSL. As shoulder abduction progressed, contact stress decreased due to gradual loss of contact with the TSL. In the TSL-free scapula, there was no contact stress on the SSN in the neutral position. Towards the end of shoulder abduction, contact stress increased again as the SSN began to contact the base of the suprascapular notch in both TSL conditions. Conclusion We identified changes in the position of the SSN path within the suprascapular notch during shoulder abduction. The SSN starts in contact with the TSL and moves toward the base of the suprascapular notch with secondary contact. These findings may provide rationale for TSL release in SSN entrapment.

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Shrug radiographs for the diagnosis of long thoracic nerve palsy in traumatic brachial plexus injury

Yukata

Doi

Okabayashi

et al. 2020

Journal of Shoulder and Elbow Surgery

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Analysis of shoulder abduction by dynamic shoulder radiograph following suprascapular nerve repair in brachial plexus injury

Cited by 5 publications

References 15 publications

Midterm Outcomes of Surgical Reconstruction and Spontaneous Recovery of Upper-Extremity Paralysis Following Acute Flaccid Myelitis

Midterm Outcomes of Surgical Reconstruction and Spontaneous Recovery of Upper-Extremity Paralysis Following Acute Flaccid Myelitis

Does the Suprascapular Nerve Move within the Suprascapular Notch? Biomechanical Perspective Using the Finite Element Method

Shrug radiographs for the diagnosis of long thoracic nerve palsy in traumatic brachial plexus injury

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