Benign Bony Lesions

Schwartz, Brandon S.; Kozin, Scott H.; Zlotolow, Dan A.; Abzug, Joshua M.

doi:10.1007/978-1-4614-8515-5_62

Cited by 1 publication

(1 citation statement)

References 113 publications

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“…NBPP results from over-stretching of the neonatal brachial plexus during complicated birthing scenarios, such as shoulder dystocia, and can significantly impact the infants’ quality of life [ 2 – 9 ]. The current standard of care allows proper diagnosis only after the first two-three months of birth and while 70–90% of affected infants recover spontaneously, 20–30% of affected infants do suffer permanent deficits such as decreased strength, size, and girth of affected muscles, and limited range of motion [ 5 , 8 , 10 ]. The delay of NBPP prognosis is inevitable due to the age of the infants, however, an understanding of the injury severity in these neonates can help predict the injury outcome.…”

Section: Introductionmentioning

confidence: 99%

In vivo biomechanical responses of neonatal brachial plexus when subjected to stretch

Singh,

Orozco,

Balasubramanian

2023

PLoS ONE

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Neonatal brachial plexus palsy (NBPP) results from over-stretching of the neonatal brachial plexus during complicated birthing scenarios. The lack of information on the biomechanical response of the neonatal brachial plexus complex when subjected to stretch limits our understanding of the NBPP injury mechanism. This study aims to fill that critical gap by using a neonatal piglet animal model and providing the in vivo biomechanical properties of the neonatal brachial plexus complex when subjected to stretch. Forty-seven brachial plexus levels (identified by the four brachial plexus terminal nerve branches namely musculocutaneous, median, ulnar, and radial), obtained from 16 neonatal Yorkshire piglets (3–5 days old), were subjected to stretch-induced failure. The average maximum load and corresponding strain were reported to be 16.6 ± 1.3 N and 36.1 ± 1.6%, respectively. Maximum loads reported at the musculocutaneous level were significantly lower than the median and radial levels. No differences in strains at failure were reported at all four tested levels. Proximal or distal failure locations were reported in 83% of the tests with 17% mid-length ruptures that were primarily reported at the bifurcation of the median and ulnar brachial plexus levels. Histological studies reported an overall loss of wavy pattern of the nerve fibers, an increase in nerve spacing, fiber disruptions, and blood vessel ruptures in the stretched tissue. This in vivo piglet animal study offers insight into the NBPP mechanism by reporting biomechanical, injury location, and structural damage responses in neonatal brachial plexus when subjected to stretch.

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