Brachial Plexus Injuries – Review of the Anatomy and the Treatment Options

Pejkova, Sofija; Filipče, Venko; Peev, Igor; Nikolovska, Bisera; Jovanoski, Tomislav; Georgieva, Gordana; Srbov, Blagoja

doi:10.2478/prilozi-2021-0008

Cited by 11 publications

(16 citation statements)

References 58 publications

(57 reference statements)

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“…Vice versa, the rate of symptoms of clinical depression among patients suffering from PNI is alarmingly high, reaching almost 40%, which is more than twice the numbers reported in the general population, ranging between 10% and 20%, depending on the studied population [38,67,68]. In case of brachial plexus injuries, even more than 50% of patients could be suffering from depression, underpinning the need for adequate treatment strategies beyond surgical intervention in this group of patients [69,70]. In conclusion, screening for depression and referral of patients for psychological and/or psychiatric counseling or treatment is advised for surgeons and any other profession involved in the treatment of patients with PNIs, especially in case of a planned operative intervention [38].…”

Section: Discussionmentioning

confidence: 95%

Beyond the Knife—Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions

Heinzel

Dadun

Prahm

et al. 2021

JPM

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Peripheral nerve injuries are a common clinical problem. They not only affect the physical capabilities of the injured person due to loss of motor or sensory function but also have a significant impact on psychosocial aspects of life. The aim of this work is to review the interplay of psychosocial factors and peripheral nerve lesions. By reviewing the published literature, we identified several factors to be heavily influenced by peripheral nerve lesions. In addition to psychological factors like pain, depression, catastrophizing and stress, social factors like employment status and worker’s compensation status could be identified to be influenced by peripheral nerve lesions as well as serving as predictors of functional outcome themselves, respectively. This work sheds a light not only on the impact of peripheral nerve lesions on psychosocial aspects of life, but also on the prognostic values of these factors of functional outcome. Interdisciplinary, individualized treatment of patients is required to identify patient at risk for adverse outcomes and provide them with emotional support when adapting to their new life situation.

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Section: Discussionmentioning

confidence: 95%

Beyond the Knife—Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions

Heinzel

Dadun

Prahm

et al. 2021

JPM

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“…2 4 35 Additional mechanisms of injury include crushing injuries, compression by adjacent tissues, and inflammation of the nervous structures. 2 7…”

Section: Etiologymentioning

confidence: 99%

“…However, injuries to the plexus often involve multiple nervous structures and make localization of the lesion substantially more difficult. 2 Thus, the mechanism of injury may provide unique insight into the etiology of brachial plexus injuries. In traction injuries, traction in the cephalad direction often results in damage to the lower plexus, while downward traction often results in damage to the upper root and trunks.…”

Section: Etiologymentioning

confidence: 99%

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Robotic Nerve Surgery: Brachial Plexus

Parham,

Cole,

Yim

et al. 2023

Semin Plast Surg

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Management of closed brachial plexus injuries has traditionally favored conservative approaches with lengthy intervals between initial injury and surgical reconstruction. The complex anatomy of this region often requires large incisions with extensive dissection. Recently, the use of robotic systems in plastic and reconstructive surgery has been increasing, and robot-assisted brachial plexus reconstruction is a novel application that is currently being explored. Current literature describing this application is primarily comprised of feasibility studies using animal and cadaver models, and literature describing use in human subjects is limited. Advantages demonstrated by these early studies include the reduction of physiologic tremor, 3D visualization of anatomical structures, and ergonomic positioning; this allows for increased surgical dexterity and the ability to perform minimally invasive microsurgical procedures within the confined anatomical spaces of the brachial plexus. Limitations revolve around inadequate instrumentation, large learning curves, and increased costs that restrict the ability to perform these complex microsurgical procedures reliably and efficiently. As companies continue to develop instrumentation specific to robot-assisted microsurgery, more extensive longitudinal studies outlining long-term costs, changes in operating time, and functional outcomes will be required before a conclusion about the utility of these systems in brachial plexus surgery can be made.

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“…The most severe type of CTIBP is its total type when both primary and secondary trunks are affected [4]. In these cases the failures are possible despite the full range of therapeutic measures taken, so the functioning of upper limb renders unrecoverable [5].…”

Section: Relevancementioning

confidence: 99%

Comparison of the Short-term Surgical Outcomes in Patients with Closed Traction Injuries to Brachial Plexus

Ulyanov¹,

Бажанов²,

Shuvalov³

et al. 2022

Preprint

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As the problem of traction injuries to brachial plexus is a common one and of high socio-economic significance, the analysis of the surgical outcomes in patients with this pathology is significant for neurosurgery, neurology, traumatology-orthopedics, and rehabilitation. The aim of the research is to compare the short-term outcomes of using various surgical methods for managing patients with closed traction injuries of brachial plexus. Material and methods. The research involved 61 patients with closed traction injury of brachial plexus divided into two groups homogeneous in sex, age and severity of their neurological deficit: Group I – 33 patients who underwent microsurgical neurolysis, Group II – 28 patients who underwent microsurgical neurolysis combined with one-level electrostimulation. The dynamic assessment of clinical and functional status of upper limbs was performed using scale methods and electrophysiological monitoring. Results. The research revealed a more evident recovery of the upper limb function in Group II patients suggesting the method of microsurgical neurolysis combined with electrostimulation to be preferable in case of closed traction injuries to brachial plexus. Conclusion. The combination of microsurgical neurolysis with one-level electrostimulation improves the short-term outcomes of surgical treatment in patients with closed traction injuries of brachial plexus due to a sooner decrease in pain in postoperative period, and positive dynamics of clinical and electrophysiological parameters.

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Brachial Plexus Injuries – Review of the Anatomy and the Treatment Options

Cited by 11 publications

References 58 publications

Beyond the Knife—Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions

Beyond the Knife—Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions

Robotic Nerve Surgery: Brachial Plexus

Comparison of the Short-term Surgical Outcomes in Patients with Closed Traction Injuries to Brachial Plexus

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