Correlation of compound muscle action potential generated by donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury

Birth brachial plexus palsy (BBPP) is an unfortunate outcome of a difficult labor, which can often lead to long-lasting upper limb impairments. Spontaneous recovery may or may not occur. Timely diagnosis of the condition and initiation of the appropriate treatment can be instrumental in decreasing the functional impact. The management begins right from the day the child presents first and ranges from physiotherapy to surgical intervention such as nerve repair/transfer or grafts. The sequelae of the condition are also quite common and need to be detected preemptively with initiation of appropriate treatment. However, prevention is the key to reducing the incidence of secondary deformities. In this study, the team of authors, based on their considerable experience, discuss their approach to the management of BBPP. This is done in the background of Indian cultural practices and social constraints. A detailed discussion has been done on importance of preoperative passive joint mobilization regime and role of botulinum toxin in the authors' preferred ways of surgical correction of primary as well as secondary deformities. An extensive review of peer-reviewed publications has been done in this study, including clinical papers, review articles, and systematic review of the subject. Good results are possible with early and appropriate intervention even in severe cases.

show abstract

“…We have shown that CMAP of donors corelates well with elbow flexion outcome in adult palsies and follow this concept in babies too. 10…”

Section: Indications For Primary Plexus Surgerymentioning

confidence: 99%

Birth Brachial Plexus Palsy: An Indian Perspective

2023

View full text Add to dashboard Cite

show abstract

Considerations in the Selection of Donor Nerves for Nerve Transfer for Reanimation of Elbow and Shoulder in Traumatic Brachial Plexus Injuries

Zhang

Varadharajan

Bhardwaj

et al. 2022

J Hand Surg Asian-Pac Vol

View full text Add to dashboard Cite

The advent of nerve transfers has revolutionised the treatment of brachial plexus and peripheral nerve injuries of the upper extremity. Nerve transfers offer faster reinnervation of a denervated muscle by taking advantage of a donor nerve, branch or fascicle close to the recipient muscle. A number of considerations in respect of donor selection for nerve transfers underlie their success. In this review article, we discuss the principles of donor selection for nerve transfers, the different options available and our considerations in choosing a suitable transfer in reanimating the elbow and the shoulder. We feel this will help nerve surgeons navigate the controversies in the selection of donor nerves and make appropriate treatment decisions for their patients. Level of Evidence: V (Therapeutic)

show abstract

Single versus double fascicular transfer for brachial plexus injuries: a systematic review and meta-analysis with meta-regression

Shekouhi,

Ahmed,

Mattia

et al. 2024

J Hand Surg Eur Vol

View full text Add to dashboard Cite

The primary objective of this review was to assess whether double fascicular transfer has superior outcomes compared with single fascicular transfer for reanimation of elbow flexion. In total, 58 studies including 1388 patients (mean age 29 years [SD 8]) were included. Subgroup analysis comparing the severity of brachial plexus injury (C5-C6, C5-C7, C5-C8) showed no significant difference in the recovery of MRC grade 3 and 4. The aggregated mean Disabilities of Arm, Shoulder and Hand score was 38 for the single fascicular transfer group and 27 for the double fascicular transfer group. Meta-regression controlling for level of injury showed that double fascicular transfer and C5-C6 injury were significant predictors of achieving MRC grade 3, while double fascicular transfer and shorter duration of surgical delay were significant predictors of achieving MRC grade 4. When controlling for the level of injury, double fascicular transfer is associated with a greater likelihood of achieving MRC grade 3 and 4 compared to single fascicular transfer. Overall donor site morbidity was not significantly different between single fascicular transfer and double fascicular transfer.

show abstract

Correlation of compound muscle action potential generated by donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury

Cited by 4 publications

References 20 publications

Birth Brachial Plexus Palsy: An Indian Perspective

Birth Brachial Plexus Palsy: An Indian Perspective

Considerations in the Selection of Donor Nerves for Nerve Transfer for Reanimation of Elbow and Shoulder in Traumatic Brachial Plexus Injuries

Single versus double fascicular transfer for brachial plexus injuries: a systematic review and meta-analysis with meta-regression

Contact Info

Product

Resources

About