Direct repair (nerve grafting), neurotization, and end-to-side neurorrhaphy in the treatment of brachial plexus injury

Haninec, Pavel; Šámal, Filip; Tomáš, Robert; Houšťava, Ladislav; Dubovwý, Petr

doi:10.3171/jns.2007.106.3.391

Cited by 72 publications

(64 citation statements)

References 28 publications

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“…16,17 We have previously reported successful reinnervation, using ETSN, in 64% of patients, and these results were obtained in 14 patients who completed a specified follow-up period. 12 In the present study, the rate of success of ETSN was 43.5%, suggesting a lower rate of successful reinnervations using ETSN than we had previously reported. Because none of the patients with effective reinnervation of the axillary nerves showed any improvement in deltoid muscle movements after a 2-year follow-up period, we think that this length of follow-up is sufficient.…”

Section: Discussioncontrasting

confidence: 50%

“…Successful reinnervation with this technique has been achieved using 1) the intercostal nerves (44%-70%), 7,12,14,19 2) spinal accessory nerve (50%-88%), 3) phrenic nerve (66%-100%),…”

Section: 14mentioning

confidence: 99%

“…12 The thoracodorsal nerve arises from C5-7 4 and is often available in injuries of the upper plexus. Recently, we used the long thoracic nerve (from C-4 to C-7) 4 when other donor nerves were not available, especially in total brachial plexus palsies.…”

mentioning

confidence: 99%

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End-to-side neurorrhaphy in brachial plexus reconstruction

Haninec¹,

Mencl²,

Kaiser³

2013

JNS

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Object. Although a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy (ETSN) have been published to date, there is still a considerable lack of clinical trials investigating this technique. Here, the authors describe their experience with ETSN in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy.Methods. From 1999 to 2007, out of 791 reconstructed nerves in 441 patients treated for brachial plexus injury, the authors performed 21 axillary and 2 musculocutaneous nerve sutures onto the median, ulnar, or radial nerves. This technique was only performed in patients whose donor nerves, such as the thoracodorsal and medial pectoral nerves, which the authors generally use for repair of axillary and musculocutaneous nerves, respectively, were not available. In all patients, a perineurial suture was carried out after the creation of a perineurial window.Results. The overall success rate of the ETSN was 43.5%. Reinnervation of the deltoid muscle with axillary nerve suture was successful in 47.6% of the patients, but reinnervation of the biceps muscle was unsuccessful in the 2 patients undergoing musculocutaneous nerve repair.Conclusions. The authors conclude that ETSN should be performed in axillary nerve reconstruction but only when commonly used donor nerves are not available.

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Section: Discussioncontrasting

confidence: 50%

“…Successful reinnervation with this technique has been achieved using 1) the intercostal nerves (44%-70%), 7,12,14,19 2) spinal accessory nerve (50%-88%), 3) phrenic nerve (66%-100%),…”

Section: 14mentioning

confidence: 99%

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End-to-side neurorrhaphy in brachial plexus reconstruction

Haninec¹,

Mencl²,

Kaiser³

2013

JNS

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“…This technique has brought great contribution, because from then on, any nerve can be used as a donor nerve without harming itself or any of the structures innervated by it. Several experimental and clinical studies has validated the study of Viterbo [5][6][7] . Use of ESN has been indicated in clinical situations in which the proximal stump of injured nerve is not available 8 .…”

Section: Introductionmentioning

confidence: 99%

Effect of electrical stimulation of the cranial tibial muscle after end-to-side neurorrhaphy of the peroneal nerve in rats

Maciel

Viterbo

Chinaque³

et al. 2013

Acta Cir. Bras.

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PURPOSE:To investigate the efficiency of electrical stimulation in the muscle maintenance and nerve regeneration after end-to-side neurorrhaphy (ESN). METHODS:Sixty male Wistar rats (Rattus norvegicus) were divided into four experimental groups. Control group (Control), Denervated Group (Denervated); Group with End-to-side neurorrhaphy (ESN); Group with End-to-side neurorrhaphy and electrical stimulation (ESN + ES). We perform electrical stimulation in rats after they had undergone muscle reinnervation by ESN. We collected morphometric and functional data. RESULTS:When comparing the mass of the treated side of cranial tibial muscle (CTM) and that of normal side of CTM, the group ESN + ES (26.12%) exhibited lower mass loss than that of group ESN (37.23%). The peroneal functional index showed that group ESN + ES equaled that of the Control group and showed an evolution of 60.5% while group ESN showed an evolution of 9.5%. In measuring maximum strength of CTM, the group ES + ESN outperformed group ESN. The muscle and nerve morphometry showed superiority of group ES+ESN over ESN group in all parameters. CONCLUSION:Electrical stimulation is an effective means of maintaining functional muscle and nerve regeneration after end-to-side neurorrhaphy.

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“…Studies of outcomes following upper-extremity peripheral nerve injury frequently include assessment of physical impairment [1][2][3][4][5][6][7][8][9][10][11][12] . Evaluations of the impact of the physical impairment on the patient and validated measures of disability are not commonly included in the surgical literature.…”

mentioning

confidence: 99%