Paralysie complète du plexus brachial au cours d’une luxation antéromédiale de l’épaule : à propos d’un cas

Koulali-Idrissi, K.; Sennoune, B; Hachimi, K. El; Messary, O; Fnini, S.; Ouarab, M.; Trafeh, M.

doi:10.1016/s1297-3203(03)00023-4

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…Similar observation was made by Robinson et al, who found that in their patient group “patients with multiple-nerve lesions were more likely to have a residually displaced greater tuberosity fracture” [ 9 ]. In some case reports GTF also coincided with total brachial plexus palsy [ 41 , 42 ]. According to Visser et al, the presence of GTF doubled the incidence of nerve injury, adversely affecting its severity and the number of injured nerves [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patient-Dependent and Trauma-Dependent Risk Factors for Persistent Brachial Plexus Injury after Shoulder Dislocation

Gutkowska

Martynkiewicz

Stepniewski

et al. 2018

BioMed Research International

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Brachial plexus injuries (BPIs) caused by shoulder dislocation usually have a transient character and tend to resolve spontaneously. However, in some patients the symptoms can persist and require operative intervention. This work aims to determine the risk factors for persistent BPIs resulting from shoulder dislocation. The study comprised 73 patients (58 men, 15 women; mean age: 50 years) treated operatively between the years 2000 and 2016 for persistent BPIs resulting from shoulder dislocation. Patient age, gender, type of initial trauma, number of affected nerves, presence of accompanying injuries, and time interval from dislocation to its reduction were analysed. Elderly patients more often sustained multiple-nerve injuries, while single nerve injuries were more often observed in younger patients. Injury to a single nerve was diagnosed in 30% of the patients. Axillary nerve was most commonly affected. Fracture of the greater tuberosity of humerus coincided with total BPI in 50% of the cases. Longer unreduced period caused injury to multiple nerves. Analysis of our patient group against relevant literature revealed that persistent BPI after shoulder dislocation is more common in older patients. Injuries to ulnar and median nerves more often require operative intervention due to low potential for spontaneous recovery of these nerves.

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Section: Discussionmentioning

confidence: 99%

Analysis of Patient-Dependent and Trauma-Dependent Risk Factors for Persistent Brachial Plexus Injury after Shoulder Dislocation

Gutkowska

Martynkiewicz

Stepniewski

et al. 2018

BioMed Research International

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“…Ce sont elles qui font le pronostic fonctionnel à long terme. Dans les luxations antérieures d'épaule, il s'agit de lésions rétro-ou infraclaviculaires dont le mécanisme classique est un étirement [8,10]. En cas de lésion vasculaire associée, il peut aussi s'agir d'une neurapraxie liée à un hématome compressif [10].…”

Section: Discussionunclassified

“…Dans les luxations antérieures d'épaule, il s'agit de lésions rétro-ou infraclaviculaires dont le mécanisme classique est un étirement [8,10]. En cas de lésion vasculaire associée, il peut aussi s'agir d'une neurapraxie liée à un hématome compressif [10]. Ainsi, chez ce patient le mécanisme était mixte : étirement par la tête humérale luxée, mais aussi compression des troncs nerveux par l'hématome.…”

Section: Discussionunclassified

“…Ainsi, chez ce patient le mécanisme était mixte : étirement par la tête humérale luxée, mais aussi compression des troncs nerveux par l'hématome. S'il n'y a pas d'indication opératoire urgente dans les lésions plexiques isolées, l'exploration du plexus brachial doit être impérativement réalisée lors du traitement chirurgical d'une lésion artérielle avec ischémie [10]. La réparation des lésions nerveuses en urgence donne en effet les meilleures chances à la repousse axonale et à la réinnervation musculaire.…”

Section: Discussionunclassified

“…Par ailleurs, elle évite l'exploration secondaire, rendue difficile par la fibrose cicatricielle et pouvant léser les vaisseaux réparés [8]. Dans cette observation, la lésion du tronc médian a récupéré complètement en quelques mois comme la majorité des atteintes plexiques liées aux luxations d'épaule [10]. Au final, en l'absence de lésion de la coiffe des rotateurs, le résultat fonctionnel n'était limité que par une capsulite rétractile accessible à la kinésithérapie.…”

Section: Discussionunclassified

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Rupture de l’artère axillaire et paralysie du plexus brachial compliquant une luxation glénohumérale antérieure récidivante : à propos d’un cas

Laurent

Chetboun

Nourissat

et al. 2009

Chirurgie de la Main

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Brachial plexus injury after shoulder dislocation: a literature review

et al. 2018

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Brachial plexus injuries are among the rarest but at the same time the most severe complications of shoulder dislocation. The symptoms range from transient weakening or tingling sensation of the upper limb to total permanent paralysis of the limb associated with chronic pain and disability. Conflicting opinions exist as to whether these injuries should be treated operatively and if so when surgery should be performed. In this review, available literature dedicated to neurological complications of shoulder dislocation has been analysed and management algorithm has been proposed. Neurological complications were found in 5.4-55% of all dislocations, with the two most commonly affected patient groups being elderly women sustaining dislocation as a result of a simple fall and young men after high-energy injuries, often multitrauma victims. Infraclavicular part of the brachial plexus was most often affected. Neurapraxia or axonotmesis predominated, and complete nerve disruption was observed in less than 3% of the patients. Shoulder dislocation caused injury to multiple nerves more often than mononeuropathies. The axillary nerve was most commonly affected, both as a single nerve and in combination with other nerves. Older patient age, higher energy of the initial trauma and longer period from dislocation to its reduction have been postulated as risk factors. Brachial plexus injury resolved spontaneously in the majority of the patients. Operative treatment was required in 13-18% of the patients in different studies. Patients with suspected neurological complications require systematic control. Surgery should be performed within 3-6 months from the injury when no signs of recovery are present.

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Paralysie complète du plexus brachial au cours d’une luxation antéromédiale de l’épaule : à propos d’un cas

Cited by 5 publications

References 8 publications

Analysis of Patient-Dependent and Trauma-Dependent Risk Factors for Persistent Brachial Plexus Injury after Shoulder Dislocation

Analysis of Patient-Dependent and Trauma-Dependent Risk Factors for Persistent Brachial Plexus Injury after Shoulder Dislocation

Rupture de l’artère axillaire et paralysie du plexus brachial compliquant une luxation glénohumérale antérieure récidivante : à propos d’un cas

Brachial plexus injury after shoulder dislocation: a literature review

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