The Surgical Treatment of Brachial Plexus Injuries in Adults

Terzis, Julia K.; Papakonstantinou, Konstantinos C.

doi:10.1097/01.prs.0000254859.51903.97

Cited by 174 publications

(160 citation statements)

References 88 publications

(109 reference statements)

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“…The application of microsurgical techniques and the establishment of the principle of tension free repair in peripheral nerve surgery, brought several new techniques for brachial plexus reconstruction, especially in supraclavicular lesions with multiple avulsions (40). A variety of extraplexus donors has been introduced to neurotize selected muscles in order to achieve essential function in the shoulder, elbow and hand (36).…”

Section: Introductionmentioning

confidence: 99%

Early post operative results after repair of traumatic brachial plexus palsy

Ahmad

2012

Turkish Neurosurgery

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AIm: Treatment options for traumatic brachial plexus injuries include nerve grafting, or neurotization. The type of lesion and the reconstructive procedures affect functional results and postoperative pain relief. mAterIAl and methOds: A total number of twenty five patients suffering from post-traumatic brachial plexus injury were included in the study. The patients underwent exploration and primary repair of the affected plexus, based on case by case policy.results: Spinal accessory nerve transfer to suprascapular nerve procedure regained 78.95% of functional muscle power, 10.50% of non functional muscle power and only 10.5 % of non innervated muscle. The Oberlin procedure regained 83.33% with elbow flexion muscle power, 16.67% with non functional muscle power. Intercostal nerve transfer to musculocutaneous nerve regained 62.5% with functional muscle power, 25% with non functional muscle power and only 12.5 % with non innervated muscle. The shoulder, elbow and wrist extension functions were significantly improved early post-operatively. In addition, the post-operative improvement of shoulder, elbow and wrist extension functions had significant negative correlations with the pre-operative elapsed time, and accompanied by a significant positive correlation with post-operative follow up period.COnClusIOn: Early intervention for traumatic brachial plexus palsy is recommended to get good results with pain relief. BulGulAr: Supraskapular sinire spinal aksesuar sinir transferi %78,95 işlevsel kas gücü, %10,50 işlevsel olmayan kas gücü ve sadece %10,5 innerve olmayan kas kazandırdı. Oberlin işlemi %83,33 dirsek fleksiyonu kas gücü ve %16,67 işlevsel olmayan kas gücü kazandırdı. Müskülokütanöz sinire interkostal sinir transferi %62,5 işlevsel kas gücü, %25 işlevsel olmayan kas gücü ve sadece%12,55 innerve olmayan kas kazandırdı. Omuz, dirsek ve bilek ekstansiyon işlevleri postoperatif erken dönemde önemli ölçüde düzeldi. Ayrıca, omuz, dirsek ve bilek ekstansiyon işlevlerinin postoperatif düzelmesinin preoperatif geçen süreyle önemli bir negatif korelasyonu bulundu ve postoperatif takip dönemiyle önemli bir pozitif korelasyonu vardı. sOnuÇ: Travmatik brakiyal pleksus palsisinde ağrı giderilmesiyle birlikte iyi sonuçlar alınması için erken girişim önerilir.

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Section: Introductionmentioning

confidence: 99%

Early post operative results after repair of traumatic brachial plexus palsy

Ahmad

2012

Turkish Neurosurgery

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“…Differences in limb length [10] and weight between our group (Caucasian) and Oriental patients were previously recognized [35,36].…”

Section: One Muscle Transfer For Simultaneous Reconstruction Of Two Fmentioning

confidence: 53%

“…Statistically significant (p=0.047) difference was found when LD was neurotized with three intercostals (MG 3.87± 0.41) as compared with two intercostals (MG 3.02±0. 35). …”

Section: Latissimus Dorsimentioning

confidence: 99%

Free Muscle Transfer in Posttraumatic Plexopathies Part II: The Elbow

Terzis¹,

Kostopoulos

2009

Hand (New York, N,Y.)

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The indications for free muscle transfer in brachial plexopathies are prolonged denervation time or inadequate upper extremity function after primary nerve reconstruction. The purpose of this study is to analyze the outcomes of free muscle transfer for elbow flexion and extension in brachial plexopathies in relation to the different muscles used and the respective motor donors. Seventy-three muscles were transferred for elbow flexion and ten for elbow extension. Latissimus dorsi (LD) was used in 37 cases, gracilis in 28, rectus femoris (RF) in seven, and vastus lateralis in one. Five LD and five gracilis were transferred for elbow extension. Patients younger than 15 years yielded better results than older patients for elbow flexion. When LD was transferred, the mean muscle grading (MG) was 3.33±0.25 when the neurotization was from intercostals; these outcomes were statistically significant when compared with outcomes of free gracilis transfer (MG 2.25±0.6). There was also a statistically significant difference when free LD was neurotized with three intercostals as compared with two intercostals nerves. RF yielded also good results when neurotized from contralateral C7 (cC7; MG 3.67±0.6). For elbow extension, the better outcomes of LD were not statistically significant. Among all the free muscle transfers for upper extremity reconstruction, elbow reanimation yielded the most rewarding outcomes. The selection of powerful muscle units was more important than the effect of neurotization which was not as strong as it was in muscle transfers for facial or hand reanimation.

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“…Patients who had thoracic outlet syndrome and brachial plexus tumors were included in this study. Also in USA, Terzis et al, 15 published study of 204 patients who underwent various surgical techniques of repair of the brachial plexus elements.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Brachial Plexus Injuries: Epidemiological Study at two Egyptian Centers over 2 Years

Elqazaz¹,

Elsebaey²

2016

Egyptian Spine Journal

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Background Data: Improving the knowledge about the epidemiology of the traumatic brachial plexus injuries (BPI) helps in providing an appropriate assessment and management of these cases. This issue is important especially in those injuries that have much burden on the individual and national income. Purpose: To evaluate the epidemiological, clinical, and outcome of traumatic brachial plexus injuries in Suez Canal University and Damanhur Medical National Institute Hospitals over 2 years. Study Design: A retrospective descriptive clinical case study. Patients and Methods: Eighteen patients had traumatic brachial plexus injury were operated by our team from January 2014 to December 2015. Data regarding the age, sex, causes of BPI, patterns of injury, surgical approaches, surgical procedures and recovery outcome were collected. Results: All the patients were males with mean age 31 years, 72% encountered road traffic accidents (RTA), and 90% were because of motorbike accidents. 60% showed upper BPI. Neurolysis, nerve grafting and nerve transfer were the surgical procedures that were followed. Functional recovery had been achieved in about 61% of the study population. Conclusion: Our study gives insight into epidemiological aspects of the BPI in Egypt and the role of our new center in the management of those injuries. Taking into consideration the small number of the study population, our results were more or less similar published literatures. (2016ESJ112)

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The Surgical Treatment of Brachial Plexus Injuries in Adults

Cited by 174 publications

References 88 publications

Early post operative results after repair of traumatic brachial plexus palsy

Early post operative results after repair of traumatic brachial plexus palsy

Free Muscle Transfer in Posttraumatic Plexopathies Part II: The Elbow

Traumatic Brachial Plexus Injuries: Epidemiological Study at two Egyptian Centers over 2 Years

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