Traumatic upper plexus palsy: Is the exploration of brachial plexus necessary?

Gkiatas, Ioannis; Papadopoulos, Dimitrios V.; Korompilias, Anastasios V.; Vekris, Marios D.; Beris, Alexandros E.; Kostas-Agnantis, Ioannis

doi:10.1007/s00590-018-2345-1

Cited by 9 publications

(3 citation statements)

References 48 publications

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“…24,25 Las cirugías tardías (> 9 o 12 meses) han demostrado tener peores resultados. 1,9,26 El tratamiento de una lesión del plexo braquial es técnicamente demandante, y los resultados de las reconstrucciones nerviosas serán evidentes luego de aproximadamente un a dos años desde la cirugía. Es muy importante la educación del paciente sobre los resultados esperables del tratamiento y los tiempos de recuperación, para no crear falsas expectativas.…”

Section: Tratamiento Quirúrgicounclassified

“…24,25 Late surgeries (> 9 or 12 months) have worse outcomes. 1,9,26 The treatment of a brachial plexus injuries is technically demanding, and the outcomes of nerve reconstructions will be apparent approximately 1 to 2 years after surgery. Informing the patient about the anticipated treatment outcomes and recovery times is critical in order not to create false expectations.…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Lesiones del plexo braquial en adultos: Una revisión narrativa de la literatura

Ananías

Pino

2022

Revista Chilena de Ortopedia y Traumatología

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ResumenLa patología traumática del plexo braquial comprende un amplio espectro de lesiones potencialmente devastadoras para la funcionalidad de los pacientes. El objetivo del presente trabajo es realizar una revisión narrativa de la literatura enfocada en el diagnóstico y estudio de las lesiones del plexo braquial en adultos, además de entregar nociones básicas sobre el manejo de esta compleja patología. Nivel de evidencia: Nivel V.

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Section: Tratamiento Quirúrgicounclassified

Section: Surgical Treatmentmentioning

confidence: 99%

Lesiones del plexo braquial en adultos: Una revisión narrativa de la literatura

Ananías

Pino

2022

Revista Chilena de Ortopedia y Traumatología

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“…Donor site morbidity associated with graft harvest and risk of neuroma formation should not be overlooked. 5 Identification of a suitable root is challenging even for the experienced surgeon, and errors in decision-making can compromise outcomes. 2 Considering these limitations, some prefer to manage closed injuries without supraclavicular exploration, using only distal nerve transfers for their reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Trends in Brachial Plexus Surgery: Characterizing Contemporary Practices for Exploration of Supraclavicular Plexus

Hill

Lanier

Rolf

et al. 2021

Hand (New York, N,Y.)

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Background There is variability in treatment strategies for patients with brachial plexus injury (BPI). We used qualitative research methods to better understand surgeons’ rationale for treatment approaches. We hypothesized that distal nerve transfers would be preferred over exploration and nerve grafting of the brachial plexus. Methods We conducted semi-structured interviews with BPI surgeons to discuss 3 case vignettes: pan-plexus injury, upper trunk injury, and lower trunk injury. The interview guide included questions regarding overall treatment strategy, indications and utility of brachial plexus exploration, and the role of nerve grafting and/or nerve transfers. Interview transcripts were coded by 2 researchers. We performed inductive thematic analysis to collate these codes into themes, focusing on the role of brachial plexus exploration in the treatment of BPI. Results Most surgeons routinely explore the supraclavicular brachial plexus in situations of pan-plexus and upper trunk injuries. Reasons to explore included the importance of obtaining a definitive root level diagnosis, perceived availability of donor nerve roots, timing of anticipated recovery, plans for distal reconstruction, and the potential for neurolysis. Very few explore lower trunk injuries, citing concern with technical difficulty and unfavorable risk-benefit profile. Conclusions Our analysis suggests that supraclavicular exploration remains a foundational component of surgical management of BPI, despite increasing utilization of distal nerve transfers. Availability of abundant donor axons and establishing an accurate diagnosis were cited as primary reasons in support of exploration. This analysis of surgeon interviews characterizes contemporary practices regarding the role of brachial plexus exploration in the treatment of BPI.

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Imaging After Birth Trauma and in Suspected Non-accidental or Inflicted Injury

Tschauner

Sorantin

2023

Imaging in Neonates

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Traumatic upper plexus palsy: Is the exploration of brachial plexus necessary?

Cited by 9 publications

References 48 publications

Lesiones del plexo braquial en adultos: Una revisión narrativa de la literatura

Lesiones del plexo braquial en adultos: Una revisión narrativa de la literatura

Trends in Brachial Plexus Surgery: Characterizing Contemporary Practices for Exploration of Supraclavicular Plexus

Imaging After Birth Trauma and in Suspected Non-accidental or Inflicted Injury

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