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Journal of Brachial Plexus and Peripheral Nerve Injury

Stefano Geuna, Pierluigi Tos, Paolo Titolo, Davide Ciclamini, Teresa Beningo, Bruno Battiston
Many surgical techniques are available for bridging peripheral nerve defects. Autologous nerve grafts are the current gold standard for most clinical conditions. In selected cases, alternative types of conduits can be used. Although most efforts are today directed towards the development of artificial synthetic nerve guides, the use of non-nervous autologous tissue-based conduits (biological tubulization) can still be considered a valuable alternative to nerve autografts. In this paper we will overview the advancements in biological tubulization of nerve defects, with either mono-component or multiple-component autotransplants, with a special focus on the use of a vein segment filled with skeletal muscle fibers, a technique that has been widely investigated in our laboratory and that has already been successfully introduced in the clinical practice...
2014: Journal of Brachial Plexus and Peripheral Nerve Injury
Theodore G Troupis, Adamantios Michalinos, Vasiliki Manou, Dimitrios Vlastos, Elizabeth O Johnson, Theano Demesticha, Panayiotis Skandalakis
In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery...
2014: Journal of Brachial Plexus and Peripheral Nerve Injury
Debora Garozzo, Gianluca Zollino, Stefano Ferraresi
BACKGROUND: Post-traumatic lumbosacral plexus injuries seem to be rare events, spontaneously recovering in high percentage: as surgery is often challenging and results in poor outcome, many Authors have advocated conservative treatment only. Nevertheless surgery should not be ruled out: in invalidating injuries, it can restore basic function in the lower extremities.Therefore, it might be necessary to establish guidelines for the management and the indication to surgery in such cases...
2014: Journal of Brachial Plexus and Peripheral Nerve Injury
Tim Kleiber, Nikica Popovic, Jörg Bahm, Catherine Disselhorst-Klug
BACKGROUND: Many disorders of the musculoskeletal system are caused by modified net joint forces resulting from individual coping movement strategies of patients suffering from neuromuscular diseases. Purpose of this work is to introduce a personalized biomechanical model which allows the calculation of individual net joint forces via inverse dynamics based on anthropometry and kinematics of the upper extremity measured by 3D optoelectronical motion analysis. METHODS: The determined resulting net joint forces in the anatomical axis of movement may be used to explain the reason for possible malfunction of the musculoskeletal system, especially joint malformation...
October 21, 2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Mamoon Rashid, Omer Salahuddin, Shumaila Yousaf, Uzair A Qazi, Kanwal Yousaf
Brachial plexus schwannomas are rare tumors. They are benign nerve sheath tumors and only about 5% of Schwannoma arise from the brachial plexus. They pose a great challenge to surgeons due to their rare occurrence and complex anatomical location. We present two cases who presented with a supraclavicular swelling, that were proven to be schwannoma on histopathology.
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Yukitoshi Kaizawa, Ryosuke Kakinoki, Souichi Ohta, Takashi Noguchi, Shuichi Matsuda
We report the case of a 34-year-old man with a total brachial plexus injury that was treated by free functional muscle transplantation to restore simultaneously elbow flexion and finger extension. The muscle had a very large muscle belly (12 cm width), which was considered anatomically to be a fusion of the gracilis and the adductor longus muscles. Although the muscle possessed two major vascular pedicles with almost equal diameters, only the proximal vascular pedicle was anastomosed to the recipient vessels during the transplantation surgery, resulting in partial necrosis of the muscle...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Jörg Bahm
We present two children with a diagnosis of upper limb arthrogryposis and report on findings about brachial plexus exploration and a nerve transfer procedure to reanimate elbow flexion. Although the etiology of arthrogryposis multiplex congenita remains unknown and multifactorial, it can be worthful to explore the brachial plexus in the affected upper limb and to perform selective motor nerve transfers on morphologically well developed but not sufficiently innervated target muscles, like the biceps brachialis, brachialis, deltoid and supra-/infraspinatus muscles...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Takashi Noguchi, Souichi Ohta, Ryosuke Kakinoki, Yukitoshi Kaizawa, Shuichi Matsuda
BACKGROUND: The nerve root avulsion injury causes decrease of motor neurons in the spinal ventral horn. To investigate the motoneuron death after avulsion injury in rats, the intradural root avulsion procedure is usually used, although it is technically demanding and associated with a risk of unexpected spinal cord damage. We have developed a new cervical nerve root avulsion procedure in rats and investigated the validity of our procedure. METHODS: Our procedure is using a posterior approach and pulling the C6 nerve root outside the vertebral foramen without intradural procedures...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Andrew E Price, Marc Fajardo, John Ai Grossman
BACKGROUND: Various approaches have been developed to treat the progressive shoulder deformity in patients with brachial plexus birth palsy. Reconstructive surgery for this condition consists of complex procedures with a risk for failure. CASE PRESENTATIONS: This is a retrospective case review of the outcome in eight cases referred to us for reoperation for failed shoulder reconstructions. In each case, we describe the initial attempt(s) at surgical correction, the underlying causes of failure, and the procedures performed to rectify the problem...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Chihab Taleb, Eric Nectoux, Therese Awada, Phillipe Liverneaux
No abstract text is available yet for this article.
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Raif Ozden, Vedat Uruc, Aydıner Kalacı, Yunus Dogramacı
Peripheral neuropathies caused by ganglion cysts are rare. They seldom cause serious complications especially in the lower extremities. The case was a 51-year-old woman referred by her physician to the vascular surgeon with diagnosis including intermittent (vascular) claudication and deep venous thrombosis. Primarily vascular surgeon performed a doppler ultrasound of the lower extremity and calculation of the ankle-brachial index. There were no abnormal pathological findings. Careful physical examination revealed soft swelling and tenderness around the fibular head and neck...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Rupeng Li, Patrick C Hettinger, Jacques A Machol, Xiping Liu, J B Stephenson, Christopher P Pawela, Ji-Geng Yan, Hani S Matloub, James S Hyde
BACKGROUND: Major peripheral nerve injuries not only result in local deficits but may also cause distal atrophy of target muscles or permanent loss of sensation. Likewise, these injuries have been shown to instigate long-lasting central cortical reorganization. METHODS: Cortical plasticity changes induced after various types of major peripheral nerve injury using an electrical stimulation technique to the rat upper extremity and functional magnetic resonance imaging (fMRI) were examined...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Juan Pablo Cáceres, Santos Palazzi, Jose Luis Palazzi, Manuel Llusá, Sanz M, Varci S
In total brachial plexus preganglionic lesions (C5-C6-C7-C8 and T1) different extraplexual neurotizations are indicated for partial motor function restitution. Mostly for the flexion of the elbow. Neurotization with intercostal nerves (ICN) to musculocutaneous nerve has been known and accepted during many years with different results 2 - 5. The customary technique as described by various authors is carried out by means of a large submammary incision to harvest three or four intercostal nerves (Figure 1). Then are connected by direct suture or grafts to the musculocutaneous nerve or its motor branches 6 - 7...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Edvard Ehler, Petr Ridzoň, Pavel Urban, Radim Mazanec, Marie Nakládalová, Bohumír Procházka, Hana Matulová, Jan Latta, Pavel Otruba
INTRODUCTION: A goal of our work was to perform nerve conduction studies (NCSs) of the ulnar nerve focused on the nerve conduction across the elbow on a sufficiently large cohort of healthy subjects in order to generate reliable reference data. METHODS: We examined the ulnar nerve in a position with the elbow flexion of 90o from horizontal. Motor response was recorded from the abductor digiti minimi muscle (ADM) and the first dorsal interosseous muscle (FDI). RESULTS: In our sample of 227 healthy volunteers we have examined 380 upper arms with the following results: amplitude (Amp)-CMAP(wrist) for ADM 9...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Munnan Al-Najjim, Abubakar Mustafa, Carl Fenton, Syam Morapudi, Mohammad Waseem
INTRODUCTION: Giant or solitary osteochondroma is part of a rare disorder known as synovial osteochondromatosis. It forms part of a spectrum of disease characterized by metaplastic changes within the joint synovium that are eventually extruded as loose bodies. It has been suggested that solitary synovial osteochondroma forms as progression of synovial osteochondromatosis through a process of either coalescence of multiple smaller bodies or the growth of a dominant synovial osteochondroma...
2013: Journal of Brachial Plexus and Peripheral Nerve Injury
Francisco Soldado, David Benito-Castillo, Cesar G Fontecha, Ignasi Barber, Mario Marotta, Sleiman Haddad, Mariano E Menendez, Vasco V Mascarenhas, Scott H Kozin
UNLABELLED: HASH(0x51533a8) BACKGROUND: Shoulder abnormalities are the major cause of morbidity in upper brachial plexus birth palsy (BPBP). We developed a rat model of upper trunk BPBP and compared our findings to previously reported animal models and to clinical findings in humans. METHODS: Forty-three 5-day-old newborn rats underwent selective upper trunk neurectomy of the right brachial plexus and were studied 3 to 20 weeks after surgery...
2012: Journal of Brachial Plexus and Peripheral Nerve Injury
Gerhard Blaauw, Robert S Muhlig
A discussion is presented concerning scoring while assessing shoulder function. Divergence in observation and in interpretation of what is observed may give rise to serious disagreement about indications for surgery. Agreement regarding starting points of measurement is essential. One must realize that the number of degrees, obtained using a scoring system, may not reflect the real amount of motion per se, it may solely indicate the limit of the motion in relation to the neutral zero point of the measurement...
2012: Journal of Brachial Plexus and Peripheral Nerve Injury
Amanda Maripuu, Anders Björkman, Isabella M Björkman-Burtscher, Peter Mannfolk, Gert Andersson, Lars B Dahlin
UNLABELLED: HASH(0x53581a8) BACKGROUND: The aim was to evaluate what can be learned from rat models when treating patients suffering from a sciatic nerve injury. METHODS: Two patients with traumatic sciatic nerve injury are presented with examination of motor and sensory function with a five-year follow-up. Reconstruction of the nerve injury was performed on the second and third day, respectively, after injury using sural nerve grafts taken from the injured leg...
2012: Journal of Brachial Plexus and Peripheral Nerve Injury
Thomas J Holland
BACKGROUND AND PURPOSE: Neuromuscular electrical stimulation (NMES) is a modality sometimes used to help strengthen weak muscles. On occasion, however, the targeted muscles do not respond to the current delivered. No response to electrical stimulation should raise the consideration of unsuspected peripheral nerve damage. Two case studies are presented showing how absence of response was due to unsuspected peripheral neuropathy, which had not been considered in either of the original referral diagnoses...
2012: Journal of Brachial Plexus and Peripheral Nerve Injury
Sabien Ga van Neerven, Ahmet Bozkurt, Dan Mon O'Dey, Juliane Scheffel, Arne H Boecker, Jan-Philipp Stromps, Sebastian Dunda, Gary A Brook, Norbert Pallua
Evaluation of functional and structural recovery after peripheral nerve injury is crucial to determine the therapeutic effect of a nerve repair strategy. In the present study, we examined the relationship between the structural evaluation of regeneration by means of retrograde tracing and the functional analysis of toe spreading. Two standardized rat sciatic nerve injury models were used to address this relationship. As such, animals received either a 2 cm sciatic nerve defect (neurotmesis) followed by autologous nerve transplantation (ANT animals) or a crush injury with spontaneous recovery (axonotmesis; CI animals)...
2012: Journal of Brachial Plexus and Peripheral Nerve Injury
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