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Brachial plexus injury

S Zuarez-Easton, N Zafran, G Garmi, J Hasanein, S Edelstein, R Salim
OBJECTIVE: Obstetric brachial plexus palsy (OBPP) at birth, is a serious neurologic injury that may lead to a long lasting disability. We aimed to examine the occurrence and risk factors associated with disability lasting >1 year. STUDY DESIGN: A retrospective cohort study conducted between 1993 and 2012 included individuals with diagnosis of OBPP at birth. Affected individual's motor function was evaluated by a direct physical exam based on a muscle grading system of the limb, shoulder, elbow and hand...
October 20, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Merritt D Kinon, Rani Nasser, Jonathan Nakhla, Rupen Desai, Jessica R Moreno, Reza Yassari, Carlos A Bagley
Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initiation of treatment have a greater chance of treatment success for the patient. However, timely treatment is complicated because torticollis can result from a variety of maladies, including: congenital abnormalities involving the C1-C2 joint or the surrounding supporting muscles and ligaments, central nervous system abnormalities, obstetric palsies from brachial plexus injuries, clavicle fractures, head and neck surgery, and infection...
October 2016: Pediatric Emergency Care
Michael C Nicoson, Michael J Franco, Thomas H Tung
BACKGROUND: With complete plexus injuries or late presentation, free functional muscle transfer (FFMT) becomes the primary option of functional restoration. Our purpose is to review cases over a 10-year period of free functioning gracilis muscle transfer after brachial plexus injury to evaluate the effect of different donor nerves used to reinnervate the FFMT on functional outcome. METHODS: A retrospective study from April 2001 to January 2011 of a single surgeon's practice was undertaken...
October 5, 2016: Microsurgery
Hubert Lenoir, Louis Dagneaux, François Canovas, Thomas Waitzenegger, Thuy Trang Pham, Michel Chammas
BACKGROUND: Neurologic lesions are relatively common after total shoulder arthroplasty. These injuries are mostly due to traction. We aimed to identify the arm manipulations and steps during reverse total shoulder arthroplasty (RTSA) that affect nerve stress. METHODS: Stress was measured in 10 shoulders of 5 cadavers by use of a tensiometer on each nerve from the brachial plexus, with shoulders in different arm positions and during different surgical steps of RTSA...
September 30, 2016: Journal of Shoulder and Elbow Surgery
Kristin L Buterbaugh, Apurva S Shah
Brachial plexus birth palsy (BPBP) is an upper extremity paralysis that occurs due to traction injury of the brachial plexus during childbirth. Approximately 20 % of children with brachial plexus birth palsy will have residual neurologic deficits. These permanent and significant impacts on upper limb function continue to spur interest in optimizing the management of a problem with a highly variable natural history. BPBP is generally diagnosed on clinical examination and does not typically require cross-sectional imaging...
September 28, 2016: Current Reviews in Musculoskeletal Medicine
Sameh Ghroubi, Samar Alila, Atika Mallek, Wafa Elleuch, Khlil Nouri, Mohamed Habib Elleuch
OBJECTIVE: To show the contribution of the sensory nerve action potential in the topographic diagnosis of traumatic brachial plexus injuries through an illustration of 7 clinical cases. OBSERVATIONS: We report 7 clinical cases of patients with unilateral traumatic brachial plexus injuries, following public highway accident. We realized an electroneuromyographic test (ENMG) for each patient in our service. A radiculopathy C5C6C7 were found in 3 subjects. Other patients had a radiculopathy C5 T1, a radiculopathy C7C8 T1, a lesion of the upper trunk or a lesion of the posterior cord...
September 2016: Annals of Physical and Rehabilitation Medicine
Hardeep S Kainth, Ankit A Patel, Raymund V Millan
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
P Raynal
Simulation in obstetrical emergency is in expansion. The important economic and human cost in simulation needs a real evaluation about enhancement in technical and non-technical skills, maternal and neonatal morbidity and mortality. We present a literature review of the results published on the subject in shoulder dystocia, post-partum haemorrhage, eclampsia and cord prolaps with a selection of publications with high evidence level or positive impact of training on obstetrical emergencies. There are few publications with a positive impact of training on obstetrical emergencies...
September 20, 2016: Gynécologie, Obstétrique & Fertilité
Mihir J Desai, Charles A Daly, John G Seiler, Walter H Wray, David S Ruch, Fraser J Leversedge
PURPOSE: Loss of active shoulder abduction after brachial plexus or isolated axillary nerve injury is associated with a severe functional deficit. The purpose of this 2-center study was to retrospectively evaluate restoration of shoulder abduction after transfer of a radial nerve branch to the axillary nerve for patients after brachial plexus or axillary nerve injury. METHODS: Patients who underwent transfer of a radial nerve branch to the anterior branch of the axillary nerve between 2004 and 2014 were reviewed...
September 20, 2016: Journal of Hand Surgery
Robert S George, Richard Milton, Nilanjan Chaudhuri, Emmanuel Kefaloyannis, Kostas Papagiannopoulos
BACKGROUND: Thoracic outlet syndrome (TOS) causes neurologic symptoms in 95% of cases and vascular symptoms in 5% of cases. Surgical resection is curative. Endoscopic-assisted transaxillary first rib resection has been previously reported. In this study we report a totally endoscopic video-assisted thoracoscopic surgery (VATS) approach using tailored endoscopic instruments. METHODS: Ten patients (8 women; average age, 32.3 ± 5.6 years) with TOS underwent VATS first rib resection following failure of symptom improvement with physiotherapy...
September 19, 2016: Annals of Thoracic Surgery
Jamison M Green, Mark H Getelman, Stephen J Snyder, Joseph P Burns
PURPOSE: To compare patient-reported outcomes and healing rates after open subpectoral and all-arthroscopic suprapectoral biceps tenodesis without the use of interference screws in patients with more than 2 years of follow-up. METHODS: Patients with at least 2 years of follow-up who underwent open subpectoral biceps tenodesis or all-arthroscopic suprapectoral biceps tenodesis without concomitant rotator cuff repair, labral repair, or Mumford procedure were considered for enrollment in the study...
September 19, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Mohammad M Al-Qattan, Amel A F El-Sayed
It is generally thought that Klumpke's palsy is not seen as obstetric injury. The authors present a case of Klumpke's palsy with Horner syndrome following delivery by emergency Cesarean section. Neurolysis and nerve grafting partially corrected the paralysis.
September 2016: Clinical Case Reports
Rahul K Nath, Chandra Somasundaram
OBJECTIVE: Assessment of surgical outcomes of biceps tendon lengthening (BTL) surgery in obstetric brachial plexus injury (OBPI) patients with elbow flexion contractures, who had unsuccessful serial casting. BACKGROUND: Serial casting and splinting have been shown to be effective in correcting elbow flexion contractures in OBPI. However, the possibilities of radial head dislocations and other complications have been reported in serial casting and splinting. Literature indicates surgical intervention when such nonoperative techniques and range-of-motion exercises fail...
2016: Eplasty
Vidushi Kulshrestha, Nutan Agarwal
Diabetes in pregnancy starts affecting the foetus even in the pre-conception period. The complications encountered in third trimester are foetal macrosomia and intrauterine foetal demise; birth of a macrosomic baby further leads to shoulder dystocia, birth trauma, brachial plexus injury. Additionally, pregnancies with overt/pregestational diabetes may be complicated with foetal growth restriction, congenital abnormalities diagnosed in third trimester and foetal hypertrophic obstructive cardiomyopathy. Even minor degrees of hyperglycaemia is associated with adverse pregnancy outcome...
September 2016: JPMA. the Journal of the Pakistan Medical Association
Bryan G Beutel, Scott D Lifchez, Eitan Melamed
BACKGROUND: Cardiovascular procedures are common and are trending toward endovascular interventions. With this increase in endovascular procedures, there is also increasing awareness of upper extremity morbidity resulting from treatment. METHODS: Articles indexed within PubMed between the years 1975 and 2015 that discussed such complications were reviewed. RESULTS: Percutaneous radial artery access can lead to nerve ischemia, especially in the setting of an incomplete arterial arch, whereas radial artery harvesting for bypass surgery more commonly causes frank tissue ischemia and radial neuropathy...
August 2016: Journal of Hand and Microsurgery
Peter Y Shen, Anna E Nidecker, Ethan A Neufeld, Paul S Lee, Michelle A James, Andrea S Bauer
BACKGROUND AND PURPOSE: The current prognostic biomarker of functional outcome in brachial plexus birth palsy is serial clinical examination throughout the first 6 months of age. This can delay surgical treatment and prolong parental anxiety in neonates who will recover spontaneously. A potentially superior biomarker is a volumetric proton density MRI performed at clinical presentation and within the first 12 weeks of life, providing a high spatial and contrast resolution examination in 4 minutes...
September 8, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Emmanuel P Estrella, Tristram D Montales
BACKGROUND: Restoration of elbow function in traumatic brachial plexus injury patients remains the priority in the reconstruction of the involved extremity. In cases of complete nerve root injuries and in delayed cases, the only option for elbow reconstruction is the functional free muscle transfer. The purpose of this paper was to present the clinical outcomes and complications of functioning free muscle transfers using the gracilis muscle for the restoration of elbow flexion in brachial plexus injury patients in a tertiary institution from January 1, 2005 to January 31, 2014...
August 24, 2016: Injury
Xiaotian Jia, Jianyun Yang, Lin Chen, Cong Yu
Myxoinflammatory fibroblastic sarcoma is a rare sarcoma that develops in patients of all ages, which usually presents as a slow-growing painless mass in the distal extremities. To date, myxoinflammatory fibroblastic sarcoma with invasion of the brachial plexus has rarely been reported in the literature. In this study, a case of large cervicothoracic sarcoma, which invaded the brachial plexus, is presented. The patient reported no sensory disturbance or dyskinesia. The tumor was completely resected without injury of the brachial plexus...
September 2016: Oncology Letters
Christopher J Dy, Jack Baty, Mohammed J Saeed, Margaret A Olsen, Daniel A Osei
PURPOSE: Despite the importance of timely evaluation for patients with brachial plexus injuries (BPIs), in clinical practice we have noted delays in referral. Because the published BPI experience is largely from individual centers, we used a population-based approach to evaluate the delivery of care for patients with BPI. METHODS: We used statewide administrative databases from Florida (2007-2013), New York (2008-2012), and North Carolina (2009-2010) to create a cohort of patients who underwent surgery for BPI (exploration, repair, neurolysis, grafting, or nerve transfer)...
September 2016: Journal of Hand Surgery
Francisco Ferrero-Manzanal, Raquel Lax-Pérez, Roberto López-Bernabé, José Ramiro Betancourt-Bastidas, Alvaro Iñiguez de Onzoño-Pérez
INTRODUCTION: Shoulder surgery is often performed with the patient in the so called "beach-chair position" with elevation of the upper part of the body. The anesthetic procedure can be general anesthesia and/or regional block, usually interscalenic brachial plexus block. We present a case of brachial plexus palsy with a possible mechanism of traction based on the electromyographic and clinical findings, although a possible contribution of nerve block cannot be excluded. PRESENTATION OF THE CASE: We present a case of a 62 year-old female, that suffered from shoulder fracture-dislocation...
2016: International Journal of Surgery Case Reports
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