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Brachial plexus injury

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https://www.readbyqxmd.com/read/28049512/a-stab-wound-to-the-axilla-illustrating-the-importance-of-brachial-plexus-anatomy-in-an-emergency-context-a-case-report
#1
Diogo Casal, Teresa Cunha, Diogo Pais, Inês Iria, Maria Angélica-Almeida, Gerardo Millan, José Videira-Castro, João Goyri-O'Neill
BACKGROUND: Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. CASE PRESENTATION: We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28047711/su-f-r-06-traumatic-brachial-plexus-injury-imaging-developing-a-coherent-clinical-protocol-from-literature-review-through-practice
#2
D Wu, E France, J Lambert, J Hinkle
PURPOSE: Medical Physics teams can now play a critical role to help plan and provide studied approaches for traumatic brachial plexus MR imaging (tbpMRI). This is especially important for coordination with uncommon applications, since it is challenging to select the right modality, parameters, and train technologists on the essential components. For this work, we started with a review of the medical literature, performed crossover/volunteer studies to bring tbpMRI to practice with greater image QC and protocol management...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28027238/free-functioning-gracilis-muscle-transfer-for-elbow-flexion-reconstruction-after-traumatic-adult-brachial-pan-plexus-injury-where-is-the-optimal-distal-tendon-attachment-for-elbow-flexion
#3
Andrés A Maldonado, Santiago Romero-Brufau, Michelle F Kircher, Robert J Spinner, Allen T Bishop, Alexander Y Shin
BACKGROUND: Reconstruction after pan-plexus root avulsions often includes gracilis free functioning muscle transfer. For elbow flexion reconstruction, the free functioning muscle transfer distal tendon is inserted into the biceps tendon or more distally (i.e., flexor digitorum profundus/flexor pollicis longus tendons) for combined elbow and finger flexion; the theoretical drawback of the latter approach is weaker elbow flexion. The authors compared elbow flexion strength with a biceps tendon versus a flexor digitorum profundus/flexor pollicis longus tendon attachment to determine which insertion point resulted in better elbow flexion...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28009788/effect-of-load-carriage-on-upper-limb-performance
#4
Amir Hadid, Inbar Katz, Tal Haker, Gabi Zeilig, Ruth Defrin, Yoram Epstein, Amit Gefen
: Carrying heavy backpacks are often associated with shoulder discomfort or pain, loss of sensorimotor functions, and brachial plexus injuries that might hamper performance. Based on previous research, the cause of these symptoms could be tissue deformations of the brachial plexus and the subclavian artery caused by the shoulder straps. PURPOSE: To evaluate the changes in the upper extremity hemodynamic and neural function, and to assess how they are associated with brachial plexus tissue deformation during heavy load carriage...
December 22, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27999953/the-role-of-magnetic-resonance-imaging-in-the-evaluation-of-peripheral-nerves-following-traumatic-lesion-where-do-we-stand
#5
REVIEW
Oswaldo Ribeiro Marquez Neto, Matheus Silva Leite, Tiago Freitas, Paulo Mendelovitz, Eric Arruda Villela, Iruena Moraes Kessler
BACKGROUND: Peripheral nerve injury is a common and important cause of morbidity and disability in patients who have suffered a traumatic injury, particularly younger people. Various different injuries can result in damage to specific nerves. In patients with multiple trauma, the prevalence of peripheral nerve injury is estimated at 2.8%, but can reach 5% with the inclusion of brachial plexus involvement. Physical examination, as well as the origin and location of the trauma, can indicate the nerve involved and the type of nerve damage...
February 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27989913/quantitative-dixon-mri-sequences-to-relate-muscle-atrophy-and-fatty-degeneration-with-range-of-motion-and-muscle-force-in-brachial-plexus-injury
#6
Bouke J Duijnisveld, Jan Ferdinand Henseler, Monique Reijnierse, Marta Fiocco, Hermien E Kan, Rob G H H Nelissen
BACKGROUND: Assessment of muscle atrophy and fatty degeneration in brachial plexus injury (BPI) could yield valuable insight into pathophysiology and could be used to predict clinical outcome. The objective of this study was to quantify and relate fat percentage and cross-sectional area (CSA) of the biceps to range of motion and muscle force of traumatic brachial plexus injury (BPI) patients. METHODS: T1-weighted TSE sequence and three-point Dixon images of the affected and non-affected biceps brachii were acquired on a 3 Tesla magnetic resonance scanner to determine the fat percentage, total and contractile CSA of 20 adult BPI patients...
October 27, 2016: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/27965621/upper-trunk-brachial-plexus-palsy-following-chiropractic-manipulation
#7
John Cunningham, Wayne Hoskins, Scott Ferris
INTRODUCTION: Upper trunk brachial plexus palsy can result from high-energy trauma and has never been reported following spinal manipulation. BACKGROUND: The case is presented of a patient who developed an acute brachial plexus upper trunk palsy following spinal manipulative therapy. DISCUSSION: Discussion is made on the incidence of complications following manipulation and recommendations to prospectively capture all serious complications...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27913804/restoration-of-shoulder-abduction-in-brachial-plexus-avulsion-injuries-with-double-neurotization-from-the-spinal-accessory-nerve-a-report-of-13-cases
#8
K W S J Huan, J S W Tan, S H Tan, L C Teoh, F C Yong
: In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries...
December 1, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27911674/cross-sectional-imaging-anatomy-and-pathologic-conditions-affecting-thoracic-nerves
#9
Kristopher W Cummings, Sreevathsan Sridhar, Matthew S Parsons, Cylen Javidan-Nejad, Sanjeev Bhalla
While in many cases they are not directly visualized, awareness of the thoracic nerves and their courses at cross-sectional imaging is important for radiologists. An understanding of the normal function of each nerve is important, as many patients present with neurologic signs and symptoms that can be used to reinforce search patterns for disease and detection of supportive radiologic abnormalities. In the case of primary neoplasms, understanding the expected presence of a nerve in the location of a mass can enhance and improve the accuracy of differential diagnoses...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27908742/arthroscopic-arthrodesis-of-the-shoulder-in-brachial-plexus-palsy
#10
Hubert Lenoir, Thomas Williams, Aude Griffart, Cyril Lazerges, Michel Chammas, Bertrand Coulet, Dominique Le Nen
BACKGROUND: Shoulder arthroscopic arthrodesis is an uncommon and non-standardized procedure. Results are poorly evaluated. We describe the findings in 8 patients who underwent shoulder arthroscopic arthrodesis for brachial plexus injury. METHODS: The humeral head and glenoid were excised through standard arthroscopic portals. A Hoffmann external fixator and cannulated screws were used to stabilize the shoulder. Standard clinical assessment and radiographic evaluation were performed each month until bony fusion occurred...
November 28, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27904475/transforming-growth-factor-beta-1-a-cytokine-with-regenerative-functions
#11
REVIEW
Wale Sulaiman, Doan H Nguyen
We review the biology and role of transforming growth factor beta 1 (TGF-β1) in peripheral nerve injury and regeneration, as it relates to injuries to large nerve trunks (i.e., sciatic nerve, brachial plexus), which often leads to suboptimal functional recovery. Experimental studies have suggested that the reason for the lack of functional recovery resides in the lack of sufficient mature axons reaching their targets, which is a result of the loss of the growth-supportive environment provided by the Schwann cells in the distal stump of injured nerves...
October 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/27901254/high-prevalence-of-neuropathic-pain-in-the-hand-of-patients-with-traumatic-brachial-plexus-injury-a-cross-sectional-study
#12
Marcus V B Santana, Mauro T Bina, Matheus G Paz, Scheila N Santos, Manoel J Teixeira, Irina Raicher, José V Martins, Daniel C Araujo Andrade, Abrahão F Baptista
Objective: To describe the pain profile of patients with traumatic brachial plexus injury. Methods: We enrolled 65 patients with traumatic brachial plexus injury. The Douleur Neuropathique 4 questionnaire was used to classify pain and the SF-36 was used to evaluate quality of life. Results: The patients with traumatic brachial plexus injury were predominantly young male victims of motorcycle accidents. Pain was present in 75.4% of the individuals and 79% presented with neuropathic pain, mostly located in the hands (30...
November 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27893490/total-wrist-arthrodesis-indications-and-clinical-outcomes
#13
David H Wei, Paul Feldon
Total wrist arthrodesis remains an important technique in the surgical armamentarium of upper extremity surgeons. The procedure has evolved over time but continues to provide reliable pain relief at the expense of wrist motion. It is indicated for management of a wide variety of upper extremity conditions, including rheumatoid arthritis, posttraumatic osteoarthritis, cerebral palsy, and brachial plexus injuries, and as a salvage technique after failed implant arthroplasty. Recent studies demonstrate high levels of patient satisfaction and good functional outcomes after bilateral wrist fusion...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27891243/a-comprehensive-musculoskeletal-and-peripheral-nervous-system-assessment-of-war-related-bilateral-upper-extremity-amputees
#14
Mostafa Allami, Batool Mousavi, Mehdi Masoumi, Ehsan Modirian, Hadi Shojaei, Fatemeh Mirsalimi, Maryam Hosseini, Pirouz Pirouzi
BACKGROUND: Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation. METHODS: The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb...
2016: Military Medical Research
https://www.readbyqxmd.com/read/27877233/the-impact-of-clinical-stage-on-radiation-doses-to-organs-at-risk-following-intensity-modulated-radiotherapy-in-nasopharyngeal-carcinoma-a-prospective-analysis
#15
Lin Xu, Ji-Jin Yao, Guan-Qun Zhou, Wang-Jian Zhang, Guo-Long Liu, Li-Zhi Liu, Jun Ma, Ying Sun
Background: The development of intensity-modulated radiotherapy (IMRT) has revolutionized the management of nasopharyngeal carcinoma (NPC). The purpose of this study was to investigate the impact of clinical stage on radiation doses to organs at risk (OARs) in NPC. Material and Methods: One hundred and forty-eight patients with newly diagnosed and untreated NPC were prospectively enrolled. Based on the anatomic definition and pathogenesis of radiation induced injury, a total of 28 OARs surrounding the nasopharynx were contoured on axial computed tomography (CT) planning images in each patient...
2016: Journal of Cancer
https://www.readbyqxmd.com/read/27866248/microanatomy-of-the-brachial-plexus-roots-and-its-clinical-significance
#16
Li-Yuan Zhong, Ai-Ping Wang, Li Hong, Sheng-Hua Chen, Xian-Qin Wang, Yun-Cheng Lv, Tian-Hong Peng
PURPOSE: To provide the anatomical basis of brachial plexus roots for the diagnosis and treatment of brachial plexus root avulsion injury. METHODS: The morphological features of brachial plexus roots were observed and measured on 15 cervicothoracic spine of adult cadavers. The relationship of brachial plexus nerve roots and the surrounding tissues also were observed, as well as the blood supply of anterior and posterior roots of the brachial plexus. RESULTS: Origination of the nerve roots in the dorsal-ventral direction from the midline was fine-tuned at each level along the spinal cord...
November 19, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27863697/a-new-model-for-the-study-of-neuropathic-pain-after-brachial-plexus-injury
#17
Yuzhou Liu, Le Wang, Chong Meng, Yingjie Zhou, Jie Lao, Xin Zhao
The study was to introduce a new and reliable behavioral model of upper trunk of brachial plexus avulsion for the study of persistent neuropathic pain. 60 rats were divided into three groups randomly: upper trunk of brachial plexus avulsion (UTBPA) group (20), global brachial plexus avulsion (GBPA) group (20), and sham- operated group (20). The animals were tested for behavioral responsiveness before surgeries and 3, 7, 14, 21, 28, 56, 84days after surgeries. The injured level of spinal cord was resected and the sections were processed for GFAP (astrocyte) and Iba1 (microglia) immunohistochemistry 3 weeks after surgeries...
November 9, 2016: Injury
https://www.readbyqxmd.com/read/27858573/multiple-nerve-and-tendon-transfers-a-new-strategy-for-restoring-hand-function-in-a-patient-with-c7-t1-brachial-plexus-avulsions
#18
Bin Xu, Zhen Dong, Cheng-Gang Zhang, Yu-Dong Gu
C7-T1 brachial plexus palsies result in a loss of finger motion and hand function. The authors have observed that finger flexion motion can be recovered after a brachialis motor branch transfer. However, finger flexion strength after this procedure merely corresponds to Medical Research Council Grades M2-M3, lowering the grip strength and practical value of the reconstructed hand. Therefore, they used 2 donor nerves and accomplished double nerve transfers for stronger finger flexion. In a patient with a C7-T1 brachial plexus injury, they transferred the pronator teres branch to the anterior interosseous nerve and the brachialis motor branch to the flexor digitorum superficialis branch for reinnervation of full finger flexors...
November 18, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27833275/passage-through-the-carotid-sheath-an-alternative-path-to-the-pre-spinal-route-for-direct-repair-of-contralateral-c7-to-the-lower-trunk-in-total-brachial-plexus-root-avulsion-injury
#19
Piyush Bhupendra Doshi, Yogesh Chimanbhai Bhatt
CONTEXT: In surgical management of global brachial plexus injuries, direct repair of contralateral C7 (cC7) to the anterior division of the lower trunk, can produce good extrinsic finger flexion. The pitfalls associated with the pre-spinal passage have, perhaps, proved to be a deterrent for using this technique routinely. AIMS: The aim of this study is to demonstrate an alternative to pre-spinal route for cC7 transfer in brachial plexus avulsion injuries. METHODS: We noted that the mobilised lower trunk, which reaches the level of the scalenus anterior by passage deep to the clavicle, can be brought to the suprasternal notch when brought out from below the clavicle...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27833273/debates-to-personal-conclusion-in-peripheral-nerve-injury-and-reconstruction-a-30-year-experience-at-chang-gung-memorial-hospital
#20
David Chwei-Chin Chuang
Significant progress has been achieved in the science and management of peripheral nerve injuries over the past 40 years. Yet there are many questions and few answers. The author, with 30 years of experience in treating them at the Chang Gung Memorial Hospital, addresses debates on various issues with personal conclusions. These include: (1) Degree of peripheral nerve injury, (2) Timing of nerve repair, (3)Technique of nerve repair, (4) Level of brachial plexus injury,(5) Level of radial nerve injury,(6) Traction avulsion amputation of major limb, (7) Proximal Vs distal nerve transfers in brachial plexus injuries and (8) Post paralysis facial synkinesis...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
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