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Brachial plexus injury

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https://www.readbyqxmd.com/read/29745256/salvage-of-cervical-motor-radiculopathy-using-peripheral-nerve-transfer-reconstruction
#1
Fardad T Afshari, Taushaba Hossain, Caroline Miller, Dominic M Power
PURPOSE: Motor nerve transfer surgery involves re-innervation of important distal muscles using either an expendable motor branch or a fascicle from an adjacent functioning nerve. This technique is established as part of the reconstructive algorithm for traumatic brachial plexus injuries. The reproducible outcomes of motor nerve transfer surgery have resulted in exploration of the application of this technique to other paralysing conditions. The objective of this study is to report feasibility and increase awareness about nerve transfer as a method of improving upper limb function in patients with cervical motor radiculopathy of different aetiology...
May 10, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29738402/is-first-rib-fracture-a-culprit-or-a-sign-of-injury-severity-it-is-both
#2
Alexander Fokin, Joanna Wycech, Eric Picard, Russell Weisz, Ivan Puente
OBJECTIVES: First rib fractures (1 RFX) have been correlated with increased morbidity and mortality. Whether this is due to the fracture of the rib itself or due to an increased number of associated injuries remains debatable. DESIGN: Retrospective cohort study SETTING:: Level 1 trauma center PATIENTS:: 1089 patients with rib fractures divided into 3 groups: Group A (n=44) with isolated 1 RFX, Group B (n=116) with 1 RFX combined with other rib fractures, and Group C (n=929) with rib fractures without 1 RFX...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29737380/the-zonal-pattern-of-arterial-supply-to-the-brachial-plexus-and-its-clinical-significance
#3
An-Bo Gao, Yun-Cheng Lv, Ai-Ping Wang, Li-Yuan Zhong, Mao-Lin Tang, Binu-Prathap Thomas, Tian-Hong Peng
PURPOSE: To provide the anatomical basis of blood supply of brachial plexus for the clinical microsurgical treatment of brachial plexus injury. METHODS: Thirteen adult anticorrosive cadaveric specimens (8 males, 5 females) were dissected in this study. 3 fresh cases (2 males, 1 female) were used to observe the zonal pattern of arteries supplying brachial plexus, and 10 cases (6 males, 4 females) were used to observe the source and distribution of the brachial plexus arteries under microscope...
May 8, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29734894/-in-situ-vascular-nerve-graft-for-restoration-of-intrinsic-hand-function-an-anatomical-study
#4
Kamran Mozaffarian, Hamid Reza Zemoodeh, Mohammad Zarenezhad, Mohammad Owji
BACKGROUND: In combined high median and ulnar nerve injury, transfer of the posterior interosseous nerve branches to the motor branch of the ulnar nerve (MUN) is previously described in order to restore intrinsic hand function. In this operation a segment of sural nerve graft is required to close the gap between the donor and recipient nerves. However the thenar muscles are not innervated by this nerve transfer. The aim of the present study was to evaluate whether the superficial radial nerve (SRN) can be used as an "in situ vascular nerve graft" to connect the donor nerves to the MUN and the motor branch of median nerve (MMN) at the same time in order to address all denervated intrinsic and thenar muscles...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29734889/oberlin-s-transfer-long-term-outcomes
#5
Karlis Verdins, Martins Kapickis
BACKGROUND: Brachial plexus injury is very commonly associated with road traffic accidents, and frequently affects young adults, causing significant disability and impact on quality of life. The successful treatment of upper plexus injury with the Oberlin technique to restore elbow flexion with good functional results. METHODS: We retrieved the records of all patients with upper plexus injury who underwent Oberlin transfer operation between March 2007 and July 2012...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29710183/an-update-on-the-management-of-neonatal-brachial-plexus-palsy-replacing-old-paradigms-a-review
#6
Brandon W Smith, Alecia K Daunter, Lynda J-S Yang, Thomas J Wilson
Importance: Neonatal brachial plexus palsy (NBPP) can result in persistent deficits for those who develop it. Advances in surgical technique have resulted in the availability of safe, reliable options for treatment. Prevailing paradigms include, "all neonatal brachial plexus palsy recovers," "wait a year to see if recovery occurs," and "don't move the arm." Practicing by these principles places these patients at a disadvantage. Thus, the importance of this review is to provide an update on the management of NBPP to replace old beliefs with new paradigms...
April 30, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29707457/lateral-branch-of-the-thoracodorsal-nerve-lat-branch-transfer-for-biceps-reinnervation
#7
M Asher Schusterman, Rishi Jindal, Jignesh V Unadkat, Alexander M Spiess
In cases of significant upper extremity trauma, the thoracodorsal nerve is a reliable secondary option for the restoration of elbow flexion. In all previous descriptions, however, the entire nerve is transferred. We describe a case utilizing the lateral thoracodorsal nerve (LaT) branch for biceps reinnervation with an associated cadaver study. Transfer of the LaT branch to the biceps branch was performed on a patient who had sustained a traumatic brachial plexus injury that left him without elbow flexion. Also, 4 cadavers (8 upper extremities) were dissected to identify the bifurcation of the thoracodorsal nerve and confirm the feasibility of transferring the LaT branch to the biceps motor branch...
March 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29705086/transaxillary-decompression-of-thoracic-outlet-syndrome-patients-presenting-with-cervical-ribs
#8
Hugh A Gelabert, David A Rigberg, Jessica B O'Connell, Sinan Jabori, Juan Carlos Jimenez, Steven Farley
OBJECTIVE: The transaxillary approach to thoracic outlet decompression in the presence of cervical ribs offers the advantage of less manipulation of the brachial plexus and associated nerves. This may result in reduced incidence of perioperative complications, such as nerve injuries. Our objective was to report contemporary data for a series of patients with thoracic outlet syndrome (TOS) and cervical ribs managed through a transaxillary approach. METHODS: We reviewed a prospectively maintained database for all consecutive patients who underwent surgery for TOS and who had a cervical rib...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29690828/evidence-for-increased-mri-signal-intensity-and-morphological-changes-in-the-brachial-plexus-and-median-nerves-of-patients-with-chronic-arm-and-neck-pain-following-whiplash-injury
#9
Jane Greening, Kamakshi Anantharaman, Rupert Young, Andrew Dilley
Study Design Cross-sectional study. Background Whiplash following a motor vehicle accident can result in chronic neck and arm pain. Patients frequently present with cutaneous hypersensitivities and hypoesthesia but without obvious clinical sign of nerve injury. T2-weighted magnetic resonance imaging (MRI) has previously been used to identify nerve pathology. Objectives To determine whether there are signs of peripheral nerve pathology on MRI in patients with chronic arm and neck pain following whiplash injury...
April 24, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29678427/the-psychological-impact-of-adult-traumatic-brachial-plexus-injury
#10
Zoe A Landers, Rishabh Jethanandani, Steve K Lee, Carol A Mancuso, Mavis Seehaus, Scott W Wolfe
PURPOSE: There is a high incidence of posttraumatic stress disorder (PTSD), depression, suicide risk, and psychological distress after orthopedic trauma and hand and upper-extremity injury. Although patients with traumatic adult brachial plexus injury are particularly vulnerable to psychologic distress, minimal clinical data exist about this cohort of patients. In this study, we sought to discover the prevalence of depression, PTSD, suicidal ideation, and substance abuse. METHODS: Between February, 2013 and July, 2014, during scheduled preoperative and/or postoperative appointments, the social worker at a metropolitan brachial plexus center conducted psychosocial assessments and questionnaire assessments of 21 patients evaluating for PTSD, depression, and substance use using 3 validated scales: PTSD Checklist-Specific, Patient Health Questionnaire-8, and National Institute on Drug Abuse Quick Screen...
April 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29657936/cellular-therapy-for-chronic-traumatic-brachial-plexus-injury
#11
Alok Sharma, Hemangi Sane, Nandini Gokulchandran, Prerna Badhe, Suhasini Pai, Pooja Kulkarni, Jayanti Yadav, Sanket Inamdar
Cellular therapy is being actively pursued as a therapeutic modality in many of the neurological diseases. A variety of stem cells from diverse sources have been studied in detail and have been shown to exhibit angiogenetic and immunomodulatory properties in addition to other neuroprotective effects. Published clinical data have shown bone marrow mononuclear cell (BMMNC) injection in neurological disorders is safe and possesses regenerative potential. We illustrate a case of 27-year-old male with traumatic brachial plexus injury, administered with autologous BMMNCs intrathecally and intramuscularly, followed by multidisciplinary rehabilitation...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29650376/trapezius-muscle-transfer-for-restoration-of-elbow-extension-in-a-traumatic-brachial-plexus-injury
#12
Hamza M Alrabai, Martin G Gesheff, Ahmed I Hammouda, Janet D Conway
Voluntary elbow extension is essential for optimal upper limb positioning required for daily living activities, particularly above-shoulder maneuvers. The authors present a case of traumatic brachial plexus injury in which paralysis of the musculature selectively supplied by the posterior cord was based on magnetic resonance imaging and nerve conduction studies. An attempt at a radial nerve graft at another center was not effective. Ipsilateral hand function improved after multiple local tendon transfers were performed...
April 9, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29623932/evaluation-of-nerve-transfer-options-for-treating-total-brachial-plexus-avulsion-injury-a-retrospective-study-of-73-participants
#13
Kai-Ming Gao, Jing-Jing Hu, Jie Lao, Xin Zhao
Despite recent great progress in diagnosis and microsurgical repair, the prognosis in total brachial plexus-avulsion injury remains unfavorable. Insufficient number of donors and unreasonable use of donor nerves might be key factors. To identify an optimal treatment strategy for this condition, we conducted a retrospective review. Seventy-three patients with total brachial plexus avulsion injury were followed up for an average of 7.3 years. Our analysis demonstrated no significant difference in elbow-flexion recovery between phrenic nerve-transfer (25 cases), phrenic nerve-graft (19 cases), intercostal nerve (17 cases), or contralateral C7 -transfer (12 cases) groups...
March 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29618870/a-simple-technique-for-temporary-marking-of-the-electrical-stimulation-points-in-brachial-plexus-injury-patients
#14
Karan Rajiv Choudhry, Hari Venkatramani, S Raja Sabapathy
No abstract text is available yet for this article.
September 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29618095/case-report-double-oberlin-nerve-transfer-to-restore-elbow-flexion-following-c5-c6-avulsion-injury
#15
Michael J Moses, Amoz Z Dai, Dylan T Lowe, Alice Chu, Themistocles S Protopsaltis
BACKGROUND AND IMPORTANCE: The use of nerve transfers to restore nerve function following traumatic avulsion injuries has been described, though there is still a paucity in the literature documenting technique and long-term outcomes for these procedures. The double Oberlin nerve transfer involves transferring fascicles from the median and ulnar nerves to the musculocutaneous nerve to restore elbow flexion in patients with a C5-C6 avulsion injury. The purpose of this case report is to present our indications and technique for a double Oberlin transfer in addition to exhibiting video footage at follow-up time points documenting the incremental improvement in elbow flexion following the injury...
April 2, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29605951/future-perspectives-in-the-management-of-nerve-injuries
#16
Susan E Mackinnon
AIM:  The author presents a solicited "white paper" outlining her perspective on the role of nerve transfers in the management of nerve injuries. METHODS:  PubMed/MEDLINE and EMBASE databases were evaluated to compare nerve graft and nerve transfer. An evaluation of the scientific literature by review of index articles was also performed to compare the number of overall clinical publications of nerve repair, nerve graft, and nerve transfer. Finally, a survey regarding the prevalence of nerve transfer surgery was administrated to the World Society of Reconstructive Microsurgery (WSRM) results...
April 1, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29605518/shoulder-arthroplasty-for-sequelae-of-obstetrical-brachial-plexus-injury
#17
Jean-David Werthel, Bradley Schoch, Mark Frankle, Robert Cofield, Bassem T Elhassan
PURPOSE: Shoulder arthroplasty following obstetrical brachial plexus injury (OBPI) is technically challenging because glenoid morphology, muscle balance, and humeral version are substantially altered compared with the neurologically intact shoulder. The purpose of this study is to report the outcome of shoulder arthroplasty in a group of patients with end-stage arthritis secondary to OBPI. MATERIALS AND METHODS: Seven patients with OBPI and secondary glenohumeral arthritis were treated with shoulder arthroplasty between 1976 and 2014...
March 29, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29596309/risk-factors-for-brachial-plexus-birth-injury
#18
Emily Louden, Michael Marcotte, Charles Mehlman, William Lippert, Bin Huang, Andrea Paulson
Over the course of decades, the incidence of brachial plexus birth injury (BPBI) has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations...
March 29, 2018: Children
https://www.readbyqxmd.com/read/29595730/recovery-of-elbow-flexion-after-nerve-reconstruction-versus-free-functional-muscle-transfer-for-late-traumatic-brachial-plexus-palsy-a-systematic-review
#19
Don Hoang, Vivi W Chen, Mitchel Seruya
BACKGROUND: In late presentation of brachial plexus trauma, it is unclear whether donor nerves should be devoted to nerve reconstruction or reserved for free functional muscle transfer. The authors systematically reviewed recovery of elbow flexion after nerve reconstruction versus free functional muscle transfer for late, traumatic brachial plexus palsy. METHODS: A systematic review was performed using the PubMed, Embase, and Cochrane databases to identify all cases of traumatic brachial plexus palsy in patients aged 18 years or older...
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29570722/thoracic-dysfunction-in-whiplash-associated-disorders-a-systematic-review
#20
Nicola R Heneghan, Richard Smith, Isaak Tyros, Deborah Falla, Alison Rushton
BACKGROUND: Research investigating Whiplash Associated Disorder (WAD) has largely focused on the cervical spine yet symptoms can be widespread. Thoracic spine pain prevalence is reported ~66%; perhaps unsurprising given the forceful stretch/eccentric loading of posterior structures of the spine, and the thoracic spine's contribution to neck mobility/function. Approximately 50% WAD patients develop chronic pain and disability resulting in high levels of societal and healthcare costs. It is time to look beyond the cervical spine to fully understand anatomical dysfunction in WAD and provide new directions for clinical practice and research...
2018: PloS One
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