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Brachial plexus injury

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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
#1
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
#2
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...
December 2, 2016: 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
#3
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
#4
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
#5
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
#6
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...
November 22, 2016: 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27830921/post-operative-physical-therapy-program-for-latissimus-dorsi-and-teres-major-tendons-transfer-to-rotator-cuff-in-children-with-obstetrical-brachial-plexus-injury
#14
Yasser A Safoury, Mohamed Eldesoky, Enas E Abutaleb, Mohamed Raafat, Ahmed M Gaber
BACKGROUND: The transfer latissimus dorsi and teres major tendons to rotator cuff have been developed to rebalance the muscular dysfunction and improve shoulder range of motion in children with obstetrical brachial plexus palsy (OBPP). No previous study reported the ideal postoperative physical therapy program for these cases. AIM: The aim of the present study was to design appropriate postoperative physical therapy (PT) program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP to improve upper limb function...
November 10, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27830483/variations-in-the-innervation-of-the-long-head-of-the-triceps-brachii-a-cadaveric-investigation
#15
Alexandra J Erhardt, Bennett Futterman
BACKGROUND: Some leading anatomy texts state that all three heads of the triceps brachii are innervated by the radial nerve. The posterior cord of the brachial plexus bifurcates to terminate as the radial and axillary nerves. Studies have noted the presence of axillary innervation to the long head of the triceps brachii muscle, patterns different from the classic exclusive radial nerve supply. An understanding of these variations may assist the clinician in the assessment of shoulder weakness and in preoperative and operative planning of radial and axillary neuropathies...
November 9, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27824736/free-functional-muscle-transfer-tendon-insertion-secondary-advancement-procedure-to-improve-elbow-flexion
#16
Sreedharan Sechachalam, Anne O'Byrne, Anthony MacQuillan
One method of restoring elbow flexion in patients with brachial plexus injuries is through the use of free functional muscle transfer. Most of our patients achieve good outcome, resulting in improved usefulness of the affected limb. However, a minority of our patients have successful reinnervation of the transferred muscle but with a suboptimal strength and range of motion (ROM) of elbow flexion. In this subset of patients, we perform a secondary procedure to improve the moment arm of the muscle on the elbow joint...
November 7, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27823370/peripheral-neuropathy-of-a-forelimb-in-horses-27-cases-2000-2013
#17
Anne-Laure Emond, Lélia Bertoni, Maeva Seignour, Virginie Coudry, Jean-Marie Denoix
OBJECTIVE To describe the clinical features, diagnostic procedures, management, and outcome of horses with peripheral neuropathy of a forelimb. DESIGN Retrospective case series. ANIMALS 27 horses. PROCEDURES Records from 2000 to 2013 were reviewed to identify horses with peripheral neuropathy of a forelimb. Horses were grouped as having predominant lesions of a suprascapular nerve, axillary nerve, or radial nerve (alone or in association with other brachial plexus nerves) on the basis of physical examination and diagnostic imaging findings...
November 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27819420/effect-of-co-morbid-conditions-on-persistent-neuropathic-pain-after-brachial-plexus-injury-in-adult-patients
#18
Asish Subedi, Pongparadee Chaudakshetrin, Haruthai Chotisukarat, Sahatsa Mandee
BACKGROUND AND PURPOSE: Neuropathic pain (NeuP) associated with traumatic brachial plexus injury (BPI) can be severe, persistent, and resistant to treatment. Moreover, comorbidity associated with NeuP may worsen the pain and quality of life. This study compared persistent NeuP after BPI between patients with and without co-morbid conditions (psychiatric dysfunction and other painful conditions) and tramadol usage as a second-line agent in combination with an antiepileptic and/or antidepressant during a 2-year follow-up...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27812060/upper-limb-birth-trauma-in-a-jordanian-population-a-prospective-study-at-king-hussein-medical-centre-amman-jordan
#19
Firas Ahmad Suleiman, Ala Awwad Almaaitah, Hashim Ezzat Aqrabawi
OBJECTIVE: To determine the incidence of and the main risk factors related to upper limb injury at birth. METHODS: This prospective study was conducted at the King Hussein Medical Centre, Amman, Jordan, from October 2014 to May 2015, and comprised newborns. The probable predisposing factors for upper limb birth injury and their relation to injury were analysed. SPSS 17 was used for data analysis. RESULTS: Of the 5,030 live births, 5,003(99...
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27803228/a-quantitative-assessment-of-the-functional-recovery-of-flexion-of-the-elbow-after-nerve-transfer-in-patients-with-a-brachial-plexus-injury
#20
T J Quick, A K Singh, M Fox, M Sinisi, A MacQuillan
AIMS: Improvements in the evaluation of outcome after nerve transfers are required. The assessment of force using the Medical Research Council (MRC) grades (0 to 5) is not suitable for this purpose. A ceiling effect is encountered within MRC grade 4/5 rendering this tool insensitive. Our aim was to show how the strength of flexion of the elbow could be assessed in patients who have undergone a re-innervation procedure using a continuous measurement scale. METHODS: A total of 26 patients, 23 men and three women, with a mean age of 37...
November 2016: Bone & Joint Journal
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