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Brachial plexus injury

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https://www.readbyqxmd.com/read/28521852/upper-limb-nerve-transfers-a-review
#1
A Forli, M Bouyer, M Aribert, C Curvale, M Delord, D Corcella, F Moutet
While upper limb nerve transfers were first described and performed several years ago, they have seen expanded use in the past 20 years. Initially indicated for surgical repair of brachial plexus injuries with nerve root avulsion, the indications have been extended to post-ganglionic lesions because of the excellent results of certain intraplexus nerve transfers. The traditional nerve repair techniques - primary suture and nerve grafting - form the basis of nerve surgery. Although nerve transfer does not replace them, they are a useful supplement as they provide a targeted approach to reinnervation and recovery of key functions of the upper limb...
June 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28521032/a-neglected-cause-of-iatrogenic-brachial-plexus-injuries-in-psychiatric-patients
#2
José Fernando Guedes-Corrêa, Maristella Reis da Costa Pereira, Francisco José Lourenço Torrão-Junior, José Vicente Martins, Daniel Alves Neiva Barbosa
BACKGROUND: Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). OBJECTIVE: To present a series of 5 psychiatric patients with BPI after being left sedated and restrained for prolonged periods of time during hospitalization. METHODS: We retrospectively reviewed the charts of 5 psychiatric patients with iatrogenic BPI referred by other institutions to our service...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28506157/motor-and-sensory-cortical-changes-after-contralateral-cervical-seventh-nerve-root-cc7-transfer-in-patients-with-brachial-plexus-injuries
#3
Ryosuke Kakinoki, Scott F M Duncan, Ryosuke Ikeguchi, Souichi Ohta, Manabu Nankaku, Hiroshi Sakai, Takashi Noguchi, Yukitoshi Kaizawa, Masao Akagi
BACKGROUND: Previous animal studies demonstrated that the sensory and motor functions in ipsilesional upper limbs that had been reconstructed by CC7 transfer eventually associated with the contralesional brain cortices that had originally mediated the functions of the ipsilesional upper limbs before brachial plexus injury (BPI). Our hypothesis was that the same findings would be seen in humans. METHODS: Four patients with total BPI treated with CC7 transfer were included...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28490272/transfer-of-the-musculocutaneous-nerve-branch-to-the-brachialis-muscle-to-the-triceps-for-elbow-extension-anatomical-study-and-report-of-five-cases
#4
J A Bertelli, F Soldado, M F Ghizoni, A Rodríguez-Baeza
We report the study of the anatomical feasibility of transferring the nerve to the brachialis muscle to the upper medial head motor branch that innervate the triceps, and outcomes of such transfers in restoring elbow extension in five patients with posterior cord lesion of the brachial plexus. The length of the branches to the brachialis muscle measured 7.6 cm and the triceps upper medial head motor branch was 5 cm in 10 adult cadavers. Five male patients were treated with this transfer 5 months after the injury (range 4 to 6 months) after posterior cord injury of the brachial plexus with a mean follow-up of 31 months (range 28 to 36 months)...
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28489913/human-perception-of-electrical-stimulation-on-the-surface-of-somatosensory-cortex
#5
Shivayogi V Hiremath, Elizabeth C Tyler-Kabara, Jesse J Wheeler, Daniel W Moran, Robert A Gaunt, Jennifer L Collinger, Stephen T Foldes, Douglas J Weber, Weidong Chen, Michael L Boninger, Wei Wang
Recent advancement in electrocorticography (ECoG)-based brain-computer interface technology has sparked a new interest in providing somatosensory feedback using ECoG electrodes, i.e., cortical surface electrodes. We conducted a 28-day study of cortical surface stimulation in an individual with arm paralysis due to brachial plexus injury to examine the sensation produced by electrical stimulation of the somatosensory cortex. A high-density ECoG grid was implanted over the somatosensory and motor cortices. Stimulation through cortical surface electrodes over the somatosensory cortex successfully elicited arm and hand sensations in our participant with chronic paralysis...
2017: PloS One
https://www.readbyqxmd.com/read/28488619/peripheral-nerve-injuries-a-retrospective-survey-of-1124-cases
#6
João A Kouyoumdjian, Carla R Graça, Vanessa F M Ferreira
BACKGROUND: Peripheral nerve injuries (PNIs) remain an important health problem often leading to severe motor disabilities predominantly in the younger population. OBJECTIVE: To analyze our experience of clinical and electrodiagnostic evaluation (EDX) of PNIs over a 26-year period. MATERIALS AND METHODS: Between 1989 and 2014, 1124 consecutive patients with 1418 PNIs were referred for clinical as well as EDX evaluation. These PNIs involved upper and lower limbs as well as the facial nerves...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28472739/inter-joint-coordination-analysis-of-reach-to-grasp-kinematics-in-children-and-adolescents-with-obstetrical-brachial-plexus-palsy
#7
Christian H Mayfield, Sahana N Kukke, Sylvain Brochard, Christopher J Stanley, Katharine E Alter, Diane L Damiano
BACKGROUND: Obstetrical brachial plexus palsy is a common birth injury to nerves passing through the brachial plexus that may result in structural and functional abnormalities. Individual joint trajectories from kinematic analyses have been used to evaluate the source and extent of abnormalities. Here, two summary measures of limb kinematics were utilized: 1) the Arm Profile Score summarizing upper limb joint kinematic abnormalities from a typical pattern across a task, and 2) the recently developed Multi-joint Coordination Measure using principal component analysis to characterize typical coordination of multiple joints throughout a task and compute deviations in time and space...
April 25, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28467619/repair-of-the-musculocutaneous-nerve-using-the-vagus-nerve-as-donor-by-helicoid-end-to-side-technique-an-experimental-study-in-rats
#8
Ji-Geng Yan, Feng-Yi Shen, Jacob Thayer, Yuhui Yan, John LoGiudice, Hani Matloub, James Sanger, Lin-Ling Zhang, Robert Havlik
Although several donor nerves can be chosen to repair avulsed brachial plexus nerve injury, available nerves are still limited. The purpose of this study is to validate whether the vagus nerve (VN) can be used as a donor. Eighteen Sprague-Dawley male rats were divided into three groups (n = 6). The right musculocutaneous nerve (McN) was transected with differing subsequent repair. (1) HS-VN group: a saphenous nerve (SN) graft-end was helicoidally wrapped round the VN side (epi-and perineurium was opened) with a 30 ° angle, distal SN end was coapted to the McN with end-to-end repair...
May 3, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28459064/comparison-of-dna-methylation-in-schwann-cells-before-and-after-peripheral-nerve-injury-in-rats
#9
Xian-Hu Zhou, Wei Lin, Yi-Ming Ren, Shen Liu, Bao-You Fan, Zhi-Jian Wei, Gui-Dong Shi, Xin Cheng, Yan Hao, Shi-Qing Feng
This study aims to find the difference of genomewide DNA methylation in Schwann cells (SCs) before and after peripheral nerve system (PNS) injury by Methylated DNA Immunoprecipitation Sequencing (MeDIP-Seq) and seek meaningful differentially methylated genes related to repairment of injured PNS. SCs harvested from sciatic nerve were named as activated Schwann cells (ASCs), and the ones harvested from brachial plexus were named as normal Schwann cells (NSCs). Genomic DNA of ASCs and NSCs were isolated and MeDIP-Seq was conducted...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28458986/erratum-proximal-versus-distal-nerve-transfer-for-biceps-reinnervation-a-comparative-study-in-a-rats-brachial-plexus-injury-model-erratum
#10
(no author information available yet)
[This corrects the article DOI: 10.1097/GOX.0000000000001130.].
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28448306/open-glenohumeral-joint-reduction-and-latissimus-dorsi-and-teres-major-tendon-transfers-for-infants-and-children-following-brachial-plexus-birth-palsy
#11
Joshua M Abzug, Scott H Kozin, Peter M Waters
Glenohumeral dysplasia can occur in brachial plexus birth palsy due to an imbalance of muscle forces. Most commonly this occurs in C5-C6 injuries where the shoulder external rotators are weak compared with the shoulder internal rotators. Treatment of the dysplasia with open reduction of the glenohumeral joint in combination with rebalancing the muscles can improve the development of the joint. Furthermore, the tendon transfer can improve shoulder function by decreasing the internal rotation forces about the shoulder while increasing the external rotation forces...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28445364/n-acetylcysteine-prevents-retrograde-motor-neuron-death-after-neonatal-peripheral-nerve-injury
#12
Joseph Catapano, Jennifer Zhang, David Scholl, Cameron Chiang, Tessa Gordon, Gregory H Borschel
BACKGROUND: Neuronal death may be an overlooked and unaddressed component of disability following neonatal nerve injuries, such as obstetric brachial plexus injury. N-acetylcysteine and acetyl-L-carnitine improve survival of neurons after adult nerve injury, but it is unknown whether they improve survival after neonatal injury, when neurons are most susceptible to retrograde neuronal death. The authors' objective was to examine whether N-acetylcysteine or acetyl-L-carnitine treatment improves survival of neonatal motor or sensory neurons in a rat model of neonatal nerve injury...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#13
Mary Claire B Manske, Jairo J Rios Roque, Gabriel Ramos Zelaya, Michelle A James
Recent reports have demonstrated that nearly two-thirds of the world's population do not have access to adequate surgical care, a burden that is borne disproportionately by residents of resource-poor countries. Although the reasons for limited access to surgical care are complex and multi-factorial, among the most substantial barriers is the lack of trained surgical providers. This is particularly true in surgical subspecialties that focus on life-improving, rather than life-saving, treatments, such as pediatric hand and upper extremity surgery, which manages such conditions as congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy)...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28442854/biceps-rerouting-after-forearm-osteotomy-an-effective-treatment-strategy-for-severe-supination-deformity-in-obstetric-plexus-palsy
#14
W P Metsaars, M Biegstraaten, R G H H Nelissen
Study Design Retrospective cohort study. Objective Supination deformity in obstetric brachial plexus injury can have debilitating consequences for the functionality of the hand. Surgical treatment by a forearm osteotomy has a recurrence rate of 20 to 42%. As a complement to forearm osteotomy, a biceps rerouting may improve outcome. Methods Children with residual brachial plexus injury, who had a forearm osteotomy for a supination contracture and had a postoperative decrease of pronation to 50 degrees or less, were indicated for a biceps rerouting...
April 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28434767/extrarenal-rhabdoid-tumor-presented-with-an-immobile-arm-in-a-one-year-old-boy
#15
Chi-Ting Chung, Yen-Lin Liu, Chien-Jui Cheng, Kevin Li-Chun Hsieh, Min-Lan Tsai, Tai-Tong Wong
Infants with an immobile arm may be easily overlooked in primary care settings. Differential diagnoses include injuries, infections, neuropathies, ischemia and rarely, neoplasms. We report the case of a one-year-old boy with weakness in his left arm after minor trauma with a diagnosis of brachial plexus palsy initially. After rehabilitation for 2months, his weakness progressed to unsteady gait and quadriparesis. MRI revealed a huge solid tumor in the left supraclavicular fossa, which also involved the left brachial plexus, upper thoracic cavity, and left paravertebral space with invasion into the spinal canal...
April 20, 2017: Brain & Development
https://www.readbyqxmd.com/read/28429047/therapeutic-outcome-of-ct-guided-radiofrequency-ablation-in-patients-with-osteoid-osteoma
#16
Louis Lassalle, R Campagna, G Corcos, A Babinet, F Larousserie, J Stephanazzi, A Feydy
OBJECTIVE: To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO). MATERIALS AND METHODS: Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications...
July 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28428928/origin-branching-and-communications-of-the-intercostobrachial-nerve-a-meta-analysis-with-implications-for-mastectomy-and-axillary-lymph-node-dissection-in-breast-cancer
#17
REVIEW
Brandon Michael Henry, Matthew J Graves, Jakub R Pękala, Beatrice Sanna, Wan Chin Hsieh, R Shane Tubbs, Jerzy A Walocha, Krzysztof A Tomaszewski
The intercostobrachial nerve (ICBN), which usually originates from the lateral cutaneous branch of the second intercostal nerve, innervates areas of the axilla, lateral chest, and medial arm. It is at risk for injury during operative procedures that are often used in the management of breast cancer and such injury has been associated with postoperative sensory loss and neuropathic pain, decreasing the quality of life. PubMed, Excerpta Medica Database (EMBASE), ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SciELO), Biosciences Information Service (BIOSIS), and Web of Science were searched comprehensively...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28426263/using-contingent-reinforcement-to-augment-muscle-activation-after-perinatal-brachial-plexus-injury-a-pilot-study
#18
S V Duff, B Sargent, J J Kutch, J Berggren, B E Leiby, L Fetters
AIM: Examine the feasibility of increasing muscle activation with electromyographically (EMG)-triggered musical-video as reinforcement for children with perinatal brachial plexus injury (PBPI). METHODS: Six children with PBPI (9.3 ± 6.3 months; 5 female, 1 male) and 13 typically developing (TD) controls (7.8 ± 3.5 months; 4 female, 9 males) participated. The left arm was affected in 5/6 children with PBPI. We recorded the integral (Vs) of biceps activation with surface EMG during two conditions per arm in one session: (1) 100 second (s) baseline without reinforcement and (2) 300 s reinforcement (musical-video triggered to play with biceps activation above threshold [V])...
April 20, 2017: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/28412188/patterns-of-brachial-plexus-stretch-palsy-in-a-prospective-series-of-565-surgically-treated-patients
#19
Jayme A Bertelli, Marcos F Ghizoni, Francisco Soldado
PURPOSE: To report the distribution of the different patterns of stretch brachial plexus injuries (BPIs) in a retrospective cohort of patients operated at our institution during an 11-year period. METHODS: From September 2002 to June 2012, we evaluated and operated on 565 patients with traction injuries of the brachial plexus. Average age was 26.8 years (SD ±9.3 years); the interval between the injury and surgery was 5.4 months (SD ±2.8 months). The pattern of injury was defined based on data obtained from a standardized clinical examination, preoperative helical computed tomography myelography after intradural contrast injection, surgical findings, and intraoperative electric stimulation...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#20
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
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