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Plexus palsy

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
B Salazard, C Philandrianos, B Tekpa
"Palsy of the upper limb" in children includes various diseases which leads to hypomobility of the member: cerebral palsy, arthrogryposis and obstetrical brachial plexus palsy. These pathologies which differ on brain damage or not, have the same consequences due to the early achievement: negligence, stiffness and deformities. Regular entire clinical examination of the member, an assessment of needs in daily life, knowledge of the social and family environment, are key points for management. In these pathologies, the rehabilitation is an emergency, which began at birth and intensively...
October 2016: Annales de Chirurgie Plastique et Esthétique
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
Christelle Pons, Dinomais Mickael, Franck Fitoussi, Marie-Charlotte D'Anjou, Mélanie Porte, Emilie Rumilly, Nathaly Quintero, Philippe Violas, Sylvain Brochard
OBJECTIVE: In children with obstetrical brachial plexus palsy (OBPP), shoulder musculoskeletal deformity is the main cause of morbidity, with a loss of range of shoulder motion, pain and a reduction in social participation. Some uncontrolled studies show that early injections of botulinum toxin (BTI) in the internal shoulder rotator muscles (which cause the deformity) are one of the most promising treatments for the prevention of bony deformity. The main objective of this study will be the evaluation of the effectiveness of BTI in the internal shoulder rotator muscles at the age of 6 months in preventing an increase in posterior subluxation of the glenohumeral joint in babies with OBPP (evaluated at the ages of 5 and 12 months), compared with a placebo...
September 2016: Annals of Physical and Rehabilitation Medicine
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
Alexa Dierig, Nicole Ritz, Uta Tacke, Ulrich Heininger
Osteoarticular infections in the newborn period are rare. A serious complication is paralysis of the affected extremity resulting from either pain or direct involvement of the nerve. We report a newborn with combined osteomyelitis and suppurative arthritis caused by Streptococcus pyogenes presenting with right brachial plexus palsy.
October 2016: Pediatric Infectious Disease Journal
B J Duijnisveld, D Steenbeek, R G H H Nelissen
PURPOSE: The objective of this study was to evaluate the effectiveness of serial casting of elbow flexion contractures in neonatal brachial plexus palsy. METHODS: A prospective consecutive cohort study was performed with a median follow-up of 5 years. Forty-one patients with elbow flexion contractures ≥ 30° were treated with serial casting until the contracture was ≤ 10°, for a maximum of 8 weeks. Range of motion, number of recurrences and patient satisfaction were recorded and analyzed using Wilcoxon signed-rank and Cox regression tests...
September 2, 2016: Journal of Pediatric Rehabilitation Medicine
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
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
Stephanie A Russo, Luisa M Rodriguez, Scott H Kozin, Dan A Zlotolow, Ross S Chafetz, Carolyn M Killelea, Kristen F Nicholson, James G Richards
OBJECTIVE: In this study, we aimed to assess whether therapeutic taping for scapular stabilization affected scapulothoracic, glenohumeral, and humerothoracic joint function in children with brachial plexus birth palsy and scapular winging. METHOD: Motion capture data were collected with and without therapeutic taping to assist the middle and lower trapezius in seven positions for 26 children. Data were compared with one-way multivariate analyses of variance. RESULTS: With therapeutic taping, scapular winging decreased considerably in all positions except abduction...
September 2016: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
B A Ghanghurde, R Mehta, K M Ladkat, B B Raut, M R Thatte
UNLABELLED: The purpose of this study was to examine the results of spinal accessory nerve to suprascapular nerve (with or without axillary nerve neurotization) and an Oberlin transfer as primary treatment in children with Narakas type I obstetric brachial plexus injuries, when parents refused to consent to conventional nerve trunk-/root-level reconstruction. A total of 20 children with poor shoulder abduction and no biceps antigravity function but with good hand function were treated with spinal accessory nerve to suprascapular nerve and an Oberlin transfer at a mean age of 5...
October 2016: Journal of Hand Surgery, European Volume
Kate W-C Chang, Amy Austin, Jan Yeaman, Lauren Phillips, Anna Kratz, Lynda J-S Yang, Noelle E Carlozzi
BACKGROUND: Currently, no published, validated patient reported outcome (PRO) measures of health-related quality of life (HRQOL) exist for use with neonatal brachial plexus palsy (NBPP). NBPP is a debilitating condition occurring during the perinatal period resulting in paralysis/paresis and loss of sensation in the affected arm. Commonly used NBPP measures are not comprehensive and do not fully account for clinically meaningful changes in function or progression of the disorder. OBJECTIVE: To evaluate important components of HRQOL for children with NBPP and identify where new PRO measures are needed...
August 9, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Menno van der Holst, Duco Steenbeek, Willem Pondaag, Rob G H H Nelissen, Thea P M Vliet Vlieland
BACKGROUND: To investigate whether parents perceive impact of neonatal brachial plexus palsy on family and quality of life and upper extremity functioning in children less than 2.5 years. METHODS: This cross-sectional study used the PedsQL Family Impact Module (36 items/one total/four scales/scores 0 to 100), TNO-AZL (Dutch Organisation of Applied Natural Science and Academic Hospital Leiden) Preschool Children Quality of Life (43 items/12 scales/scores 0 to 100) and 21 upper extremity functioning questions...
September 2016: Pediatric Neurology
Francisco Abaete Chagas-Neto, Vitor Faeda Dalto, Michel Daoud Crema, Peter M Waters, Everaldo Gregio-Junior, Nilton Mazzer, Marcello Henrique Nogueira-Barbosa
OBJECTIVE: To assess imaging parameters related to the morphology of the glenohumeral joint in children with unilateral brachial plexus birth palsy (BPBP), in comparison with those obtained for healthy shoulders. MATERIALS AND METHODS: We conducted a retrospective search for cases of unilateral BPBP diagnosed at our facility. Only patients with a clinical diagnosis of unilateral BPBP were included, and the final study sample consisted of 10 consecutive patients who were assessed with cross-sectional imaging...
May 2016: Radiologia Brasileira
Sambeet Patra, Jayakrishnan K Narayana Kurup, Ashwath M Acharya, Anil K Bhat
A 5-year-old child presented to us with weakness of the left upper limb since birth. With the given history of obstetric trauma and limb examination, a diagnosis of birth brachial plexus palsy was made. Brachial plexus exploration along with microsurgery was performed at the same time which included extrinsic neurolysis of the roots and trunks and nerve transfer for better shoulder external rotation and elbow flexion. Both the movements were severely restricted previously due to co-contractures with the shoulder internal rotators and triceps...
2016: BMJ Case Reports
Shokei Yamada, Russell R Lonser, Daniel J Won, Bryan E Tsao
INTRODUCTION: Previously, the authors presented the coaptation of C3 and C4 primary rami to one of brachial plexus trunks to regain function from cervical root avulsion-caused paralysis. The purpose of this presentation is 2-fold: (1) discuss specific surgical techniques and (2) discuss control or prevention of intractable pain associated with root avulsion. METHODS: (1) The surgical procedure consists of exposure of C3 and C4 anterior rami coaptation to the upper trunk (Erb-Duchenne) or lower trunk (Klumpke), with sural nerve bridge graft, and additionally intercostal nerve coaptation to median and ulnar nerves for flail arm...
August 2016: Neurosurgery
Filippo M Senes, Nunzio Catena, Emanuela Dapelo, Jacopo Senes
No abstract text is available yet for this article.
May 2016: Annals of the Academy of Medicine, Singapore
Mohammadreza Emamhadi, Babak Alijani, Sasan Andalib
BACKGROUND: For the reconstruction of brachial plexus lesions, restoration of elbow flexion and shoulder function is fundamental and is achieved by dual nerve transfers. Shoulder stabilization and movement are crucial in freedom of motion of the upper extremity. In patients with C5-C6 brachial plexus injury, spinal accessory nerve transfer to the suprascapular nerve and a fascicle of ulnar nerve to musculocutaneous nerve (dual nerve transfer) are carried out for restoration of shoulder abduction and elbow flexion, respectively...
September 2016: Acta Neurochirurgica
Lei Zhang, Zhen Dong, Chun-Lin Zhang, Yu-Dong Gu
Background C7 - T1 palsy results in complete loss of finger motion and poses a surgical challenge. This study investigated the anatomy of the radial nerve in the elbow and forearm and the feasibility of intraplexus nerve transfer to restore thumb and finger extension. Methods The radial nerves were dissected in 28 formalin-fixed upper extremities. Branching pattern, length, diameter, and number of myelinated fibers were recorded. Results Commonly, the branching pattern (from proximal to distal) was to the brachioradialis, extensor carpi radialis longus, superficial sensory proximal to the lateral epicondyle, extensor carpi radialis brevis, supinator, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis distal to the lateral epicondyle...
June 28, 2016: Journal of Reconstructive Microsurgery
Christian T Bonde, Lisa Toft Jensen, Tina Tos, Birgitte Jul Kiil, Gete Ester Toft, Søren Erik Larsen, Peter Birkeland, Jens Ahm Sørensen
Microsurgery is defined as surgery performed with the aid of ocular magnification. In Denmark, this is undertaken by four units. This review describes the history of microsurgery which evolved during the 1960s. Microsurgery in hand surgery is primarily replantation and revascularisation but also peripheral nerve surgery as well as brachial plexus surgery. Lymphoedema is being treated with super microsurgery on an experimental basis. Dynamic reconstruction of facial palsy is performed in a two-stage operation with cross-over nerve graft and a free microvascular muscle flap, typically gracilis...
June 6, 2016: Ugeskrift for Laeger
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