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Plexus palsy

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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
#1
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...
April 26, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#2
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
#3
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
#4
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/28419287/prediction-algorithm-for-surgical-intervention-in-neonatal-brachial-plexus-palsy
#5
Thomas J Wilson, Kate W C Chang, Lynda J S Yang
BACKGROUND: Neonatal brachial plexus palsy (NBPP) results in reduced function of the affected arm with profound ramifications on quality of life. Advances in surgical technique have shown improvements in outcomes for appropriately selected patients. Patient selection, however, remains difficult. OBJECTIVE: To develop a decision algorithm that could be applied at the individual patient level, early in life, to reliably predict persistent NBPP that would benefit from surgery...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28413272/an-analysis-of-perioperative-adverse-neurological-events-associated-with-anesthetic-management-at-a-tertiary-care-center-of-a-developing-country
#6
Fauzia Anis Khan, Sobia Khan, Gauhar Afshan
BACKGROUND AND AIMS: Existing literature on neurological complications related to anesthesia is reported from affluent countries but the trends may vary in less affluent countries. MATERIAL AND METHODS: The objective was to find the associated factors contributing to neurological adverse events occurring within 48 h of anesthesia and surgery. The existing departmental morbidity and mortality database was reviewed from 1992 to 2012 for major adverse neurological events...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412188/patterns-of-brachial-plexus-stretch-palsy-in-a-prospective-series-of-565-surgically-treated-patients
#7
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/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#8
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28394871/triplanar-humeral-osteotomy-for-restoration-of-midline-function-in-patients-with-brachial-plexus-birth-palsy
#9
John D Jennings, Dustin A Greenhill, Scott H Kozin, Dan A Zlotolow
Brachial plexus birth palsy resolves spontaneously in a majority of patients, however, others may have serious permanent dysfunction. Although nerve transfers or grafts are early options for treatment, many children have residual deficits or present too late for such procedures. In these patients, rotational osteotomy of the humerus may restore improved function and motion. Unfortunately, traditional humeral osteotomies only provide correction in a single plane, therefore appropriate correction of the typical residual deformity is incomplete...
April 7, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28387564/reliability-of-functioning-free-muscle-transfer-and-vascularized-ulnar-nerve-grafting-for-elbow-flexion-in-complete-brachial-plexus-palsy
#10
S M Potter, S I Ferris
We compared outcomes of primary vascularized ulnar nerve grafts from the C5 root neurotizing biceps and brachialis muscles, and gracilis functioning free muscle transfer neurotized by the distal spinal accessory nerve, as a primary or salvage procedure after complete brachial plexus injury. At 45 months, three of eight primary vascularized ulnar nerve graft patients regained grade 4 elbow flexion, while one regained grade 3. All 13 primary gracilis transfer patients regained grade 4 elbow flexion. Four patients with vascularized ulnar nerve grafts failed and subsequently had salvage functioning free muscle transfer procedures resulting in delayed recovery...
April 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28362958/outcomes-of-transferring-a-healthy-motor-fascicle-from-the-radial-nerve-to-a-branch-for-the-triceps-to-recover-elbow-extension-in-partial-brachial-plexus-palsy
#11
Leandro Pretto Flores
BACKGROUND: Triceps reinnervation is an important objective to pursue when repairing the brachial plexus for cases with upper roots injuries, and a number of different techniques have been developed in order to restore elbow extension in such cases. OBJECTIVE: To demonstrate the surgical outcomes associated with the technique of transferring a single healthy motor fascicle from the radial nerve of the affected arm to a branch innervating 1 of the 3 heads of the triceps...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28362931/outcome-of-finger-extension-after-nerve-transfer-to-repair-c7-t1-brachial-plexus-palsy-in-rats-comparative-study-of-the-supinator-motor-branch-transfer-to-the-posterior-interosseous-nerve-and-the-contralateral-c7-transfer-to-the-lower-trunk
#12
Lei Zhang, Chun-Lin Zhang, Zhen Dong, Yu-Dong Gu
BACKGROUND: Functional recovery following supinator motor branch transfer requires further investigation. OBJECTIVE: To compare the outcome of finger extension after supinator motor branch transfer or contralateral C7 (cC7) transfer in C7-T1 brachial plexus palsies in rats. METHODS: In this study, 120 adult rats underwent C7-T1 nerve root avulsion and received different nerve transfer repairs: group A, cC7 nerve transfer to the lower trunk; group B, supinator motor branch nerve transfer to the posterior interosseous nerve (PIN); and group C, no repair...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28356671/brachial-plexus-compression-due-to-subclavian-artery-pseudoaneurysm-from-internal-jugular-vein-catheterization
#13
T N Mol, A Gupta, U Narain
Internal jugular vein (IJV) catheterization has become the preferred approach for temporary vascular access for hemodialysis. However, complications such as internal carotid artery puncture, vessel erosion, thrombosis, and infection may occur. We report a case of brachial plexus palsy due to compression by right subclavian artery pseudoaneurysm as a result of IJV catheterization in a patient who was under maintenance hemodialysis.
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28350557/double-versus-single-tendon-transfers-to-improve-shoulder-function-in-brachial-plexus-birth-palsy
#14
Dustin A Greenhill, William R Smith, F V Ramsey, Scott H Kozin, Dan A Zlotolow
BACKGROUND: In children with brachial plexus birth palsy (BPBP) undergoing tendon transfers to augment shoulder external rotation, it is unclear whether transfer of the latissimus dorsi with its combined latissimus dorsi and teres major (cLT) versus isolated teres major (iTM) tendon transfer yield different outcomes. METHODS: Records of patients with BPBP who underwent shoulder tendon transfers to augment external rotation were retrospectively reviewed. Transfer type (cLT or iTM) was considered indiscriminate by virtue of surgeon preference...
March 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28347577/utility-of-ultrasound-guided-injection-of-botulinum-toxin-type-a-for-muscle-imbalance-in-children-with-obstetric-brachial-plexus-palsy-description-of-the-procedure-and-action-protocol
#15
A García Ron, R Gallardo, B Huete Hernani
INTRODUCTION: Obstetric brachial plexus palsy (OBPP) usually has a favourable prognosis. However, nearly one third of all severe cases have permanent sequelae causing a high level of disability. In this study, we explore the effectiveness of ultrasound-guided injection of botulinum toxin A (BoNT-A) and describe the procedure. PATIENTS AND METHODS: We designed a prospective, descriptive study including patients with moderate to severe OBPP who were treated between January 2010 and December 2014...
March 24, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28325096/effects-of-elastic-therapeutic-taping-on-motor-function-in-children-with-motor-impairments-a-systematic-review
#16
Andréa Baraldi Cunha, Carolina Daniel de Lima-Alvarez, Ana Carolinne Portela Rocha, Eloisa Tudella
BACKGROUND: The elastic therapeutic taping has been considered a promising resource for disabled children. OBJECTIVE: To systematically review the evidence of the effects of elastic therapeutic taping on motor function in children with motor impairments. METHOD: Three independent evaluators conducted searches in electronic databases (MEDLINE/PubMed, Scopus, LILACS, BIREME/BVS, Science Direct, SciELO, and PEDro). Clinical studies design, published until 2016, involving elastic therapeutic taping and children aged 0-12 years with motor impairments were included...
March 22, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28318741/neonatal-magnetic-resonance-imaging-without-sedation-correlates-with-injury-severity-in-brachial-plexus-birth-palsy
#17
Andrea S Bauer, Peter Y Shen, Anna E Nidecker, Paul S Lee, Michelle A James
PURPOSE: Which infants with brachial plexus birth palsy (BPBP) should undergo microsurgical plexus reconstruction remains controversial. The current gold standard for the decision for plexus reconstruction is serial clinical examinations, but this approach obviates the possibility of early surgical treatment. We hypothesize that a new technique using 3-dimensional volumetric proton density magnetic resonance imaging (MRI) without sedation can evaluate the severity of BPBP injury earlier than serial clinical examinations...
March 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28161491/shoulder-and-elbow-kinematics-during-the-mallet-score-in-obstetrical-brachial-plexus-palsy
#18
Olivier Herisson, Nathalie Maurel, Amadou Diop, Morgane Le Chatelier, Adeline Cambon-Binder, Franck Fitoussi
BACKGROUND: The physical signs of obstetrical brachial plexus palsy range from temporary upper-limb dysfunction to a lifelong impairment and deformity in one arm. The aim of this study was to analyze the kinematics of the upper limb and to evaluate the contribution of glenohumeral and scapulothoracic joints of obstetrical brachial plexus palsy children. METHODS: Six children participated in this study: 2 males and 4 females with a mean age of 11.7years. Three patients had a C5, C6 lesion and 3 had a C5, C6, C7 lesion...
January 15, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28149223/successful-nerve-transfers-for-traumatic-brachial-plexus-palsy-in-a-septuagenarian-a-case-report
#19
Parker H Johnsen, Scott W Wolfe
Background: Conventional wisdom and the available literature demonstrate compromised outcomes following nerve reconstruction for traumatic brachial plexus palsy in the elderly. We present a 74-year-old male who was reconstructed with multiple nerve transfers for brachial plexus palsy after a ski accident. Methods: Triceps to axillary nerve transfer, spinal accessory to suprascapular nerve transfer, and ulnar to musculocutaneous nerve transfer were performed 16 weeks post injury. Results: At 11 years post-op, the patient could abduct to 65° and forward flex at M4 strength, limited only by painful glenohumeral arthritis...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28140349/reliability-of-3d-upper-limb-motion-analysis-in-children-with-obstetric-brachial-plexus-palsy
#20
Judy Mahon, Ailish Malone, Damien Kiernan, Dara Meldrum
Kinematics, measured by 3D upper limb motion analysis (3D-ULMA), can potentially increase understanding of movement patterns by quantifying individual joint contributions. Reliability in children with obstetric brachial plexus palsy (OBPP) has not been established. OBJECTIVE: This study aimed to determine between session reliability and measurement errors of 3D-ULMA using the acromion method (AM) in children with OBPP. APPROACH: Ten participants (mean 10 years, range 7-15 years, Narakas classification I-III) completed 3D-ULMA on two occasions, mean interval of 8...
January 31, 2017: Physiological Measurement
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