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Plexus palsy

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https://www.readbyqxmd.com/read/29016426/the-epidemiology-of-brachial-plexus-birth-palsy-in-the-united-states-declining-incidence-and-evolving-risk-factors
#1
Christopher J DeFrancesco, Divya K Shah, Benjamin H Rogers, Apurva S Shah
BACKGROUND: The epidemiology of brachial plexus birth palsy (BPBP) in the United States may be changing over time due to population-level changes in obstetric care. METHODS: The Kids' Inpatient Database from 1997 to 2012 was analyzed. Annual estimates of BPBP incidence and disease determinant distribution were calculated for the general population and the study population with BPBP. Long-term trends were analyzed. A multivariate logistic regression model was used to quantify the risk associated with each determinant...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28989239/scarring-of-the-c8-t1-roots-with-partial-avulsion-in-situ-in-total-obstetric-brachial-plexus-palsy
#2
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach. METHODS: A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots)...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28977148/elective-amputation-of-the-upper-limb-is-an-option-in-the-treatment-of-traumatic-injuries-of-the-brachial-plexus
#3
Mário Gilberto Siqueira, Roberto Sérgio Martins, Carlos Otto Heise, Luciano Foroni
The treatment of complete post-traumatic brachial plexus palsy resulting in a flail shoulder and upper extremity remains a challenge to peripheral nerve surgeons. The option of upper limb amputation is controversial and scarcely discussed in the literature. We believe that elective amputation still has a role in the treatment of select cases. The pros and cons of the procedure should be intensely discussed with the patient by a multidisciplinary team. Better outcomes are usually achieved in active patients who strongly advocate for the procedure...
September 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28961945/age-as-a-predictor-of-long-term-results-in-patients-with-brachial-plexus-palsies-undergoing-surgical-repair
#4
Mariano Socolovsky, Gilda di Masi, Gonzalo Bonilla, Ana Carolina Lovaglio, Dan López
BACKGROUND: Among other factors, like the time from trauma to surgery or the number of axons that reach the muscle target, a patient's age might also impact the final results of brachial plexus surgery. OBJECTIVE: To identify (1) any correlations between age and the 2 outcomes: elbow flexion strength and shoulder abduction range; (2) whether childhood vs adulthood influences outcomes; and (3) other baseline variables associated with surgical outcomes. METHODS: Twenty pediatric patients (under age 20 yr) who had sustained a traumatic brachial plexus injury were compared against 20 patients, 20 to 29 yr old, and 20 patients, 30 yr old or older...
August 16, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28944946/nerve-grafting-vs-common-infraclavicular-intraplexal-nerve-transfer-in-elbow-flexion-restoration
#5
Vesna SİMİć, Andrija SAVİć, Milan JOVANOVİć, Filip VİTOšEVİć, Branko ĐUROVİć, Čedomir MİLOšEVİć, Novak LAKİćEVİć, Miroslav SAMARDžİć, Lukas RASULİć
AIM: The aim of this study is to compare the results of nerve grafting vs. common infraclavicular intraplexal nerve transfer in elbow flexion restoration. MATERIAL AND METHODS: The study included 39 patients with upper brachial plexus palsy who were operated using common intraplexal nerve transfer (Oberlin procedure) and the thoracodorsal and medial pectoral nerve transfer to the musculocutaneous nerve or grafting of C5 to the musculocutneous nerve, for elbow flexion restoration...
July 12, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28944700/participation-restrictions-among-adolescents-and-adults-with-neonatal-brachial-plexus-palsy-the-patient-perspective
#6
Menno van der Holst, Jeroen Groot, Duco Steenbeek, Willem Pondaag, Rob Ghh Nelissen, Thea Pm Vliet Vlieland
PURPOSE: To examine the impact of neonatal brachial plexus palsy (NBPP) on societal participation of adolescents and adults. METHODS: This cross-sectional study was conducted among patients with NBPP, aged ≥16 years, who had visited our NBPP clinic. Patients completed questions on the influence of NBPP on their choices regarding education/work and their work-performance, the Impact on Participation/Autonomy questionnaire and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P)...
September 24, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28943070/structural-glenoid-grafting-during-primary-reverse-total-shoulder-arthroplasty-using-humeral-head-autograft
#7
Robert Z Tashjian, Erin Granger, Peter N Chalmers
BACKGROUND: Large glenoid bone defects in the setting of glenohumeral arthritis can present a challenge to the shoulder arthroplasty surgeon. The results of large structural autografting at the time of reverse total shoulder arthroplasty (RTSA) are relatively unknown. METHODS: This retrospective case series describes the clinical and radiographic results of large structural autografting from the humeral head to the glenoid during primary RTSA. RESULTS: Of 17 patients who met inclusion criteria, 14 (82% follow-up) were evaluated postoperatively at a mean of 2...
September 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28932283/glenohumeral-arthrodesis-for-late-reconstruction-of-flail-shoulder-in-patients-with-traumatic-supraclavicular-brachial-plexus-palsy
#8
Tanujan Thangarajah, Simon M Lambert
BACKGROUND: Flail shoulder can occur following a brachial plexus injury and is characterized by painful subluxation of the glenohumeral joint and the inability to independently position the hand in space. The present study aimed to report the clinical outcomes following glenohumeral arthrodesis for late reconstruction of flail shoulder in patients with traumatic supraclavicular brachial plexus palsy. METHODS: Seven patients were included in the present study and were followed-up for a mean of 98 months (range 27 months to 197 months)...
October 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28884592/peripheral-nerve-intersectional-repair-by-bi-directional-induction-and-systematic-remodelling-biodegradable-conduit-tubulization-from-basic-research-to-clinical-application
#9
Zhang Peixun, Han Na, Yuhui Kou, Yin Xiaofeng, Baoguo Jiang
In terms of the clinical effect of peripheral nerve injury repair, the biological degradable conduit 2 mm small gap tubulization is far better than the traditional epineurial or perineurium neurorrhaphy. The assumption of the bi-directional induction between the central system and the terminal effector during peripheral nerve regeneration is purposed and proved in clinical by our group. The surgical approach of transferring a portion of or the whole contralateral C7 nerve to repair a part of or the whole ipsilateral brachial plexus injury is clinically promoted, in which the most important idea and practice is to use the cone conduit designed by the group to repair thick nerves with fine nerves...
September 8, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28869062/supination-contractures-in-brachial-plexus-birth-palsy-long-term-upper-limb-function-and-recurrence-after-forearm-osteotomy-or-nonsurgical-treatment
#10
Wieneke P Metsaars, Jan Ferdinand Henseler, Jochem Nagels, Rob G Nelissen
PURPOSE: Forearm osteotomy for supination deformity in brachial plexus birth palsy (BPBP) may lead to improved function of the upper limb. However, recurrence rates are high and limit satisfactory results. METHODS: We reviewed the long-term outcome of the entire upper limb of 22 BPBP patients with a supination contracture who were treated by forearm osteotomy and compared them with an age-matched group that was treated nonsurgically (n = 28). Recurrence was defined as a passive pronation below 30°...
August 28, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28834853/motion-necessary-to-achieve-mallet-internal-rotation-positions-in-children-with-brachial-plexus-birth-palsy
#11
Stephanie A Russo, Scott H Kozin, Dan A Zlotolow, Kristen F Nicholson, James G Richards
BACKGROUND: Upper extremity function in children with brachial plexus birth palsy (BPBP) is assessed with clinical tests such as the Mallet classification, which uses a hand to spine position to assess shoulder internal rotation, or the modified Mallet classification, which adds an additional internal rotation task (hand to belly). Children with BPBP frequently have difficulty performing the hand to spine task. This study compared scapulothoracic and glenohumeral (GH) parameters associated with successful completion of the hand to spine and hand to belly modified Mallet positions...
August 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28819602/fracture-dislocation-of-shoulder-with-brachial-plexus-palsy-a-case-report-and-review-of-management-options
#12
Sameer Rathore, Srinivas Kasha, Srinivas Yeggana
INTRODUCTION: Injuries causing fracture dislocation of shoulder and brachial plexus palsy are extremely rare. As per authors' knowledge, three part fracture of proximal humerus with shoulder dislocation and brachial plexus palsy has not been reported in the literature. CASE PRESENTATION: A 53 year old female sustained a three part fracture of right proximal humerus along with dislocation of shoulder joint and brachial plexus palsy following a fall from a flight of stairs...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28798538/the-outcome-of-primary-brachial-plexus-reconstruction-in-extended-erb-s-obstetric-palsy-when-two-roots-are-available-for-intraplexus-neurotization
#13
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: The outcome of primary brachial plexus reconstruction in extended Erb's obstetric palsy with single root avulsion has not been specifically documented in the literature. METHODS: A series of 46 consecutive cases of extended Erb's obstetric palsy with single root avulsion was retrospectively reviewed. The upper and middle trunks were reconstructed with nerve grafts from the available two roots. No nerve transfers were used. The percentage of a satisfactory motor recovery was documented...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28798537/the-outcome-of-primary-brachial-plexus-reconstruction-in-extended-erb-s-obstetric-palsy-when-only-one-root-is-available-for-intraplexus-neurotization
#14
Mohammad M Al-Qattan, Amel Ahmed F El-Sayed
BACKGROUND: A recent review by the International Federation of Societies for Surgery of the Hand showed no studies comparing the results of nerve grafting to distal nerve transfer for primary reconstruction of the brachial plexus in infants with obstetric brachial plexus palsy (OBBP). The aim of this retrospective study is to compare two surgical reconstructive strategies in primary reconstruction of the brachial plexus in extended Erb's obstetric palsy with double root avulsion: one with and one without distal nerve transfer for elbow flexion...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28783492/shoulder-muscle-atrophy-and-its-relation-to-strength-loss-in-obstetrical-brachial-plexus-palsy
#15
Christelle Pons, Frances T Sheehan, Hyun Soo Im, Sylvain Brochard, Katharine E Alter
BACKGROUND: Treatment/prevention of shoulder muscle strength imbalances are major therapeutic goals for children with obstetrical brachial plexus palsy. The study aims were to characterize muscle atrophy in children/adolescents with unilateral obstetrical brachial plexus palsy, to quantify the agonist-antagonist muscle volume balance and the association between muscle volume and strength. METHODS: Eight boys and four girls (age=12.1, standard deviation=3.3) participated in this case-control study...
October 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28746282/outcomes-of-muscle-brachialis-transfer-to-restore-finger-flexion-in-brachial-plexus-palsy
#16
Brent R DeGeorge, Hillary A Becker, John H Faryna, Robert J Spinner, Allen T Bishop, Alexander Y Shin
BACKGROUND: In adults with lower trunk brachial plexus injury, proximal nerve surgery for restoration of prehension demonstrates poor outcomes secondary to long distances required for nerve regeneration and time-dependent degradation of motor endplates. Options for reconstruction are limited to distal tendon or nerve transfers and free-functioning muscle transfers. In this article, the authors describe the long-term outcomes of brachialis muscle-to-flexor digitorum profundus transfer to restore prehension in patients with traumatic lower trunk brachial plexus injuries...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28719549/long-term-follow-up-of-neonatal-brachial-plexopathy-psychological-and-physical-function-in-adolescents-and-young-adults
#17
Lesley Butler, Janith Mills, Heather M Richard, Russell Riddle, Marybeth Ezaki, Scott Oishi
PURPOSE: The prevalence of neonatal brachial plexus palsy (NBPP) has been increasing since the early 1980s. No known studies have examined long-term psychological health and quality of life (QOL) in young adults. The purpose of this study was to investigate the psychosocial and intellectual aspects of NBPP during adolescence into young adulthood. METHODS: A total of 31 patients were enrolled in the adolescent group (16 to 18 y) and 25 in the young adult group (23 to 28 y)...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28719548/forearm-pronation-osteotomy-for-supination-contracture-secondary-to-obstetrical-brachial-plexus-palsy-a-retrospective-cohort-study
#18
Aharon Z Gladstein, Brant Sachleben, Emily S Ho, Alison Anthony, Howard M Clarke, Sevan Hopyan
BACKGROUND: Obstetrical brachial plexus palsy can lead to fixed forearm supination contracture. Fixed supination may lead to functional deficits as the affected hand cannot be positioned optimally for activities on a desk such as writing and typing, or for using tools including utensils, which require a neutral or pronated forearm. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not been clearly defined...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28716694/-isolated-long-thoracic-nerve-palsy-more-than-meets-the-eye
#19
Andrés A Maldonado, Scott L Zuckerman, B Matthew Howe, Michelle L Mauermann, Robert J Spinner
INTRODUCTION: Two main hypotheses have been proposed for the pathophysiology of long thoracic nerve (LTN) palsy: nerve compression and nerve inflammation. We hypothesized that critical reinterpretation of electrodiagnostic (EDX) studies and MRIs of patients with a diagnosis of non-traumatic isolated LTN palsy could provide insight into the pathophysiology and, potentially, the treatment. MATERIAL AND METHODS: A retrospective review was performed of all patients with a diagnosis of non-traumatic isolated LTN palsy and an EDX and brachial plexus or shoulder MRI studies performed at our institution...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28709767/obstetrical-brachial-plexus-palsy
#20
Patricia O'Berry, Mackenzie Brown, Leslie Phillips, Sarah Helen Evans
Obstetrical brachial plexus palsy is a disorder of the peripheral nervous system and occurs in as many as 0.4% of infants born. It is associated with shoulder dystocia, use of mechanical extraction, and macrosomia; it occurs more frequently in infants born by vaginal delivery. The unilateral injury to the brachial plexus complex occurs during the delivery phase as lateral traction is applied to the head to permit shoulder clearance. The infant typically presents in the delivery room with decreased active movements of the affected arm and asymmetrical primitive reflex responses...
July 2017: Current Problems in Pediatric and Adolescent Health Care
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