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Plexus palsy

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https://www.readbyqxmd.com/read/29223630/postoperative-loss-of-midline-function-in-brachial-plexus-birth-palsy
#1
Dustin A Greenhill, Arianna Trionfo, Frederick V Ramsey, Scott H Kozin, Dan A Zlotolow
PURPOSE: To identify the rate of and predictive variables for functionally limited shoulder internal rotation in postoperative patients with brachial plexus birth palsy. METHODS: Records of patients with brachial plexus birth palsy who had surgery on the affected upper extremity during a 10-year period were retrospectively reviewed. Patient demographics, physical examinations, and all upper extremity procedures were recorded. Loss of midline function (LOM) was defined as a Modified Mallet Scale or Active Movement Scale (AMS) internal rotation score <3...
December 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29219789/oberlin-transfer-compared-with-nerve-grafting-for-improving-early-supination-in-neonatal-brachial-plexus-palsy
#2
Kate W C Chang, Thomas J Wilson, Miriana Popadich, Susan H Brown, Kevin C Chung, Lynda J S Yang
OBJECTIVE The use of nerve transfers versus nerve grafting for neonatal brachial plexus palsy (NBPP) remains controversial. In adult brachial plexus injury, transfer of an ulnar fascicle to the biceps branch of the musculocutaneous nerve (Oberlin transfer) is reportedly superior to nerve grafting for restoration of elbow flexion. In pediatric patients with NBPP, recovery of elbow flexion and forearm supination is an indicator of resolved NBPP. Currently, limited evidence exists of outcomes for flexion and supination when comparing nerve transfer and nerve grafting for NBPP...
December 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29214081/a-rare-complication-of-a-tap-block-performed-after-caesarean-delivery
#3
Osman Nawazish Salaria, Murlikrishna Kannan, Bryan Kerner, Howard Goldman
The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section.
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29199193/effect-of-virtual-reality-versus-conventional-physiotherapy-on-upper-extremity-function-in-children-with-obstetric-brachial-plexus-injury
#4
S El-Shamy, R Alsharif
OBJECTIVES: The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury. METHODS: Forty children with Erb's palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks)...
December 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
https://www.readbyqxmd.com/read/29169721/active-range-of-motion-over-time-in-patients-with-obstetrical-brachial-plexus%C3%A2-palsy-a-10-year-analysis
#5
Robert Bains, Abdullah Kattan, Christine G Curtis, Derek Stephens, Gregory Borschel, Howard M Clarke
PURPOSE: In our experience, and from the personal report of others, children with obstetrical brachial plexus palsy appear to lose some of their initially recovered active range of motion over the time in both operated and nonsurgical patients. This study investigates whether such a diminution of active movement occurs over time. METHODS: We performed a retrospective analysis of data from our obstetrical brachial plexus clinic. Between 1991 and 2000, 139 patients with a minimum follow-up of 10 years were included in the study...
November 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29134042/direct-nerve-sutures-in-extended-upper-obstetric-brachial-plexus-repair
#6
J Bahm, A Gkotsi, S Bouslama, W El-Kazzi, F Schuind
Background  In rare, selected cases of severe (extended) upper obstetric brachial plexus palsy (OBPP), after supraclavicular exposure and distal mobilization of the traumatized trunks and careful neuroma excision, we decided to perform direct nerve coaptation with tolerable tension and immobilized the affected arm positioned in adduction and 90-degree elbow flexion for three weeks. Objectives  We present our surgical technique and preliminary results in a prospective open patient series, including 22 patients (14 right and 8 left side affected) between 2009 and 2016, operated at a mean age of 8...
January 2017: Journal of Brachial Plexus and Peripheral Nerve Injury
https://www.readbyqxmd.com/read/29092081/novel-findings-in-obstetric-brachial-plexus-palsy-a-study-of-corpus-callosum-volumetry-and-resting-state-functional-magnetic-resonance-imaging-of-sensorimotor-network
#7
Kishore Kislay, Bhagavatula Indira Devi, Dhananjaya Ishwar Bhat, Dhaval Prem Shukla, Arun Kumar Gupta, Rajanikant Panda
BACKGROUND: The response of the brain to obstetric brachial plexus palsy (OBPP) is not clearly understood. We propose that even a peripheral insult at the developmental stage may result in changes in the volume of white matter of the brain, which we studied using corpus callosum volumetry and resting-state functional magnetic resonance imaging (rsfMRI) of sensorimotor network. OBJECTIVE: To study the central neural effects in OBPP. METHODS: We performed an MRI study on a cohort of 14 children who had OBPP and 14 healthy controls...
October 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29042331/the-first-experience-of-triple-nerve-transfer-in-proximal-radial-nerve-palsy
#8
Mohammadreza Emamhadi, Sasan Andalib
BACKGROUND: Injury to distal of posterior cord of brachial plexus leads to palsy of the radial and axillary nerves. The symptoms are usually motor deficits of the deltoid muscle, triceps brachii muscle, and the extensor muscles of the wrist, thumb and fingers. Tendon transfers, nerve grafts, and nerve transfers are options of surgical treatment of proximal radial nerve palsy to restore some motor functions. Tendon transfer is painful, requires a long immobilization, and decreases donor muscle strength; nevertheless, nerve transfer produces promising outcome...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29016426/the-epidemiology-of-brachial-plexus-birth-palsy-in-the-united-states-declining-incidence-and-evolving-risk-factors
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
December 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
#18
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°...
November 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
#19
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
#20
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
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