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Brachial plexus

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https://www.readbyqxmd.com/read/28549367/-transfer-of-the-long-head-of-triceps-for-elbow-flexion-in-braquial-plexus-sequelae
#1
E Vergara-Amador, F Vela-Rodríguez
The independent neurovascular anatomy of the long head of the triceps brachii and its suitability as a free muscle transfer have been extensively studied. Instead muscle transposition of the long head of the triceps brachii to enhance elbow flexion has been rarely described. We describe in this paper two cases of injury of brachial plexus sequel in which transposition was performed only on the long head of the triceps. The elbow flexion was improved, the extension was preserved.
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28546718/brachial-plexus-injury-after-right-hepatectomy
#2
Garima Daga, Prashant Balwant Kerkar
Iatrogenic nerve palsies due to faulty positioning on the operating table are commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus (BP) is rarely encountered and is a recently reported phenomenon due to the increasing number of complex surgeries including hepatobiliary surgical procedures. Brachial plexus injury (BPI) needs to be recognized as a potential complication of prolonged abdominal surgery. The present case report highlights the potential for BPI and its early recognition, management, and prevention in complex prolonged abdominal surgical procedures...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28542052/continuous-interscalene-block-for-postoperative-analgesia-and-shoulder-immobilization-after-pectoralis-major-tendon-reinsertion-a-case-report
#3
John J Finneran, Brian M Ilfeld, Jacklynn F Sztain
We present the case of a 38-year-old man undergoing surgical repair of his pectoralis major tendon. An interscalene catheter was placed between the middle and lower trunks of the brachial plexus. Postoperatively, ropivacaine 0.2% was infused through postoperative day. The patient had excellent pain control requiring minimal opioid analgesics. A catheter between the middle and lower trunks of the brachial plexus provided excellent postoperative analgesia after pectoralis major tendon reinsertion. Additionally, the block likely protected the surgical repair during emergence from anesthesia and in the early postoperative period by providing a motor block of the pectoralis major muscle...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28540442/outcome-after-brachial-plexus-injury-surgery-and-impact-on-quality-of-life
#4
Lukas Rasulić, Andrija Savić, Bojana Živković, Filip Vitošević, Mirko Mićović, Vladimir Baščarević, Vladimir Puzović, Nenad Novaković, Milan Lepić, Miroslav Samardžić, Stefan Mandić-Rajčević
BACKGROUND: The aim of this study was to investigate outcomes after surgery for brachial plexus injury (BPI), not only motor outcomes but also the quality of life of the patients. METHODS: We operated on 128 consecutive patients with BPI from 1992 to 2012. We documented the information on the injured nerve, level of injury, type of treatment used, timing of surgery, patient age, and preoperative and postoperative motor deficits. In 69 patients who agreed to participate in a quality of life study, additional assessments included functionality, pain, quality of life, patient satisfaction, and psychosocial health...
May 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#5
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28536218/backpack-palsy-with-horner-s-syndrome
#6
Olivia Sharp, Kai Yuen Wong, Paul Stephens
Traumatic injuries to the brachial plexus are typically high impact and can be debilitating, life-changing injuries. Backpack palsy is a rare but well-established cause of brachial plexus injury, arising as a result of heavy backpack use. We present an unusual case of backpack palsy with Horner's syndrome.
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#7
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28523213/brachial-plexus-magnetic-resonance-imaging-differentiates-between-inflammatory-neuropathies-and-does-not-predict-disease-course
#8
Bas A Jongbloed, Jeroen W Bos, Dirk Rutgers, Willem Ludo van der Pol, Leonard H van den Berg
OBJECTIVE: The main objective of this study was to evaluate the correlation between the distribution of brachial plexus magnetic resonance imaging (MRI) abnormalities and clinical weakness, and to evaluate the value of brachial plexus MRI in predicting disease course and response to treatment in multifocal motor neuropathy (MMN), Lewis-Sumner syndrome (LSS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). METHODS: Sixty-seven patients with an inflammatory neuropathy diagnosed at our tertiary referral center for neuromuscular diseases had undergone bilateral T2-weighted short tau inversion recovery (STIR) MRI of the brachial plexus...
May 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28521852/upper-limb-nerve-transfers-a-review
#9
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
#10
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/28515517/a-clinical-comparison-between-0-5-levobupivacaine-and-0-5-levobupivacaine-with-dexamethasone-8-mg-combination-in-brachial-plexus-block-by-the-supraclavicular-approach
#11
Nibedita Pani, Sidharth Sraban Routray, Debasis Mishra, Basant Kumar Pradhan, Bishnu Prasad Mohapatra, Deepti Swain
BACKGROUND AND AIMS: Dexamethasone as an adjuvant to bupivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, the effect of dexamethasone (8 mg) when added to levobupivacaine has not been well studied. This study was conducted to find out analgesic efficacy of dexamethasone as adjuvant to levobupivacaine in SCBP block. METHODS: Ultrasound- guided SCBP block was given to sixty patients, randomly assigned into two groups...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28514330/-mri-morphometry-of-neuroplastic-changes-in-the-brain-after-conservative-treatment-of-traumatic-brachial-plexopathy
#12
S A Zhivolupov, E N Gnevyshev, A G Trufanov, L V Voronkov, A A Jurin, N A Rashidov, I N Samartsev, I D Poltavsky
AIM: To identify neuroplastic changes in the brain structures during treatment of traumatic axonotomy of the brachial plexus (the pathology of peripheral nervous system). MATERIAL AND METHODS: MRI morphometry of white and grey matter was studied in 62 patients with traumatic axonotomy of the brachial plexus. RESULTS: There were correlations between the thickness of sensorimotor cortex, morphometric parameters (volume, diffusion, fractional anisotropy) of subcortical formations (corticospinal tracts, the forceps minor), severity of neurological deficit and dynamics of clinical course depending on the therapeutic strategy...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28514241/phrenic-nerve-palsy-and-regional-anesthesia-for-shoulder-surgery-anatomical-physiologic-and-clinical-considerations
#13
Kariem El-Boghdadly, Ki Jinn Chin, Vincent W S Chan
Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery...
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28506346/-role-of-short-latency-somatosensory-evoked-potential-in-the-diagnosis-of-chronic-inflammatory-demyelinating-polyneuropathy
#14
Rui-Di Sun, Bing Fu, Jun Jiang
OBJECTIVE: To investigate the role of short-latency somatosensory evoked potential (SSEP) in the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). METHODS: A total of 48 children with a confirmed or suspected CIDP and 40 healthy children were enrolled. Nerve electrophysiological examination and/or SSEP examination was performed (the children in the healthy control group only underwent SSEP examination). Four-lead electromyography was used for nerve electrophysiological examination, including at least 4 motor nerves and 2 sensory nerves...
May 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28506179/value-of-soft-tissue-release-procedure-around-the-shoulder-to-improve-shoulder-abduction-in-birth-brachial-plexus-palsy-and-analysis-of-the-factors-affecting-outcome
#15
S Raja Sabapathy, Praveen Bhardwaj, Hari Venkatramani
BACKGROUND: A lack of shoulder abduction in spontaneously recovered birth brachial plexus palsy (BBPP) is a common presentation. We have performed a soft tissue release operation in these patients to remove the tethering effect of the tight and cocontracting shoulder adductors. This study was undertaken in order to assess the outcome of this surgical procedure. METHODS: We performed a retrospective analysis of 120 patients who displayed spontaneous recovery from BBPP and subsequently underwent soft tissue release procedure to improve shoulder abduction...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
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
#16
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/28504029/obstetric-brachial-plexus-palsy-a-population-based-retrospective-case-control-study-and-medicolegal-considerations
#17
Simona Zaami, Francesco Paolo Busardò, Fabrizio Signore, Nicola Felici, Vito Briganti, Giovanni Baglio, Enrico Marinelli, Vittorio Fineschi
AIMS: The aim of this study was to examine 24 cases of obstetric brachial plexus palsy (OBPP) in 41,002 deliveries occurred at San Camillo-Forlanini Hospital in Rome, during the period 2000-2012. MATERIALS AND METHODS: A population-based retrospective case-control study was designed and the database of the hospital was searched; for each case, maternal and fetal records were examined and some risk factors were evaluated. RESULTS: A statistically significant association between the 24 cases OBPP and the following risk factors: primiparity (p < ...
May 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28500749/local-resectability-assessment-of-head-and-neck-cancer-positron-emission-tomography-mri-versus-positron-emission-tomography-ct
#18
Tetsuro Sekine, Felipe de Galiza Barbosa, Gaspar Delso, Irene A Burger, Paul Stolzmann, Edwin E Ter Voert, Gerhard F Huber, Spyros S Kollias, Gustav K von Schulthess, Patrick Veit-Haibach, Martin W Huellner
BACKGROUND: The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for local resectability of head and neck cancer. METHODS: Sequential contrast-enhanced PET/CT-MRI was performed in 58 patients referred for the staging or restaging of head and neck cancer. Tumors were assessed with PET/CT and PET/MRI for the presence of resectability-defining factors: T4b status (mediastinal invasion, invasion of the prevertebral space, and vascular encasement), and another 8 findings that would imply obstacles for surgical cure (invasion of the laryngeal cartilage, invasion of the preepiglottic fat pad, perineural spread, orbital invasion, bone infiltration, skull base invasion, dural infiltration, and invasion of the brachial plexus)...
May 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/28497932/individual-duration-of-axillary-brachial-plexus-block-is-unpredictable-a-prospective-double-centred-observational-study
#19
Wouter Droog, D-Yin Lin, José S Huisman, Fleur A Franssen, G Peter van Aggelen, J Henk Coert, Eilish M Galvin
BACKGROUND: The duration of effect for axillary plexus block using ropivacaine is highly variable. The available literature does not offer any plausible means of predicting time of block offset for individual patients, making it difficult to give accurate information and plan postoperative analgesics. This study was designed to identify factors influencing axillary plexus block offset time. METHODS: A total of 92 patients participated in this prospective double centred observational study...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28495173/late-treatment-of-obstetrical-brachial-plexus-palsy-by-humeral-rotational-osteotomy-and-lengthening-with-an-intramedullary-elongation-nail
#20
Ahmet Emrah Acan, Onur Gursan, Nihat Demirhan Demirkiran, Hasan Havitcioglu
To date, all the authors who have recommended external rotation osteotomy (ERO) in the late treatment of obstetrical brachial plexus palsy (OBPP), have neglected upper limb length discrepancy, which is an another sequelae of OBPP. In this paper, a new technique is reported for the late treatment of OBPP patients with upper limb length discrepancy, in which both humeral external rotation osteotomy (ERO) and lengthening are applied with an intramedullary elongation nail. With this technique, upper limb function is improved through re-orientation of the shoulder arc to a more functional range, and further improvements will be seen in the appearance of the upper limb with the elimination of length discrepancy...
May 8, 2017: Acta Orthopaedica et Traumatologica Turcica
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