Safety of the Prevertebral Approach for Cross C7 Transfer in Traumatic Brachial Plexus Palsy | ||||
The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
Article 11, Volume 42, Issue 1, January 2018, Page 67-74 PDF (25.85 MB) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejprs.2018.215066 | ||||
View on SCiNiTO | ||||
Author | ||||
Mohammad Reda Ahmad* | ||||
The Plastic and Reconstructive Surgery Unit, Faculty of Medicine, Zagazig University, Zagazig | ||||
Abstract | ||||
Introduction: High disability present in traumatic brachial plexus palsy with total nerve root avulsion, as nothing left for intra plexus repair. Nerve transfer from nearby donors has a disadvantage of having a low number of myelinated fibers to innervate totally avulsed plexus. Using cross C7 (CC7) could add more donor myelinated fibers to solve this problem. The Aim of Study: Is to assess the safety of pre-vertebral approach (retro-esophageal) in comparison with a subcutaneous tunnel by using vascularized ulnar nerve graft (VUNG). Patients and Methods: Nineteen patients with total nerve root avulsion were divided according to the operative procedure into two groups: Prevertebral approach for turned on cross C7 (group I), and subcutaneous tunnel with VUNG (group < br />II). Results: No significance difference could be detected between group I and group II regarding the mean value of shoulder motor recovery, elbow motor recovery, hand motor recovery, hand sensation, or follow-up period. However, the duration of surgery in group I was significantly lower and the hospital stay was significantly shorter than that of group II. Moreover, the incidence postoperative complications were higher in group II. In Conclusion: Cross C7 can be done through subcutaneous approach with VUNG or through pre-vertebral retroesophageal approach. Pre-spinal retro-esophageal approach is safer, easy, and protected tunnel for CC7 transfer to lower plexus avulsion neuritization. | ||||
Keywords | ||||
Cross C7; Brachial plexus; Prevertebral; retro-esophageal; Vascularized ulnar | ||||
References | ||||
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