Functional Outcomes of Primary Restoration of Elbow Flexion after Traumatic Brachial Plexus Palsy | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 3, Volume 43, Issue 1, January 2019, Page 7-11 PDF (7.4 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2019.65148 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohammad S Al Sabbahi* 1; Mohamad Abd El Aal1; Ahmed M Ali1; Mohammad H Ahmad1; Mohamed H Abdel Azeem* 2 | ||||
| 1The Department of Plastic Surgery, Faculty of Medicine, Zagazig University, Zagazig | ||||
| 2The Departments of General Surgery (Plastic Surgery Unit), Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| Brachial plexus injury represents a wide spectrum of a complex presentation. The primary goal in salvaging upper extremity function in adult patients is restoration of elbow flexion, because it's highly needed in routine daily activity. So the goal of this study study is to assess different primary nerve procedures used in elbow flexion restoration after traumatic brachial plexus palsy. Method: From April 2014 to May 2017, 22 patients with upper or total brachial plexus injury have had a primary procedure for elbow flexion restoration; nerve repair, nerve grafting and nerve transfer (double fascicular or intercostals) were used. Results: Of the 22 patients (one patient had bilateral injury so 23 procedures were done). Double fascicular transfer in 7 limbs, 12 intercostal nerve transfers in 12 limbs and nerve grafts in 4 limbs. 16 cases (69.6%) could achieve M3 or more | ||||
| Keywords | ||||
| Brachial plexus palsy – Erb's palsy – Nerve graft; – Nerve transfer – Intercostals | ||||
| References | ||||
|
Matsuyama T., Okuchi K., Akahane M., Inada Y. and Murao Y.: Clinical analysis of 16 patients with brachial plexus injury. Neurologia Medico-chirurgica. 42 (3): 114- 21, Discussion, 22, 2002. 2- Ahmad M.R.: Early post-operative results after repair of traumatic brachial plexus palsy. Turkish Neurosurgery, 23 (1): 1-9, 2013. 3- Terzis J.K. and Barbitsioti A.: Primary restoration of elbow flexion in adult post-traumatic plexopathy patients. Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS, 65 (1): 72-84, 2012. 4- Mackinnon S.E., Novak C.B., Myckatyn T.M. and Tung T.H.: Results of reinnervation of the biceps and brachialis muscles with a double fascicular transfer for elbow flexion. J. Hand Surg. Am., 30 (5): 978-85, 2005. 5- Tung T.H. and Moore A.E.: Brachial Plexus Injuries. In: Mackinnon SE, editor. Nerve Surgery New York: Thieme, p. 339-485, 2015. 6- Bhandari P. and Bhatoe H.: Is fascicular selection by nerve stimulation techniques a necessity in selective nerve transfers targeted at restoration of elbow flexion in upper brachial plexus injuries? Indian Journal of Neurotrauma, 8 (2): 99-104, 2011. 7- Quinones-Hinojosa A. Schmidek and Sweet: Operative Neurosurgical Techniques E-Book: Indications, Methods and Results (Expert Consult - Online and Print): Elsevier Health Sciences, 2012. 8- Fox I.K. and Mackinnon S.E.: Adult peripheral nerve disorders: Nerve entrapment, repair, transfer, and brachial plexus disorders. Plastic and Reconstructive Surgery, 127 (5): 105e-18e, 2011. 9- El-Hoseny A.Y., Ahmad M.R. and Hussein Y.: New proposed prevertebral approach for turned on normal contralateral C7 as a donor for avulsed brachial plexus. Journal of American Science, 7 (4): 661-8, 2012. 10- Oberlin C., Beal D., Leechavengvongs S., Salon A., Dauge M.C. and Sarcy J.J.: Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: Anatomical study and report of four cases. J. Hand Surg. Am., 19 (2): 232-7, 1994. 11- Ahmed M.R. and Aly A.M.: Biceps Neurotization Versus Biceps and Brachialis Neurotization in Brachial Plexus Injury: Comparative Study. Egypt, J. Plast. Reconstr. Surg., 41 (1): 111-6, 2017. 12- Seddon H.J.: Nerve grafting. Annals of the Royal College of Surgeons of England, 32: 269-80, 1963. 13- Chuang D.C., Yeh M.C. and Wei F.C.: Intercostal nerve transfer of the musculocutaneous nerve in avulsed brachial Egypt, J. Plast. Reconstr. Surg., January 2019 11 plexus injuries: Evaluation of 66 patients. J. Hand Surg. Am., 17 (5): 822-8, 1992. 14- Malessy M.J., Van Dijk J.G. and Thomeer R.T.: Respiration- related activity in the biceps brachii muscle after intercostal-musculocutaneous nerve transfer. Clinical Neurology and Neurosurgery, 95 Suppl: S95-102, 1993. 15- Socolovsky M. and Paez M.D.: A literature review of intercostal-to-musculocutaneous-nerve transfers in brachial plexus injury patients: Does body mass index influence results in Eastern versus Western countries? Surgical Neurology International, 4: 152, 2013. 16- Ray W.Z., Pet M.A., Yee A. and Mackinnon S.E.: Double fascicular nerve transfer to the biceps and brachialis muscles after brachial plexus injury: Clinical outcomes in a series of 29 cases. Journal of Neurosurgery, 114 (6): 1520-8, 2011. 17- Faglioni W., Jr., Siqueira M.G., Martins R.S., Heise C.O. and Foroni L.: The epidemiology of adult traumatic brachial plexus lesions in a large metropolis. Acta. Neurochirurgica, 156 (5): 1025-8, 2014. 18- Tung T.H. and Mackinnon S.E.: Nerve transfers: Indications, techniques, and outcomes. J. Hand Surg. Am., 35 (2): 332-41, 2010. 19- Estrella E.P.: Functional outcome of nerve transfers for upper-type brachial plexus injuries. Journal of plastic, reconstructive & aesthetic surgery: JPRAS, 64 (8): 1007- 13, 2011. 20- Liverneaux P.A., Diaz L.C., Beaulieu J.Y., Durand S. and Oberlin C.: Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies. Plastic and Reconstructive Surgery, 117 (3): 915- 9, 2006. 21- Terzis J.K. and Kostopoulos V.K.: The surgical treatment of brachial plexus injuries in adults. Plastic and Reconstructive Surgery, 119 (4): 73e-92e, 2007. | ||||
|
Statistics Article View: 221 PDF Download: 488 |
||||
