Restoration of elbow function in severe brachial plexus paralysis via muscle transfers

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Μικρογραφία εικόνας

Ημερομηνία

Συγγραφείς

Vekris, M. D.
Beris, A. E.
Lykissas, M. G.
Korompilias, A. V.
Vekris, A. D.
Soucacos, P. N.

Τίτλος Εφημερίδας

Περιοδικό ISSN

Τίτλος τόμου

Εκδότης

Περίληψη

Τύπος

Είδος δημοσίευσης σε συνέδριο

Είδος περιοδικού

peer-reviewed

Είδος εκπαιδευτικού υλικού

Όνομα συνεδρίου

Όνομα περιοδικού

Injury-International Journal of the Care of the Injured

Όνομα βιβλίου

Σειρά βιβλίου

Έκδοση βιβλίου

Συμπληρωματικός/δευτερεύων τίτλος

Περιγραφή

SUMMARY: Reconstruction of elbow function in severe or late brachial plexus injuries represents a challenge to the reconstructive microsurgeons. The current sophisticated techniques of nerve reconstruction in combination with secondary local or free functional muscle transfers, may offer satisfactory outcome. Latissimus dorsi can be transferred as a pedicled or free muscle to restore elbow function. We present our experience with elbow reanimation in late cases of brachial plexus paralysis utilising latissimus dorsi muscle transfer. From 1998 to 2006 we operated 103 patients with brachial plexus paralysis. Amongst these patients, 21 were late cases and underwent latissimus dorsi muscle transfer for elbow reanimation. Ten patients had free latissimus dorsi transfer for elbow flexion. Free latissimus dorsi muscle was neurotised either directly via three intercostals in three patients or with a nerve transfer procedure using the contralateral seventh cervical nerve root in seven patients. Care was taken to maintain the proper tension to the muscle, which must hold the elbow in static flexion of about 120 degrees at the end of the procedure. Powerful elbow flexion (M4-M4+) or extension (M4) was obtained after the first 3 months in all patients who had an ipsilateral pedicled latissimus dorsi transfer. In the group of free muscle transfers, elbow flexion was seen after 6-8 months. After the initiation of muscle contraction, eight of the patients regained elbow flexion of M3-M4+. Latissimus dorsi muscle transfer is a reliable method for elbow reanimation. Appropriate postoperative management is also an important factor to obtain better outcome.

Περιγραφή

Λέξεις-κλειδιά

Brachial Plexus/*injuries, Brachial Plexus Neuropathies/physiopathology/*surgery, Elbow Joint/innervation/*physiopathology, Humans, Microsurgery/methods, Muscle, Skeletal/*transplantation, Nerve Transfer/methods, Postoperative Complications, Range of Motion, Articular, Recovery of Function, Treatment Outcome

Θεματική κατηγορία

Παραπομπή

Σύνδεσμος

http://www.ncbi.nlm.nih.gov/pubmed/18687429
http://ac.els-cdn.com/S0020138308002672/1-s2.0-S0020138308002672-main.pdf?_tid=f9b83216ad540f3b54e61a305c1b85f5&acdnat=1333542790_2c07b731a42b32a957461501dab06ff2

Γλώσσα

en

Εκδίδον τμήμα/τομέας

Όνομα επιβλέποντος

Εξεταστική επιτροπή

Γενική Περιγραφή / Σχόλια

Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος

Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής

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Χορηγός

Βιβλιογραφική αναφορά

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