Shoulder reanimation in posttraumatic brachial plexus paralysis
Φόρτωση...
Ημερομηνία
Συγγραφείς
Vekris, M. D.
Beris, A. E.
Pafilas, D.
Lykissas, M. G.
Xenakis, T. A.
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
INTRODUCTION: Posttraumatic brachial plexus paralysis invariably involves the upper roots leading to paralysis of the shoulder region musculature. Early neurotisation of the suprascapular and the axillary nerve should be one of the priorities in plexus reconstruction in order to reanimate the shoulder. PATIENTS AND METHODS: From 1998 to 2007, 78 patients with posttraumatic brachial plexus palsy were operated in our department. Forty-three patients presented with supraclavicular lesions with involvement of C5 and C6 roots in all cases. Reconstruction of the shoulder function was achieved with neurotisation of the suprascapular nerve in 41 patients. Extraplexus donors were utilised in 34 patients, while intraplexus donors via nerve grafts in 7 patients. Neurotisation of the axillary nerve was performed in 25 patients, utilising intraplexus donors in 16 patients, extraplexus donors in 4, and combination of intraplexus and extraplexus donors in 5 patients. RESULTS: Suprascapular nerve neurotisation gave good or excellent results (supraspinatus>M3+ or shoulder abduction>40 degrees) in 35 patients. Intraplexus donors regained good or excellent function in 5 out of 6 patients (83%), while extraplexus neurotisations achieved good or excellent function of the supraspinatus in 30 out of 34 patients (88%). Axillary nerve neurotisation offered good or excellent results (deltoid>M3+ or shoulder abduction>60 degrees) in 14 patients (58%). Direct neurotisation of the axillary nerve via the motor branch for the long head of the triceps gave shoulder abduction of >110 degrees, as well as external rotation of >30 degrees in 3 out of 5 patients. Combined neurotisation of suprascapular and axillary nerves gave the best outcome achieving shoulder abduction of >60 degrees as well as external rotation of >30 degrees. CONCLUSIONS: Shoulder reanimation should be one of the first priorities in brachial plexus reconstruction. Early neurotisation of the suprascapular, and if possible the axillary nerve offers the best outcome.
Περιγραφή
Λέξεις-κλειδιά
*Accidents, Traffic, Adolescent, Adult, Axilla/innervation, Brachial Plexus/*injuries/surgery, Brachial Plexus Neuropathies/etiology/physiopathology/*surgery, Female, Humans, Male, Muscle Strength, Nerve Transfer/*methods, Radiculopathy/surgery, Range of Motion, Articular, Reconstructive Surgical Procedures/methods, Recovery of Function, Shoulder/innervation/*physiopathology, Spinal Nerve Roots/injuries/surgery, Treatment Outcome, Young Adult
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/20176172
http://ac.els-cdn.com/S0020138309004781/1-s2.0-S0020138309004781-main.pdf?_tid=c48bd459015528d5fa07dd348c4a9f49&acdnat=1333381766_fb89d0fb34b38f4cea0f44f34138ed31
http://ac.els-cdn.com/S0020138309004781/1-s2.0-S0020138309004781-main.pdf?_tid=c48bd459015528d5fa07dd348c4a9f49&acdnat=1333381766_fb89d0fb34b38f4cea0f44f34138ed31
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