Shoulder reanimation in posttraumatic brachial plexus paralysis

dc.contributor.authorVekris, M. D.en
dc.contributor.authorBeris, A. E.en
dc.contributor.authorPafilas, D.en
dc.contributor.authorLykissas, M. G.en
dc.contributor.authorXenakis, T. A.en
dc.contributor.authorSoucacos, P. N.en
dc.date.accessioned2015-11-24T18:51:40Z
dc.date.available2015-11-24T18:51:40Z
dc.identifier.issn1879-0267-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/18290
dc.rightsDefault Licence-
dc.subject*Accidents, Trafficen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAxilla/innervationen
dc.subjectBrachial Plexus/*injuries/surgeryen
dc.subjectBrachial Plexus Neuropathies/etiology/physiopathology/*surgeryen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectMaleen
dc.subjectMuscle Strengthen
dc.subjectNerve Transfer/*methodsen
dc.subjectRadiculopathy/surgeryen
dc.subjectRange of Motion, Articularen
dc.subjectReconstructive Surgical Procedures/methodsen
dc.subjectRecovery of Functionen
dc.subjectShoulder/innervation/*physiopathologyen
dc.subjectSpinal Nerve Roots/injuries/surgeryen
dc.subjectTreatment Outcomeen
dc.subjectYoung Adulten
dc.titleShoulder reanimation in posttraumatic brachial plexus paralysisen
heal.abstractINTRODUCTION: 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1016/j.injury.2009.09.009-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/20176172-
heal.identifier.secondaryhttp://ac.els-cdn.com/S0020138309004781/1-s2.0-S0020138309004781-main.pdf?_tid=c48bd459015528d5fa07dd348c4a9f49&acdnat=1333381766_fb89d0fb34b38f4cea0f44f34138ed31-
heal.journalNameInjury-International Journal of the Care of the Injureden
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2010-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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