Pathological findings identified during the posterior approach to the spinal accessory nerve after high-energy trauma

Autor:	Paul Malone, Devanshi Jimulia, Colin Shirley, Tahseen Chaudhry, Dominic Power
Rok vydání:	2021
Předmět:	Shoulder High energy Accessory nerve business.industry Anatomy Suprascapular nerve Posterior approach Accessory Nerve Nerve Transfer Humans Medicine Brachial Plexus Surgery Anterior approach Brachial Plexus Neuropathies business Brachial plexus Pathological
Zdroj:	Journal of Hand Surgery (European Volume). 47:393-398
ISSN:	2043-6289 1753-1934
DOI:	10.1177/17531934211039698
Popis:	The spinal accessory to suprascapular nerve transfer is a key procedure for restoring shoulder function in upper brachial plexus injuries and is typically undertaken via an anterior approach. The anterior approach may miss injury to the suprascapular nerve about the suprascapular notch, which may explain why functional outcomes are often limited. In 2014 we adopted a posterior approach to enable better visualization of the suprascapular nerve at the notch. Over the next 6 years we have used this approach for 20 explorations after high-energy trauma. In 7/20 we identified abnormalities at the level of the suprascapular ligament, which we would not have identified with an anterior approach: there were two ruptures, two neuromas-in-continuity and three cases of scar encasement, necessitating neurolysis. Nerve transfer could be undertaken distal to the suprascapular notch, bypassing the site of injury. These pathological findings support the wider adoption of the posterior approach in cases of high-energy trauma. Level of evidence: IV
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::52e25de5b7fadd1eb4add3594bb60e7e https://doi.org/10.1177/17531934211039698 Zobrazit plný text záznamu