Simultaneous Phrenic and Intercostal Nerves Transfer for Elbow Flexion and Extension in Total Brachial Plexus Root Avulsion Injury
| Autor: | Valerie Huali Tan, Chairoj Uerpairojkit, Dechporn Putthiwara, Akaradech Pitakveerakul, Kanchai Malungpaishope, Navapong Anantavorasakul, Sarun Jindahara, Somsak Leechavengvongs, Patamaporn Ratchawatana |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Brachial plexus root Adolescent Intercostal nerves Avulsion 03 medical and health sciences Young Adult 0302 clinical medicine Accessory Nerve Elbow Joint medicine Humans Brachial Plexus Range of Motion Articular Elbow flexion Brachial Plexus Neuropathies Nerve Transfer Phrenic nerve Retrospective Studies 030222 orthopedics business.industry General Medicine Anatomy musculoskeletal system medicine.disease body regions Phrenic Nerve Brachial plexus injury Female Intercostal Nerves Avulsion injury business 030217 neurology & neurosurgery |
| Zdroj: | The journal of hand surgery Asian-Pacific volume. 23(4) |
| ISSN: | 2424-8363 |
| Popis: | Background: To report the results of restoring the elbow flexion and extension in patients with total brachial root avulsion injuries by simultaneous transfer of the phrenic nerve to the nerve to the biceps and three intercostal nerves to the nerve of the long head of the triceps. Methods: Ten patients with total brachial root avulsion injuries underwent the spinal accessory nerve transfer to the suprascapular nerve for shoulder reconstruction. Simultaneous transfer of the phrenic nerve to the nerve to the biceps via the sural nerve graft and three intercostal nerves to the nerve of the long head of the triceps was done for restoration of the elbow flexion and extension. Trunk flexion exercise program was used for all patients postoperatively. The mean follow up period was 36 months. Results: For elbow flexion, there were two M4, seven M3, and one M1. For elbow extension, there were three M4, four M3, two M2, and one M1. No patient demonstrated a respiratory problem clinically postoperatively. The average FVC% decreased to 61% of the predicted value at 24 months after surgery. Conclusions: The simultaneous nerve transfer using the phrenic nerve to the nerve to the biceps and 3 intercostal nerves to the nerve of the long head of the triceps with postoperative trunk flexion exercise provide a comparable result for restoration of elbow function in total brachial plexus root avulsion injury. The patients who appear to have a respiratory problem and are unable to comply with the post-operative respiratory muscles training should be contraindicated for this simultaneous transfer. |
| Databáze: | OpenAIRE |
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