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      Brachial plexus injury in adults: Diagnosis and surgical treatment strategies

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          Abstract

          Adult post traumatic Brachial plexus injury is unfortunately a rather common injury in young adults. In India the most common scenario is of a young man injured in a motorcycle accident. Exact incidence figures are not available but of the injuries presenting to us about 90% invole the above combination This article reviews peer-reviewed publications including clinical papers, review articles and Meta analysis of the subject. In addition, the authors′ experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Results have been discussed and analysed to get an idea of factors influencing final recovery. It appears that time from injury and number of roots involved are most crucial.

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          Nerves and nerves injuries

          S. Sunderland (1978)
          Article 0 comments Cited 36 times – based on 0 reviews     Review now
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            Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: a report of 7 cases.

            Phairat Thuvasethakul, Somsak Leechavengvongs, Kiat Witoonchart … (2003)
            This study reports the results of nerve transfer to the deltoid muscle using the nerve to the long head of the triceps. Seven patients with an average age of 25 years with loss of shoulder abduction secondary to upper brachial plexus injuries had nerve transfer using the nerve to the long head of the triceps to the anterior branch(es) of the axillary nerve through the posterior approach. The spinal accessory nerve was used simultaneously for nerve transfer to the suprascapular nerve. The follow-up period ranged from 18 to 28 months (average, 20 mo). All patients recovered deltoid power against resistance (M4) at the last follow-up evaluation. Useful functional recovery was achieved in all 7 patients; 5 had excellent recoveries and 2 had good results. The average shoulder abduction was 124 degrees. No notable weakness of elbow extension was observed. This method is a reliable and effective procedure for deltoid reconstruction in brachial plexus injury (upper-arm type) and should be combined with spinal accessory nerve transfer to the suprascapular nerve to obtain good shoulder abduction.
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              The surgical treatment of brachial plexus injuries in adults.

              Julia Terzis, K Papakonstantinou (2000)
              Posttraumatic brachial plexus palsy is a severe injury primarily affecting young individuals at the prime of their life. The devastating neurological dysfunction inflicted in those patients is usually lifelong and creates significant socioeconomic issues. During the past 30 years, the surgical repair of these injuries has become increasingly feasible. At many centers around the world, leading surgeons have introduced new microsurgical techniques and reported a variety of different philosophies for the reconstruction of the plexus. Microneurolysis, nerve grafting, recruitment of intraplexus and extraplexus donors, and local and free-muscle transfers are used to achieve optimal outcomes. However, there is yet no consensus on the priorities and final goals of reconstruction among the various centers.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Indian Acad Neurol
                Journal ID (iso-abbrev): Ann Indian Acad Neurol
                Journal ID (publisher-id): AIAN
                Title: Annals of Indian Academy of Neurology
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0972-2327
                ISSN (Electronic): 1998-3549
                Publication date (Print): Jan-Mar 2013
                Volume: 16
                Issue: 1
                Pages: 26-33
                Affiliations
                [1]Department of Plastic Surgery, Bombay Hospital Institute of Medical Sciences, New Marine Lines, Mumbai, Maharashtra, India
                Author notes
                For correspondence: Dr. Mukund R. Thatte, Department of Plastic Surgery, Bombay Hospital Institute of Medical Sciences, New Marine Lines, Mumbai - 400 020, Maharashtra, India. E-mail: mthatte@ 123456gmail.com
                Article
                Publisher ID: AIAN-16-26
                DOI: 10.4103/0972-2327.107686
                PMC ID: 3644778
                PubMed ID: 23661959
                SO-VID: d8921c3a-083a-4722-9f51-d2217495bb72
                Copyright © Copyright: © Annals of Indian Academy of Neurology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 06 August 2012
                Date revision received : 25 August 2012
                Date accepted : 18 September 2012
                Categories
                Subject: Mini Series: Brachial Plexus

                ScienceOpen disciplines: Neurology
                Keywords: brachial plexus injury,adult,surgical strategy
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: brachial plexus injury, adult, surgical strategy

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