Journal of Brachial Plexus and Peripheral Nerve Injury最新文献_第2页

Patient-Reported Outcomes and Provocative Testing in Peripheral Nerve Injury and Recovery. 患者报告的周围神经损伤和恢复的结果和刺激试验。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2023-01-01 DOI: 10.1055/s-0043-1764352

Albin John, Stephen Rossettie, John Rafael, Cameron T Cox, Ivica Ducic, Brendan J Mackay

{"title":"Patient-Reported Outcomes and Provocative Testing in Peripheral Nerve Injury and Recovery.","authors":"Albin John, Stephen Rossettie, John Rafael, Cameron T Cox, Ivica Ducic, Brendan J Mackay","doi":"10.1055/s-0043-1764352","DOIUrl":"https://doi.org/10.1055/s-0043-1764352","url":null,"abstract":"Background Peripheral nerve function is often difficult to assess given the highly variable presentation and subjective patient experience of nerve injury. If nerve assessment is incomplete or inaccurate, inappropriate diagnosis and subsequent treatment may result in permanent dysfunction. Objective As our understanding of nerve repair and generation evolves, so have tools for evaluating peripheral nerve function, recovery, and nerve-related impact on the quality of life. Provocative testing is often used in the clinic to identify peripheral nerve dysfunction. Patient-reported outcome forms provide insights regarding the effect of nerve dysfunction on daily activities and quality of life. Methods We performed a review of the literature using a comprehensive combination of keywords and search algorithms to determine the clinical utility of different provocative tests and patient-reported outcomes measures in a variety of contexts, both pre- and postoperatively. Results This review may serve as a valuable resource for surgeons determining the appropriate provocative testing tools and patient-reported outcomes forms to monitor nerve function both pre- and postoperatively. Conclusion As treatments for peripheral nerve injury and dysfunction continue to improve, identifying the most appropriate measures of success may ultimately lead to improved patient outcomes.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"18 1","pages":"e10-e20"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9443297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peroneal Nerve Repair with Cross-Bridge Ladder Technique: Parallel End-to-Side Neurorrhaphies. 交叉桥梯技术修复腓神经:神经端侧平行吻合。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2023-01-01 DOI: 10.1055/s-0043-1768996

Simon Ammanuel, Daniel Burkett, Jason J Kim, Evalina S Bond, Amgad S Hanna

{"title":"Peroneal Nerve Repair with Cross-Bridge Ladder Technique: Parallel End-to-Side Neurorrhaphies.","authors":"Simon Ammanuel, Daniel Burkett, Jason J Kim, Evalina S Bond, Amgad S Hanna","doi":"10.1055/s-0043-1768996","DOIUrl":"https://doi.org/10.1055/s-0043-1768996","url":null,"abstract":"Background Multiple nerve transfer techniques are used to treat patients with nerve injuries when a primary repair is not possible. These techniques are categorized to end-to-end, end-to-side, and side-to-side neurorrhaphy. Our study aims to explore the utility of the cross-bridge ladder technique (H-shaped), which has shown promising results in animal models and probably underutilized clinically. Methods Four patients with significant loss of ankle dorsiflexion were seen in the clinic and underwent evaluation, including electrodiagnostic studies. A cross-bridge ladder repair technique was used between the tibial nerve as the donor and the common peroneal nerve as the recipient via one or two nerve grafts coapted in parallel with end-to-side neurorrhaphies. Dorsiflexion strength was measured preoperatively using the Medical Research Council (MRC) grading system and at each postoperative follow-up appointment. Results All four patients had suffered persistent and severe foot drop (MRC of 0) following trauma that had occurred between 6 and 15 months preoperatively. Three of the four patients improved to an MRC of 2 several months postoperatively. The last patient had an immediate improvement to an MRC of 2 by his first month and had a complete recovery of ankle dorsiflexion within 4 months from surgery. Conclusion We demonstrate the utility and clinical outcomes of the cross-bridge ladder technique in patients with persistent and prolonged foot drop following trauma. Both early and late recovery were seen while all patients regained motor function, with some patients continuing to improve up to the most recent follow-up. IRB Approval: Obtained 2013-1411-CP005.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"18 1","pages":"e21-e26"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9527036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fusion of the Median and Musculocutaneous Nerves Masquerading as Biceps' Innervation from the Median Nerve 正中神经与肌皮神经的融合伪装成二头肌正中神经支配

Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2023-01-01 DOI: 10.1055/s-0043-1767674

Ioannis Antonopoulos, Margarita- Michaela Ampadiotaki, George Tsikouris, Ioannis Chiotis, Georgios Tsakotos, Ioannis Pathiakis, Theodore G. Troupis

引用次数: 0

Effects of Prestretch on Neonatal Peripheral Nerve: An In Vitro Study 预拉伸对新生儿周围神经影响的体外研究

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2022-01-01 DOI: 10.1055/s-0042-1743132

Anita Singh, T. Majmudar, R. Magee, B. Gonik, Sriram Balasubramanian

{"title":"Effects of Prestretch on Neonatal Peripheral Nerve: An In Vitro Study","authors":"Anita Singh, T. Majmudar, R. Magee, B. Gonik, Sriram Balasubramanian","doi":"10.1055/s-0042-1743132","DOIUrl":"https://doi.org/10.1055/s-0042-1743132","url":null,"abstract":"Background Characterizing the biomechanical failure responses of neonatal peripheral nerves is critical in understanding stretch-related peripheral nerve injury mechanisms in neonates. Objective This in vitro study investigated the effects of prestretch magnitude and duration on the biomechanical failure behavior of neonatal piglet brachial plexus (BP) and tibial nerves. Methods BP and tibial nerves from 32 neonatal piglets were harvested and prestretched to 0, 10, or 20% strain for 90 or 300 seconds. These prestretched samples were then subjected to tensile loading until failure. Failure stress and strain were calculated from the obtained load-displacement data. Results Prestretch magnitude significantly affected failure stress but not the failure strain. BP nerves prestretched to 10 or 20% strain, exhibiting significantly lower failure stress than those prestretched to 0% strain for both prestretch durations (90 and 300 seconds). Likewise, tibial nerves prestretched to 10 or 20% strain for 300 seconds, exhibiting significantly lower failure stress than the 0% prestretch group. An effect of prestretch duration on failure stress was also observed in the BP nerves when subjected to 20% prestretch strain such that the failure stress was significantly lower for 300 seconds group than 90 seconds group. No significant differences in the failure strains were observed. When comparing BP and tibial nerve failure responses, significantly higher failure stress was reported in tibial nerve prestretched to 20% strain for 300 seconds than BP nerve. Conclusion These data suggest that neonatal peripheral nerves exhibit lower injury thresholds with increasing prestretch magnitude and duration while exhibiting regional differences.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"17 1","pages":"e1 - e9"},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48329761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy. 18岁女性伸展臂丛分娩性麻痹斜方肌活动的运动分析。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2021-10-26 eCollection Date: 2021-01-01 DOI: 10.1055/s-0041-1731748

Jasmine J Lin, Gromit Y Y Chan, Cláudio T Silva, Luis G Nonato, Preeti Raghavan, Aleksandra McGrath, Alice Chu

{"title":"Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy.","authors":"Jasmine J Lin, Gromit Y Y Chan, Cláudio T Silva, Luis G Nonato, Preeti Raghavan, Aleksandra McGrath, Alice Chu","doi":"10.1055/s-0041-1731748","DOIUrl":"https://doi.org/10.1055/s-0041-1731748","url":null,"abstract":"Background The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method An 18-year-old female with extended upper trunk (C5-6-7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e51-e55"},"PeriodicalIF":0.7,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Outcome Modeling of Preoperative Clinical Symptoms and Electrodiagnostic Data in Tarsal Tunnel Surgery. 跗骨隧道手术术前临床症状和电诊断数据的预测结果建模。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2021-07-27 eCollection Date: 2021-01-01 DOI: 10.1055/s-0041-1731747

Geoffrey K Seidel, Salma Al Jamal, Eric Weidert, Frederick Carington, Michael T Andary, Scott R Millis, Brian G Loder

{"title":"Predictive Outcome Modeling of Preoperative Clinical Symptoms and Electrodiagnostic Data in Tarsal Tunnel Surgery.","authors":"Geoffrey K Seidel, Salma Al Jamal, Eric Weidert, Frederick Carington, Michael T Andary, Scott R Millis, Brian G Loder","doi":"10.1055/s-0041-1731747","DOIUrl":"10.1055/s-0041-1731747","url":null,"abstract":"Background The relationship between tarsal tunnel syndrome (TTS), electrodiagnostic (Edx) findings, and surgical outcome is unknown. Analysis of TTS surgical release outcome patient satisfaction and comparison to Edx nerve conduction studies (NCSs) is important to improve outcome prediction when deciding who would benefit from TTS release. Methods Retrospective study of 90 patients over 7 years that had tarsal tunnel (TT) release surgery with outcome rating and preoperative tibial NCS. Overall, 64 patients met study inclusion criteria with enough NCS data to be classified into one of the following three groups: (1) probable TTS, (2) peripheral polyneuropathy, or (3) normal. Most patients had preoperative clinical provocative testing including diagnostic tibial nerve injection, tibial Phalen's sign, and/or Tinel's sign and complaints of plantar tibial neuropathic symptoms. Outcome measure was percentage of patient improvement report at surgical follow-up visit. Results Patient-reported improvement was 92% in the probable TTS group ( n = 41) and 77% of the non-TTS group ( n = 23). Multivariate modeling revealed that three out of eight variables predicted improvement from surgical release, NCS consistent with TTS ( p = 0.04), neuropathic symptoms ( p = 0.045), and absent Phalen's test ( p = 0.001). The R 2 was 0.21 which is a robust result for this outcome measurement process. Conclusion The best predictors of improvement in patients with TTS release were found in patients that had preoperative Edx evidence of tibial neuropathy in the TT and tibial nerve plantar symptoms. Determining what factors predict surgical outcome will require prospective evaluation and evaluation of patients with other nonsurgical modalities.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e37-e45"},"PeriodicalIF":0.7,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

First Study of the Prevalence and Characterization of Brachial Plexus Injuries in Guatemala. 危地马拉臂丛神经损伤的患病率和特征的首次研究。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2021-07-27 eCollection Date: 2021-01-01 DOI: 10.1055/s-0041-1731746

Carmen Joanna González Lemus, Fernando Xavier Romero Prieto

{"title":"First Study of the Prevalence and Characterization of Brachial Plexus Injuries in Guatemala.","authors":"Carmen Joanna González Lemus, Fernando Xavier Romero Prieto","doi":"10.1055/s-0041-1731746","DOIUrl":"https://doi.org/10.1055/s-0041-1731746","url":null,"abstract":"Objective This study aimed to estimate the prevalence of brachial plexus injuries and to characterize clinically and epidemiologically patients with brachial plexus injury. Materials and Methods In this cross-sectional descriptive study, 2,923 medical records of patients aged 1 to 64 years who presented at outpatient peripheral nerve unit of the Orthopedic Surgery Department of Hospital Roosevelt, Guatemala, from January 2017 to December 2017, were prospectively analyzed to identify the prevalence and factors associated with brachial plexus injuries. Results The prevalence rate of brachial plexus injuries in patients was 5.74%. This injury is more common in men (90.5%) aged 24 to 64 years. Brachial plexus injuries occurred secondary to motorcycle accident in 72% of the cases, with the majority affecting the dominant upper extremity. In addition, 64.28% of the patients took 1 to 6 months to seek consultation, whereas only 16.07% requested medical assistance <1 month from the onset of symptoms, and this result was associated with early diagnosis and adequate recovery during follow-up. Furthermore, 66.67% presented upper brachial plexus injury with no associated fractures or vascular injury, manifesting distress while performing daily activities that required hand, arm, and elbow movements. Conclusion The risk of suffering BPIs in Guatemala increases in economically active male patients that use motorcycles as main mode of transportation. Patients should consult immediately after injury onset to optimize management results. For this reason, hospitals must develop specialized clinical guidelines to speed up the identification and treatment of BPI injuries.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e46-e50"},"PeriodicalIF":0.7,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: Α Cadaveric Study. 肩胛上切迹的形态和内容及其潜在的临床意义:Α尸体研究。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2021-07-27 eCollection Date: 2021-01-01 DOI: 10.1055/s-0041-1731749

George Tsikouris, Ioannis Antonopoulos, Dionysia Vasdeki, Dimosthenis Chrysikos, Athanasios Koukakis, George Tsakotos, Panagiotis Georgakopoulos, Theodore Troupis

{"title":"Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: Α Cadaveric Study.","authors":"George Tsikouris, Ioannis Antonopoulos, Dionysia Vasdeki, Dimosthenis Chrysikos, Athanasios Koukakis, George Tsakotos, Panagiotis Georgakopoulos, Theodore Troupis","doi":"10.1055/s-0041-1731749","DOIUrl":"https://doi.org/10.1055/s-0041-1731749","url":null,"abstract":"Background The suprascapular notch (SN) represents the point along the route of the suprascapular nerve (SSN) with the greatest potential risk for injury and compression. Thus, factors reducing the area of the notch have been postulated for suprascapular neuropathy development. Methods Thirty-one fresh-frozen shoulders were dissected. The contents of the SN were described according to four types as classified by Polguj et al and the middle-transverse diameter of the notch was measured. Also, the presence of an ossified superior transverse scapular ligament (STSL) was identified. Results The ligament was partially ossified in 8 specimens (25.8%), fully ossified in 6 (19.35%), and not ossified in the remaining 17 (54.85%). The mean middle-transverse diameter of the SN was 9.06 mm (standard deviation [SD] = 3.45). The corresponding for type-I notches was 8.64 mm (SD = 3.34), 8.86 mm (SD = 3.12) was for type-II, and 14.5 mm (SD = 1.02) was for type III. Middle-transverse diameter was shorter when an ossified ligament was present (mean = 5.10 mm, SD = 0.88 mm), comparing with a partially ossified ligament (mean =7.67 mm, SD = 2.24 mm) and a nonossified one (mean = 11.12 mm, SD = 2.92 mm). No statistically significant evidence was found that the middle-transverse diameter depends on the number of the elements, passing below the STSL. Conclusion Our results suggest that SSN compression could be more likely to occur when both suprascapular vessels pass through the notch. Compression of the nerve may also occur when an ossified transverse scapular ligament is present, resulting to significant reduction of the notch's area.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e31-e36"},"PeriodicalIF":0.7,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Techniques for Imaging Vascular Supply of Peripheral Nerves. 外周神经血管供应成像技术。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2021-07-23 eCollection Date: 2021-01-01 DOI: 10.1055/s-0041-1731280

Alec Giron, Cameron Cox, Brendan MacKay

引用次数: 0

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves. 用于评估外周神经的磁共振神经显像。

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Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2021-05-14 eCollection Date: 2021-01-01 DOI: 10.1055/s-0041-1729176

Vanessa Ku, Cameron Cox, Andrew Mikeska, Brendan MacKay

引用次数: 0