{"title":"Commentary to \"Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: A Cadaveric Study\".","authors":"Azzat Al-Redouan, David Kachlik","doi":"10.1055/s-0042-1747960","DOIUrl":"https://doi.org/10.1055/s-0042-1747960","url":null,"abstract":"We article “ Morphometry and contents of the suprascapular notch with potential clinical implications: a cadaveric study ” by Tsikouris et al. 1 However, we would like to point out several data that we fi nd contra-dictory to our fi ndings in previous studies and we have differing point of view. The aforementioned study brought up an interesting hy-pothesis which discussed whether there is a correlation of an ossi fi ed superior scapular transverse ligament, also called suprascapular ligament (SL), 2 to a dimensioned middle-trans-verse diameter of the suprascapular notch (SSN) in the SSN Type-IVaccording to Polguj et al SSN morphometric classi fi cation, 3 which is also referred to as suprascapular foramen. 2 The presented study suggested that an ossi fi cation process in the SL was correlated to SSN space narrowing in its horizontal plane and contributing to suprascapular nerve (SN) compres-sion, but thispremise does not seem to bethe case. A SSNwith a middle-transverse diameter mean of 5.10mm can still accommodate the passing SN. The study by Tubbs et al dem-onstrating a compressed SN in 5 SSN out of 50 cadaveric studies was evidenced by histolopathological examination of the SN, and the diameter of those SSN was at critical stenosed range of 1.8","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":" ","pages":"e10-e11"},"PeriodicalIF":0.7,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9208910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40225527","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}
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}
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":"<p><p><b>Background</b> 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. <b>Method</b> 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. <b>Results</b> 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. <b>Conclusion</b> 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.</p>","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}
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":"<p><p><b>Background</b> 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. <b>Methods</b> 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. <b>Results</b> Patient-reported improvement was 92% in the probable TTS group ( <i>n</i> = 41) and 77% of the non-TTS group ( <i>n</i> = 23). Multivariate modeling revealed that three out of eight variables predicted improvement from surgical release, NCS consistent with TTS ( <i>p</i> = 0.04), neuropathic symptoms ( <i>p</i> = 0.045), and absent Phalen's test ( <i>p</i> = 0.001). The <i>R</i> <sup>2</sup> was 0.21 which is a robust result for this outcome measurement process. <b>Conclusion</b> 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.</p>","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}
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":"<p><p><b>Objective</b> This study aimed to estimate the prevalence of brachial plexus injuries and to characterize clinically and epidemiologically patients with brachial plexus injury. <b>Materials and Methods</b> 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. <b>Results</b> 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. <b>Conclusion</b> 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.</p>","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}
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":"<p><p><b>Background</b> 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. <b>Methods</b> 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. <b>Results</b> 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. <b>Conclusion</b> 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.</p>","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}
{"title":"Techniques for Imaging Vascular Supply of Peripheral Nerves.","authors":"Alec Giron, Cameron Cox, Brendan MacKay","doi":"10.1055/s-0041-1731280","DOIUrl":"10.1055/s-0041-1731280","url":null,"abstract":"<p><p>Few studies have been developed to map the vascular structures feeding peripheral nerves, with the majority using cadaveric models and inadequate sample sizes. Preliminary evidence, while limited, indicates that the mapping of these vessels may allow or preclude certain procedures in nerve reconstruction due to the location of essential arterial inflow to the vasa nervorum. This review evaluates the evidence regarding historical, current, and emerging techniques for visualizing these vascular structures in vivo and considers their potential application in peripheral nerve vasculature.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e24-e30"},"PeriodicalIF":0.7,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227783","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}
Vanessa Ku, Cameron Cox, Andrew Mikeska, Brendan MacKay
{"title":"Magnetic Resonance Neurography for Evaluation of Peripheral Nerves.","authors":"Vanessa Ku, Cameron Cox, Andrew Mikeska, Brendan MacKay","doi":"10.1055/s-0041-1729176","DOIUrl":"10.1055/s-0041-1729176","url":null,"abstract":"<p><p>Peripheral nerve injuries (PNIs) continue to present both diagnostic and treatment challenges. While nerve transections are typically a straightforward diagnosis, other types of PNIs, such as chronic or traumatic nerve compression, may be more difficult to evaluate due to their varied presentation and limitations of current diagnostic tools. As a result, diagnosis may be delayed, and these patients may go on to develop progressive symptoms, impeding normal activity. In the past, PNIs were diagnosed by history and clinical examination alone or techniques that raised concerns regarding accuracy, invasiveness, or operator dependency. Magnetic resonance neurography (MRN) has been increasingly utilized in clinical settings due to its ability to visualize complex nerve structures along their entire pathway and distinguish nerves from surrounding vasculature and tissue in a noninvasive manner. In this review, we discuss the clinical applications of MRN in the diagnosis, as well as pre- and postsurgical assessments of patients with peripheral neuropathies.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e17-e23"},"PeriodicalIF":0.7,"publicationDate":"2021-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38925690","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}
Oliver Gembruch, Yahya Ahmadipour, Mehdi Chihi, Thiemo F Dinger, Laurèl Rauschenbach, Daniela Pierscianek, Ramazan Jabbarli, Ulrich Sure, Karsten H Wrede, Anne-Kathrin Uerschels
{"title":"Lipomas as an Extremely Rare Cause for Brachial Plexus Compression: A Case Series and Systematic Review.","authors":"Oliver Gembruch, Yahya Ahmadipour, Mehdi Chihi, Thiemo F Dinger, Laurèl Rauschenbach, Daniela Pierscianek, Ramazan Jabbarli, Ulrich Sure, Karsten H Wrede, Anne-Kathrin Uerschels","doi":"10.1055/s-0041-1726087","DOIUrl":"https://doi.org/10.1055/s-0041-1726087","url":null,"abstract":"<p><p><b>Introduction</b> Brachial plexus lipomas are extremely rare benign tumors that may cause slow progression of neurological deficits leading to thoracic outlet syndrome. Up to now, surgery remains challenging. The aim of this study is to present our surgical treatment regime and long-term neurological outcome in three cases of giant brachial plexus lipomas and to show results of systematic review. <b>Patients and Methods</b> Retrospective analysis of our database \"peripheral nerve lesion\" to identify patients suffering from brachial plexus lipomas between January 1, 2012, and December 31, 2019. Systematic review was performed for literature published until March 31, 2020, analyzing PubMed, Google Scholar, Scopus, and the Cochrane Collaboration Library independently by two authors. <b>Results</b> Over the past years, three patients suffering from giant brachial plexus lipomas attended to our neurosurgical department. All patients underwent preoperative magnetic resonance imaging (MRI), ultrasound examinations, and electrophysiological testing. Tumors were removed microsurgically via anterior/posterior, supraclavicular/infraclavicular, and combined approaches. The patients were accessed postoperatively by MRI and clinical follow-up. Systematic review of the literature revealed 22 cases, which were analyzed in regard to demographics, surgical treatment, and neurological outcome. <b>Conclusion</b> Brachial plexus lipomas are an extremely rare cause for brachial plexus compression. Total microsurgical removal with intraoperative electrophysiological monitoring is the treatment of choice with excellent long-term MRI and clinical outcome.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e10-e16"},"PeriodicalIF":0.7,"publicationDate":"2021-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1726087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38818300","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}
Kazuteru Doi, Sei Haw Sem, Bipin Ghanghurde, Yasunori Hattori, Sotetsu Sakamoto
{"title":"Pearls and Pitfalls of Phrenic Nerve Transfer for Shoulder Reconstruction in Brachial Plexus Injury.","authors":"Kazuteru Doi, Sei Haw Sem, Bipin Ghanghurde, Yasunori Hattori, Sotetsu Sakamoto","doi":"10.1055/s-0041-1722979","DOIUrl":"https://doi.org/10.1055/s-0041-1722979","url":null,"abstract":"<p><p><b>Objectives</b> The purpose of this study was to report the functional outcomes of phrenic nerve transfer (PNT) to suprascapular nerve (SSN) for shoulder reconstruction in brachial plexus injury (BPI) patients with total and C5-8 palsies, and its pulmonary complications. <b>Methods</b> Forty-four out of 127 BPI patients with total and C5-8 palsies who underwent PNT to SSN for shoulder reconstruction were evaluated for functional outcomes in comparison with other types of nerve transfers. Their pulmonary function was analyzed using vital capacity in the percentage of predicted value and Hugh-Jones (HJ) breathless classification. The predisposing factors to develop pulmonary complications in those patients were examined as well. <b>Results</b> PNT to SSN provided a better shoulder range of motion significantly as compared with nerve transfer from C5 root and contralateral C7. The results between PNT and spinal accessory nerve transfer to SSN were comparable in all directions of shoulder motions. There were no significant respiratory symptoms in majority of the patients including six patients who were classified into grade 2 HJ breathlessness grading. Two predisposing factors for poorer pulmonary performance were identified, which were age and body mass index, with cut-off values of younger than 32 years old and less than 23, respectively. <b>Conclusions</b> PNT to SSN can be a reliable reconstructive procedure in restoration of shoulder function in BPI patients with total or C5-8 palsy. The postoperative pulmonary complications can be prevented with vigilant patient selection.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":0.7,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1722979","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25367942","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}