Journal of Brachial Plexus and Peripheral Nerve Injury最新文献

{"title":"Does the Duration and Severity of Symptoms Have an Impact on Relief of Symptoms after Carpal Tunnel Release?","authors":"Mehreen Masud,&nbsp;Mamoon Rashid,&nbsp;Saleem Akhtar Malik,&nbsp;Muhommad Ibrahim Khan,&nbsp;Saad-Ur-Rehman Sarwar","doi":"10.1055/s-0038-1668552","DOIUrl":"https://doi.org/10.1055/s-0038-1668552","url":null,"abstract":"<p><p><b>Rationale</b>  Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb. The treatment of CTS ranges from conservative management to carpal tunnel release. Many patients with misconception about the potential morbidity and with the hope of successful conservative treatment delay the surgical release of carpal tunnel. This delay results in reduced recovery of sensory and motor median nerve function. <b>Objective</b>  The aim of this study was to evaluate the influence of preoperative duration and severity of symptom on the outcome of carpal tunnel surgery. <b>Method</b>  It included 45 cases of CTS, all treated with limited access open carpal tunnel release. The duration of symptoms (i.e., pain, numbness, tingling, waking up at night because of pain/numbness, difficulty in grasping small objects, and their preoperative severity) was noted using Boston CTS questionnaire. To investigate the outcome, patients were divided into three groups based on their duration of symptoms. <b>Result</b>  Group1: The severity of symptoms was reduced to normal in a short period of time in patients who presented with duration of symptoms less than 6 months. Group 2: Patients in whom symptoms lasted for 6 to 12 months had reduced or delayed recovery of hand function as compared with first group. Group 3: Patients who had symptoms for more than 12 months had incomplete recovery of grip strength. Return to normal function took the longest time (median: 16 weeks) in this group. <b>Conclusion</b>  This study suggests that patients who present late have delayed/incomplete relief of symptoms after carpal tunnel release.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e1-e8"},"PeriodicalIF":0.7,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1668552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36938367","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":"A New Surgical Technique for Internal Shoulder Contractures Secondary to Obstetric Brachial Plexus Injury: An Anterior Coracohumeral Ligament Release","authors":"Ç. Saraç, S. Hogendoorn, R. Nelissen","doi":"10.1055/s-0039-1693746","DOIUrl":"https://doi.org/10.1055/s-0039-1693746","url":null,"abstract":"Abstract Background Obstetric brachial plexus injuries result from traction injury during delivery; 30% of these children sustain persisting functional limitations related to an external rotation deficit of the shoulder. The aim of this study was to compare the intraoperative gain in external rotation after a posterior subscapular release and an anterior coracohumeral ligament release. Methods This is a prospective study on 102 children with an internal rotation contracture of the shoulder who received either a posterior subscapular release (posterior skin incision along the medial border of the scapula of 3–5 cm) or an anterior (5-mm skin incision) coracohumeral ligament release between 1996 and 2010. After general anesthesia, internal and external rotations in both adduction and abduction were measured before and after the surgical release. Results After a posterior subscapular release, the intraoperative external rotation improved with a mean of 64 degrees (95% confidence interval [CI]: 54–74; p < 0.001) in adduction and with a mean of 41 degrees (95% CI: 32–49; p < 0.001) in abduction. After an anterior coracohumeral ligament release, external rotation increased with a mean of 61 degrees (95% CI: 56–66; p < 0.001) in adduction and a mean of 42 degrees in abduction (95%CI: 39–45, p < 0.001). Differences between these two groups were not statistically different. Conclusion The anterior release technique shows comparable results with the posterior subscapular release. And since it is performed through a smaller incision of 5 mm, this is our preferred method to increase passive external rotation. Level of evidence II.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e35 - e38"},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1693746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46484398","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}

{"title":"The Pathogenesis of Glenohumeral Deformity and Contracture Formation in Obstetric Brachial Plexus Palsy—A Review","authors":"P. Olofsson, A. Chu, A. Mcgrath","doi":"10.1055/s-0039-1692420","DOIUrl":"https://doi.org/10.1055/s-0039-1692420","url":null,"abstract":"Abstract Contractures of the shoulder joint and glenohumeral joint dysplasia are well known complications to obstetrical brachial plexus palsy. Despite extensive description of these sequelae, the exact pathogenesis remains unknown. The prevailing theory to explain the contractures and glenohumeral joint dysplasia states that upper trunk injury leads to nonuniform muscle recovery and thus imbalance between internal and external rotators of the shoulder. More recently, another explanation has been proposed, hypothesizing that denervation leads to reduced growth of developing muscles and that reinnervation might suppress contracture formation. An understanding of the pathogenesis is desirable for development of effective prophylactic treatment. This article aims to describe the current state of knowledge regarding these important complications.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e24 - e34"},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1692420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42682836","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}

{"title":"A Comparison of Patients from Argentina and Germany to Assess Factors Impacting Brachial Plexus and Brain Injury","authors":"M. Socolovsky, G. Antoniadis, A. Lovaglio, G. Durner, Gonzalo Bonilla, Markus Schmidhammer, G. di Masi","doi":"10.1055/s-0039-1693687","DOIUrl":"https://doi.org/10.1055/s-0039-1693687","url":null,"abstract":"Abstract Background Traumatic brachial plexus injuries (BPIs) represent a major cause of disability in young patients. The purpose of this study was to compare two populations (from Argentina and Germany) who suffered a traumatic BPI after a motorcycle accident to identify predictors of BPI and brain injury severity. Methods Univariate and multivariable intergroup comparisons were conducted, and odds ratios were calculated to assess the associations between the different demographic, morphometric, and trauma-related variables, and the type and severity of patients' injuries. Pearson correlation coefficients were generated to identify statistically significant correlations. Results A total of 187 patients were analyzed, 139 from Argentina and 48 from Germany. The two countries differed significantly in age and several morphometric and trauma-related variables. The clinical presentation was also convincingly different in the two countries. The following three variables remained as statistically significant predictors of a complete (vs. partial) BPI: living in Argentina (p < 0.001), presenting prior to 2015 (p = 0.004), and greater estimated speed at the time of impact (p = 0.074). As for BPIs, a disproportionate percentage (85.6%) of more severe brain injuries occurred in Argentinian patients (p < 0.001) and among those whose accident involved striking a stationary vertical object. Conclusions This study identified several factors that might be considered when planning governmental policies and education initiatives to reduce BPI and brain injuries related to motorcycle use. Level of evidence II-2 (evidence obtained from case–control studies).","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e39 - e46"},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1693687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44523703","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}

{"title":"Shoulder Subluxation Pain as a Secondary Indication for Trapezius to Deltoid Transfer.","authors":"Andrew I Elkwood,&nbsp;Michael I Rose,&nbsp;Matthew R Kaufman,&nbsp;Tushar R Patel,&nbsp;Russell L Ashinoff,&nbsp;Adam Saad,&nbsp;Lisa F Schneider,&nbsp;Eric G Wimmers,&nbsp;Hamid Abdollahi,&nbsp;Deborah Yu","doi":"10.1055/s-0038-1676786","DOIUrl":"https://doi.org/10.1055/s-0038-1676786","url":null,"abstract":"<p><p>Brachial plexus injuries can be debilitating. We have observed that manual reduction of the patients' shoulder subluxation improves their pain and have used this as a second reason to perform the trapezius to deltoid muscle transfer beyond motion. The authors report a series of nine patients who all had significant improvement of pain in the shoulder girdle and a decrease in pain medication use after a trapezius to deltoid muscle transfer. All patients were satisfied with the outcomes and stated that they would undergo the procedure again if offered the option. The rate of major complications was low. The aim is not to describe a new technique, but to elevate a secondary indication to a primary for the trapezius to deltoid transfer beyond improving shoulder function: pain relief from chronic shoulder subluxation.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"13 1","pages":"e20-e23"},"PeriodicalIF":0.7,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1676786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36875249","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":"Posterior Tibial Neuropathy Secondary to Pseudoaneurysm of the Proximal Segment of the Anterior Tibial Artery with Delayed Onset.","authors":"Abolfazl Rahimizadeh,&nbsp;Manuchehr Davaee,&nbsp;Majid Shariati,&nbsp;Shaghayegh Rahimizadeh","doi":"10.1055/s-0038-1669403","DOIUrl":"https://doi.org/10.1055/s-0038-1669403","url":null,"abstract":"<p><p>Anterior tibial artery is a nonvital artery which is one of the three arteries of the leg. This artery has a short proximal l segment in the popliteal region and a long segment in the anterior compartment of the leg designated as distal segment. With consideration of the deep location of the proximal segment in the popliteal fossa, it is less susceptible to trauma and subsequent formation of an aneurysm. On the contrary, the superficial long distal segment is more susceptible to trauma with high chance of pseudoaneurysm formation at the site of unrecognized injury. In this article, a 38-year-old military man being manifested about a decade after a trivial missile fragment injury with progressive posterior tibial neuropathy is presented. A giant pseudoaneurysm arising from the proximal segment of the anterior tibial artery was confirmed with angiography and the exact size of this pathology was documented with contrasted computed tomographic scan. The aneurysmal sac removal was accomplished after ligation of the corresponding artery proximal and distal to the sac followed by tibial nerve neurolysis which result in full recovery. In careful review we found that neither pseudoaneurysm arising from the proximal tibial artery nor posterior tibial neuropathy due to the compressive effect of the aneurysmal sac of this segment has been reported previously. Our primary purpose for reporting this case is not to describe the rarity of pseudoaneurysm formation at proximal segment of this artery but rather to describe delayed-onset posterior tibial vascular compressive neuropathy due to such an aneurysm. Eventually due to the potential sequel of a pseudoaneurysm, it is important for the surgeons to have high index of suspicion to prevent a missed or delayed diagnosis.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"13 1","pages":"e15-e19"},"PeriodicalIF":0.7,"publicationDate":"2018-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1669403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36522368","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":"Biomechanical Responses of Neonatal Brachial Plexus to Mechanical Stretch.","authors":"Anita Singh,&nbsp;Shania Shaji,&nbsp;Maria Delivoria-Papadopoulos,&nbsp;Sriram Balasubramanian","doi":"10.1055/s-0038-1669405","DOIUrl":"https://doi.org/10.1055/s-0038-1669405","url":null,"abstract":"<p><p>This study investigated the biomechanical responses of neonatal piglet brachial plexus (BP) segments-root/trunk, chord, and nerve at two different rates, 0.01 mm/second (quasistatic) and 10 mm/second (dynamic)-and compared their response to another peripheral nerve (tibial). Comparisons of mechanical responses at two different rates reported a significantly higher maximum load, maximum stress, and Young's modulus (E) values when subjected to dynamic rate. Among various BP segments, maximum stress was significantly higher in the nerve segments, followed by chord and then the root/trunk segments except no differences between chord and root/trunk segments at quasistatic rate. E values exhibited similar behavior except no differences between the chord and root/trunk segments at both rates and no differences between chord and nerve segments at quasistatic rate. No differences were observed in the strain values. When compared with the tibial nerve, only mechanical properties of BP nerves were similar to the tibial nerve. Mechanical stresses and E values reported in BP root/trunk and chord segments were significantly lower than tibial nerve at both rates. When comparing the failure pattern, at quasistatic rate, necking was observed at maximum load, before a complete rupture occurred. At dynamic rate, partial rupture at maximum load, followed by a full rupture, was observed. Occurrence of the rate-dependent failure phenomenon was highest in the root/trunk segments followed by chord and nerve segments. Differences in the maximum stress, E values, and failure pattern of BP segments confirm variability in their anatomical structure and warrant future histological studies to better understand their stretch responses.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"13 1","pages":"e8-e14"},"PeriodicalIF":0.7,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1669405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36486899","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":"Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases.","authors":"Amgad Hanna,&nbsp;Larry O'Neil Bodden,&nbsp;Gabriel R L Siebiger","doi":"10.1055/s-0037-1607977","DOIUrl":"https://doi.org/10.1055/s-0037-1607977","url":null,"abstract":"<p><p>Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"13 1","pages":"e1-e3"},"PeriodicalIF":0.7,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0037-1607977","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35878492","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":"Neurosurgical Operative Atlas: Spine and Peripheral Nerves","authors":"J. Bahm","doi":"10.1055/s-0038-1669395","DOIUrl":"https://doi.org/10.1055/s-0038-1669395","url":null,"abstract":"Spine","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"13 1","pages":"e7 - e7"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1669395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47277913","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}

{"title":"Manual of Peripheral Nerve Surgery","authors":"J. Bahm","doi":"10.1055/S-0038-1669393","DOIUrl":"https://doi.org/10.1055/S-0038-1669393","url":null,"abstract":"Manual of Peripheral Nerve Surgery edited by M. Socolovsky, L. Rasulic, R. Midha, and D. Garozzo [Thieme 2018] This concise and well-focused compendium is the fruit of a very active Peripheral Nerve Surgery Committeewithin the World Federation of Neurosurgical Societies, driven by the book editors who represent clinical and scientific knowledge in this particular field from different continents—a must in an areawith sometimes rare clinical cases and few dedicated specialists in every country. The present book is perfect for beginners or experts and is based on solid ground, starting with current reviews on nerve anatomy of the limbs, the clinical aspect of nerve trauma including war injuries, and diagnostic tools (electrodiagnosis, magnetic resonance, and ultrasound). The different neurosurgical techniques are detailed in this book, starting with neurolysis, direct repair, nerve grafting, and increasing use of tubes. Compressive lesions including the thoracic outlet syndrome are presented; several chapters deal with the traumatic brachial plexus lesions, in adults and the neonate, and lumbosacral plexus. Reconstruction of the facial nerve palsy is exposed by one skilled neurosurgeons’ personal experience and the last two chapters summarize the actual knowledge on benign and malignant peripheral nerve tumors, wherein many authors contributed their knowledge and cases together to help readers better understand the guidelines on diagnosis and surgical strategy. The editors stand for an excellent activity in their committee, aimed to raise interest and performance in the sometimes “neglected” field of the peripheral nerve, also addressed in other surgical specialties such as plastic and hand or orthopaedic surgery. Dedication to the peripheral nerve is a surgical passion, and the book reflects this enthusiasm. Although many textbooks on this topic came up in the last decade, this work is a milestone as it has a clear message as stated in the title “from the basics to complex procedures” in 200 pages, allowing the newcomers to go through it in a reasonable time without being discouraged by a 2,000 page encyclopedia, and still detailed enough on so delicate topics like the malignant peripheral nerve sheath tumors to satisfy surgical experts, facing rare and complex cases. Also, it is not just about “doing”: a lot of emphasis is given to the timing and the outcome of nerve reconstructions, which are not always perfect or predictable and frequently claim an interdisciplinary approach with secondary procedures performed by other specialties. But this is beyond the scope of this book, which clearly fulfils its scope, to address all those, especially neurosurgeons and neurologists, who want to know how surgery on peripheral nerves should be indicated, done, and followed up. This manual fits in the list of existing textbooks as being very well documented, clearly written, and concise, reflecting today’s peripheral nerve surgeon’s activity.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"13 1","pages":"e5 - e5"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0038-1669393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46262487","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}