{"title":"Effects of Timing of Nerve Injury and Repair in Neonatal and Adult Brachial Plexus Injury Models","authors":"G. Bourke, Lev Novokov, A. Hart, M. Wiberg","doi":"10.5772/intechopen.99359","DOIUrl":"https://doi.org/10.5772/intechopen.99359","url":null,"abstract":"Brachial plexus Injury causes severe and long-term upper limb deficits at any age. The outcome from current reconstructive options depends on the severity of nerve injury and timing of intervention. This chapter summarises the differing biological responses to nerve injury that occur during neonatal, young adult and mature adult life. The central and peripheral reactions to nerve injury, the effects of timing of repair on both motor and sensory neuronal survival and basic science evidence to support early intervention are discussed.","PeriodicalId":313596,"journal":{"name":"Brachial Plexus Injury [Working Title]","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126433002","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}
Lin-lin Yang, Yaxuan Li, Qianling Zhang, Mengnan Jiang, J. He
{"title":"The Role of Functional Electrical Stimulation in Brachial Plexus Injury Repair","authors":"Lin-lin Yang, Yaxuan Li, Qianling Zhang, Mengnan Jiang, J. He","doi":"10.5772/intechopen.99660","DOIUrl":"https://doi.org/10.5772/intechopen.99660","url":null,"abstract":"Brachial plexus injury (BPI) is a type of peripheral nerve injury, which is mainly manifested as upper limb sensory and motor dysfunction. Although the injury will not endanger life, it can cause serious functional loss and high disability rate, and eventually lead to patients unable to live normally. At present, the treatment methods for BPI mainly include conservative treatment, such as limb massage, exercise, drug therapy, autonomous movement and strength training; In clinic, nerve repair, nerve transplantation and muscle transfer can also be used. Although surgical treatment can better restore the function of injured brachial plexus, there is a certain risk, so it is not the first choice of treatment. As a mature electrical stimulation method, functional electrical stimulation (FES) can play a good role in promoting injured nerve regeneration and preventing skeletal muscle denervation atrophy, so it can be widely used in the treatment and functional recovery of BPI. This article will review the research progress of FES in the treatment of BPI.","PeriodicalId":313596,"journal":{"name":"Brachial Plexus Injury [Working Title]","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116366812","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":"Nerve Transfers for Restoring Elbow Flexion in Brachial Plexus Palsy","authors":"T. Stamate, D. Moraru","doi":"10.5772/intechopen.98869","DOIUrl":"https://doi.org/10.5772/intechopen.98869","url":null,"abstract":"Nerve transfers (NT) consist in sectioning a donor nerve and connecting it to the distal stump of a recipient unrepairable nerve. For elbow flexion restoration in brachial plexus palsy (BPP) we used different NT: 1) GF motor Ulnar Nerve to Biceps nerve (Oberlin technique), 2) Double fascicular median/ulnar to biceps/brachialis nerve transfer (Mackinnon), 3) InterCostal Nerves (ICN) to MCN (+/− nerve graft), 4) Medial Pectoral Nerve (MPN) to MCN, 5) ThoracoDorsal Nerve (TDN) to MCN, 6) Spinal Accessory Nerve (SAN) to MCN transfer, 7) Phrenic Nerve (PhN) to MCN, 8) Cervical Plexus C3-C4 to MCN and 9) Contralateral C7 (CC7). I want to present my personal experience using the phrenic nerve (PhN), the intercostal nerves (ICN) and Oberlin’s technique. The aim of this retrospective study is to evaluate the results of this procedure in BPP. NT is an important goal in BPP. ICN transfer into the nerve of biceps for elbow flexion recovery is a reliable procedure in BPP. ICN transfer for triceps offers a positive alternative (Carroll transposition). Oberlin technique is simple and offers better results in a shorter amount of time and is an effective and safe option.","PeriodicalId":313596,"journal":{"name":"Brachial Plexus Injury [Working Title]","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122866920","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}
J. Reinsch, A. Zdunczyk, T. A. Sargut, Maren Denker, M. Engelhardt, P. Vajkoczy, T. Picht, N. Dengler
{"title":"Factors of Cortical Plasticity in Brachial Plexus Injury","authors":"J. Reinsch, A. Zdunczyk, T. A. Sargut, Maren Denker, M. Engelhardt, P. Vajkoczy, T. Picht, N. Dengler","doi":"10.5772/intechopen.98822","DOIUrl":"https://doi.org/10.5772/intechopen.98822","url":null,"abstract":"Cortical plasticity is the brain’s capability of decoding new information through growth and reorganization over our whole life spam. It is the basis for good outcomes after reinnervation and for rehabilitation of adult and obstetric brachial plexus injury. Knowledge about cortical reorganization is crucial to reconstructive surgeons and physiotherapists that aim to give their patients a reasonable prognosis. This chapter intends to present and summarize the current literature on how to detect and quantify cortical plasticity and how research on factors that influence cortical plasticity, mainly in relation to peripheral nerve and more precise brachial plexus injury progresses. Peculiarities of adult and obstetric brachial plexus injuries and their treatment are given. We present techniques that visualize and quantify cortical plasticity with focus on functional imaging like fMRI and nTMS as well as molecular aspects. Future research is needed to understand mechanisms of how molecular changes on a synaptic level of a neuron influence the macroscopic plasticity, to improve rehabilitative resources, to understand the exact prognostic value of nTMS in brachial plexus injury and to investigate the therapeutic capability of rTMS.","PeriodicalId":313596,"journal":{"name":"Brachial Plexus Injury [Working Title]","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124031946","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}
Shivani Gupta, Nivetha Srinivasan, Jasmine Mahajan, Amy Song, A. Chu, A. Mcgrath
{"title":"Outcome Measures in OBPP","authors":"Shivani Gupta, Nivetha Srinivasan, Jasmine Mahajan, Amy Song, A. Chu, A. Mcgrath","doi":"10.5772/intechopen.98796","DOIUrl":"https://doi.org/10.5772/intechopen.98796","url":null,"abstract":"Traditional outcome measurement scales, such as the Medical Research Council (MRC) score, the Active Movement Scale (AMS), and Mallet score, are used by surgeons to assess outcomes in patients with obstetric brachial plexus palsy (OBPP). The measurement scales used to evaluate patients fall under the International Classification of Functioning (ICF) domains of Body Function, Body Structure, Activity, Participation, and Environment and are used to assess function and disability of patients. Currently used outcome measures scales for OBPP are also contrasted with those used for another perinatal condition affecting the upper limb, cerebral palsy (CP).","PeriodicalId":313596,"journal":{"name":"Brachial Plexus Injury [Working Title]","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115677951","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":"Nerve Transfers to Recover External Rotation of the Shoulder after Brachial Plexus Injuries in Adults","authors":"J. Goubier, C. Echalier, E. Dubois, F. Teboul","doi":"10.5772/intechopen.99330","DOIUrl":"https://doi.org/10.5772/intechopen.99330","url":null,"abstract":"Restoration of external rotation of the shoulder in adults with partial brachial plexus palsies is challenging. While nerve grafts are possible, nerve transfers are currently the most use method for satisfactory restoration of function. Numerous nerve transfers have been described, although the transfer of the spinal accessory nerve to the suprascapular nerve remains the gold standard. The suprascapular nerve and the nerve to the teres minor muscle are the two preferred targets to restore external rotation of the shoulder. There are numerous nerve donors, but their use obviously depends on the initial injury. The most common donors are the spinal accessory nerve, the rhomboid nerve, branches of the radial nerve, the C7 root fascicle or the ulnar nerve. The choice for the transfer depends on the available nerves and first of all on chosen approach, whether it be cervical or scapular. It also depends on the other associated reconstruction procedures, grafts, or nerve transfers for the recovery of other functions, specifically, elevation of the shoulder and flexion of the elbow. The objective of this chapter is to present the main nerve transfers and to propose a therapeutic strategy.","PeriodicalId":313596,"journal":{"name":"Brachial Plexus Injury [Working Title]","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122719015","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}