Clinical and functional outcome after different surgical approaches for brachial plexus injuries: Cohort study

Suroto, Heri

doi:10.1016/j.amsu.2022.103714

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…The lack of spontaneous improvement in this case may have been related to the size of the puncture needle and the surface area of the injured nerve. External denervation has been reported to be effective for peripheral nerve injuries resistant to conservative therapy[ 16 - 18 ], and the same principle was applied in this case. The preoperative findings led to a diagnosis of median nerve injury, and the median nerve did in fact show marked adhesions at the site of the positive tinel-like sign.…”

Section: Discussionmentioning

confidence: 95%

Median neuropathy after multiple punctures of the forearm for catheterization: A case report

Suzuki,

Matsui,

Momma

et al. 2023

World J Clin Cases

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Insulin, a small protein with 51 amino acids synthesized by pancreatic β-cells, is crucial to sustain glucose homeostasis at biochemical and molecular levels. Numerous metabolic dysfunctions are related to insulin-mediated altered glucose homeostasis. One of the significant pathophysiological conditions linked to the insulin associated disorder is diabetes mellitus (DM) (type 1, type 2, and gestational). Insulin resistance (IR) is one of the major underlying causes of metabolic disorders despite its association with several physiological conditions. Metabolic syndrome (MS) is another pathophysiological condition that is associated with IR, hypertension, and obesity. Further, several other pathophysiological disorders/diseases are associated with the insulin malfunctioning, which include polycystic ovary syndrome, neuronal disorders, and cancer. Insulinomas are an uncommon type of pancreatic β-cell-derived neuroendocrine tumor that makes up 2% of all pancreatic neoplasms. Literature revealed that different biochemical events, molecular signaling pathways, microRNAs, and microbiota act as connecting links between insulin disorder and associated pathophysiology such as DM, insuloma, neurological disorder, MS, and cancer. In this review, we focus on the insulin-related disorders and the underlying mechanisms associated with the pathophysiology.

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Section: Discussionmentioning

confidence: 95%

Median neuropathy after multiple punctures of the forearm for catheterization: A case report

Suzuki,

Matsui,

Momma

et al. 2023

World J Clin Cases

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“…Rehabilitation should incorporate the treatment supporting nerve regeneration, muscle strengthening, and maintaining functional ranges of motion of the injured extremities. It comprises the neuromuscular electrical stimulation (NMES) [12,34,35]. Contemporary researches show that NMES increases the strength of stimulated muscles, thereby preventing atrophy while waiting for the results of axonal regeneration.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical assessment analyses the sensory perception, physiological reflexes in the upper extremity, range of movement of the extremities, muscle tension, muscle strength, and atrophy, compared to the asymptomatic side [12,13]. Imaging tests such as magnetic resonance imaging (MRI) and ultrasound (USG) also provide objectivity to the clinical examination.…”

Section: Introductionmentioning

confidence: 99%

Determining the Algorithm of Rehabilitation Procedures in Patients with Brachial Plexus Injuries Based on the Prospective Single-Centre Clinical Neurophysiology Studies: Preliminary Results

Lewczuk,

Wiertel-Krawczuk,

Huber

2024

Applied Sciences

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The clinical neurophysiological tests allow us to determine the type, extent, and nature of brachial plexus damage. They are crucial in decision making regarding surgical procedures or conservative treatment. This report aimed to present an algorithm for rehabilitation procedures in patients with brachial plexus injury of various origins based on the results of neurophysiology findings for the selection of procedures supporting the process of nerve and muscle regeneration. The research group consisted of patients whose medical documentation was analysed concerning the reason, level, and localization of damage to the brachial plexus structures, surgical and or rehabilitative treatment, as well as the MRI results. Among the group of fourteen patients, the clinical studies showed the greatest incidence of brachial plexus injuries of the mixed (both pre- and postganglionic), all trunks, and cervical root injuries, respectively. Results of the motor evoked potentials (MEP) and electroneurography (ENG) recordings induced at levels of spinal roots and Erb’s point showed a decrease of more than 40% in amplitudes on the symptomatic side in comparison to the asymptomatic side. This diffeence was recorded for the axillary and radial innervation and the C5, C6, and C7 root domains, ranging from 57% to 66%; the lowest decrease was recorded following electrical stimulation at Erb’s point for the ulnar nerve (34%). The latency prolongation on the symptomatic side in CMAP and MEP tests ranged from 0.2 to 1.7 ms, with the most following magnetic stimulation of the C5 cervical root for the axillary innervation. Most of the results indicated the axonotmesis and neuropraxia type of injury in motor fibers (40%) confirmed by EMG results. The sensory conduction studies (SNCS) in distal nerve branches did not confirm the severe advancement of the brachial plexus injury (63%). The proposed algorithm of the physiotherapeutic procedures should be mainly targeted for recovery of motor dysfunction as the consequence of brachial plexus injury. Rehabilitation should incorporate the treatment supporting nerve regeneration, muscle strengthening, and maintaining functional ranges of motion of the injured extremities. The rehabilitation treatment for patients with brachial plexus injuries is an individualised process, and the selection of procedures and the effectiveness of the treatment undertaken should be confronted with results of neurophysiological tests verifying the motor neural transmission from the level of the cervical motor centre to the effector, peripheral nerve function, and muscle’s motor unit activity.

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The Psychological Impact of Adult Traumatic Brachial Plexus Injury

Emani,

Garg,

Elhassan

et al. 2024

Hand (New York, N,Y.)

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Background: Adult traumatic brachial plexus injuries (BPIs) present a significant medical challenge, potentially leading to life-altering consequences for patients’ upper extremity pain and function. However, the psychological impact on patients has not been extensively studied. Methods: Adult patients with traumatic BPIs treated at 2 tertiary referral centers in the United States from 2015 to 2019 were retrospectively identified. This cohort of 84 patients was targeted for prospective interviews, and 44 patients (52%) responded. Validated measures including the posttrumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (PCL-5), Decision Regret Scale, Patient-Reported Outcome Measurement Information System (PROMIS) Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) were obtained through telephone-based interviews. Additional data were collected through electronic medical record review. Results: On average, patients experience low post-traumatic stress (median score 6, interquartile range [IQR] 3-20) and decision regret (median score 5, IQR 0-22.5). However, a notable fraction (18%) of patients met the clinical threshold for PTSD. Significant correlations were observed between PCL-5 scores and worse PROMIS Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and QuickDASH. Decision regret scores correlated with worse PROMIS Upper Extremity and QuickDASH. Conclusions: While the overall incidence of PTSD and treatment decision regret after adult traumatic BPI is low, clinical PTSD was found in a significant percentage of patients associated with pain and functional impairment. This study highlights the importance of understanding and addressing the psychological burden of traumatic BPI.

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Clinical and functional outcome after different surgical approaches for brachial plexus injuries: Cohort study

Cited by 4 publications

References 29 publications

Median neuropathy after multiple punctures of the forearm for catheterization: A case report

Median neuropathy after multiple punctures of the forearm for catheterization: A case report

Determining the Algorithm of Rehabilitation Procedures in Patients with Brachial Plexus Injuries Based on the Prospective Single-Centre Clinical Neurophysiology Studies: Preliminary Results

The Psychological Impact of Adult Traumatic Brachial Plexus Injury

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