Measuring Outcomes in Adult Brachial Plexus Reconstruction

Bengtson, Keith A.; Spinner, Robert J.; Bishop, Allen T.; Kaufman, Kenton R.; Coleman-Wood, Krista; Kircher, Michelle F.; Shin, Alexander Y.

doi:10.1016/j.hcl.2008.04.001

Cited by 64 publications

(62 citation statements)

References 82 publications

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“…From the practical standpoint, this classification is only partially useful, as the day-by-day contact with different patients demonstrated that some cases could not be included in any of these groups. Moreover, our personal observation, supported by data from the literature [10][11][12] , suggested that the preoperative functional status of the hand is one of the most important predictors associated to brachial plexus surgery. The strength of the hand is directly related to better outcomes (i.e., a strong pre-operative wrist and finger flexion and extension is usually associated to better outcomes, and such outcomes become poorer as the hand become weaker or paralyzed).…”

Section: Discussionsupporting

confidence: 67%

The importance of the preoperative clinical parameters and the intraoperative electrophysiological monitoring in brachial plexus surgery

Flores

2011

Arq. Neuro-Psiquiatr.

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Objective:The study aims to demonstrate the impact of some preoperative clinical parameters on the functional outcome of patients sustaining brachial plexus injuries, and to trace some commentaries about the use of intraoperative monitoring techniques. Method: A retrospective study one hundred cases of brachial plexus surgery. The analysis regarding postoperative outcomes was performed by comparing the average of the final result of the surgery for each studied cohort. Results: Direct electrical stimulation was used in all patients, EMG in 59%, SEPs in 37% and evoked NAPs in 19% of the cases. Patients in whom the motor function of the hand was totally or partially preserved before surgery, and those in whom surgery was delayed less than 6 months demonstrated significant (p<0.05) better outcomes. Conclusion: The preoperative parameters associated to favorable outcomes in reconstruction of the brachial plexus are a good post-traumatic status of the hand and a short interval between injury and surgery. Key words: brachial plexus, palsy, nerve surgery.A importância dos parâmetros clínicos pré-operatórios e da monitoração eletrofisiológica intra-operatória para a cirurgia do plexo braquial RESUMO Objetivo: Apresentar o impacto de alguns parâmetros clínicos pré-operatórios sobre o prognóstico de pacientes com lesões traumáticas do plexo braquial e tecer comentários a respeito da monitorização eletrofisiológica intraoperatória. Método: Estudo retrospectivo de cem cirurgias de plexo braquial, incluindo apenas os casos que atingiram um tempo de seguimento em que poderia se assumir que o resultado final da cirurgia foi obtido. Resultados: Pacientes apresentando função motora da mão normal ou parcialmente preservada após o trauma, além daqueles nos quais o intervalo entre trauma e cirurgia foi menor do que de seis meses, apresentaram os melhores resultados (p<0,05). Conclusão: Os parâmetros clínicos mais fortemente associados à obtenção de melhores resultados cirúrgicos são o estado neurológico pré-operatório da mão e um curto intervalo entre o trauma e a cirurgia. A estimulação elétrica simples é um método útil em casos de lesões associadas à tração; EMG e NAP são úteis para lesões infraclaviculares de nervos longos. Palavras-chave: plexo braquial, paralisia, cirurgia de nervos periféricos.

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Section: Discussionsupporting

confidence: 67%

The importance of the preoperative clinical parameters and the intraoperative electrophysiological monitoring in brachial plexus surgery

Flores

2011

Arq. Neuro-Psiquiatr.

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“…Authors of previous studies of outcomes following peripheral nerve injury have emphasized measures of motor and sensory recovery, data that reflect nerve regeneration and reinnervation of the motor fibers and/or sensory end organs but not the impact on the patient. More recently, investigators have recognized the importance of patient selfreport questionnaires, disability, and health-related quality of life [13][14][15]19,52 . Disability is defined as a limitation in the ability to perform tasks, activities of daily living, or other activities [53][54][55][56] .…”

Section: Discussionmentioning

confidence: 99%

“…Although few investigators have evaluated disability after peripheral nerve injury, the evidence points to high levels of disability after such injuries [13][14][15] . Disability following peripheral nerve injury may be related to biomedical factors, including motor or sensory dysfunction and pain.…”

mentioning

confidence: 99%

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

Novak

Anastakis

Beaton

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

114

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“…1,2,3 Thus, multiple complex treatment algorithms have been devised to achieve even small gains in upper extremity function. 1,2 These algorithms are intellectually and technically demanding, and, given the rarity of the brachial plexus injury, are often difficult to substantiate with evidence in the literature.…”

mentioning

confidence: 99%

The Importance of Shoulder External Rotation in Activities of Daily Living: Improving Outcomes in Traumatic Brachial Plexus Palsy

Langer

Sueoka

Wang

2012

The Journal of Hand Surgery

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Measuring Outcomes in Adult Brachial Plexus Reconstruction

Cited by 64 publications

References 82 publications

The importance of the preoperative clinical parameters and the intraoperative electrophysiological monitoring in brachial plexus surgery

The importance of the preoperative clinical parameters and the intraoperative electrophysiological monitoring in brachial plexus surgery

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

The Importance of Shoulder External Rotation in Activities of Daily Living: Improving Outcomes in Traumatic Brachial Plexus Palsy

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