Postoperative Brachial Plexus Palsy

Kwaan, Jack H. M.; Rappaport, I

doi:10.1097/00132586-197202000-00056

Cited by 4 publications

(4 citation statements)

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“…The pathogenesis of plexus injury had been well‐studied and ischaemia to the vasa nervorum seems to play an underlying role 2,6 , 8 . Animal studies have shown cessation of blood flow in the intraneural circulation at stretch of 15% or more of the resting length 9 .…”

Section: Discussionmentioning

confidence: 99%

Bilateral brachial plexus injury during laparoscopic sigmoid colectomy

Chin

Poole

2003

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Bilateral brachial plexus injury during laparoscopic sigmoid colectomy

Chin

Poole

2003

ANZ Journal of Surgery

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“…tion of involvement (Buidinger, 1894;Krumm, 1895;Garrigues, 1897;Clausen, 1942;Ewing, 1950;Kiloh, 1950;Raffan, 1950;Wood-Smith, 1952;Kwaan and Rappaport, 1970; Table 4). An affection of the whole brachial plexus occurred in about three-quarters of the cases, and was com-plete in about 60%.…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological findings in pressure palsy of the brachial plexus.

Trojaborg¹

1977

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY Two patients with signs and symptoms of paralysis of the brachial plexus, caused by compression during surgery in one (case 1) and by a knapsack in the oither (case 2), were examined. The characteristic electrophysiological findings were: (i) Clausen, 1942;Dhuner, 1950;Ewing, 1950;Kiloh, 1950; WoodSmith, 1952;Petrick, 1955;Stephens, 1962;Kwaan and Rappaport, 1970). A so-called pack palsy, which also involves the brachial plexus, seems to be less well recognised; about 30 cases have been published so far (Sternberg, 1917; Woodhall, 1944, cited by Weinstein, 1947Jequier, 1949;Bom, 1953;Scharfetter, 1963;Ford, 1966;White, 1968;Daube, 1969). Both the postoperative paralysis and the pack palsy have been classified as neuropraxias and usually resolve within a few months (Leffert, 1974). Apart from the study of rucksack paralysis by Daube (1969) no electrophysiological data are available in pressure palsies localised to the brachial plexus. Daube (1969) (EMG 17322) A 50 year old housewife was operated upon for a lumbar disc under general anaesthesia. The operation lasted about three and a half hours. When the patient woke up from anaesthesia she was unable to move her left arm and her right arm was weak. A neurological examination the day after the operation showed paralysis of the whole left arm and moderate to severe paresis of all muscles of the right arm. There was analgesia of the left arm but normal sensation on the right. The tendon reflexes were absent. The palsies were thc'ught to be due to compression by shoulder braces used during the operation. Seven days later there was practically normal force and mobility of the right arm, but only very faint movements of the fingers on the left side. There was anaesthesia-analgesia of the whole left arm. An electrophysiological examination was performed one month after the onset of the palsy when the left deltoid, biceps and triceps brachii, the brachioradialis, the extensor and the flexor muscles of wrist and fingers were still paralysed, and the force of the small muscles of the hand was 0-1 ( Table 1). At that time there was hypaesthesia-hypalgesia corre-

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“…Most postoperative nerve injuries are thought to be the result of stretching or compression of nerves when the patient is malpositioned for long periods of time during anesthesia 1–3. It is commonly accepted that brachial plexus injuries are most likely caused by stretch through overextension (hyperabduction) of the arm, while mononeuropathies of the upper extremity are usually caused by direct compression of the nerve 2–11.…”

Section: Discussionmentioning

confidence: 99%