Surgery of the brachial plexus

Ka, Solonen; Vastamäki, Martti; Strom, Brock T.

doi:10.3109/17453678408992390

Cited by 44 publications

(12 citation statements)

References 9 publications

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“…We agree with Solonen et al (1984) that the best time to operate is as early as possible. In a traction lesions it may be possible to tell within 3 months of the injury if spontaneous recovery will occur.…”

Section: Discussionsupporting

confidence: 67%

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Microsurgery in brachial plexus lesions

Simesen

Haase

1985

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 67%

“…He used three to four intercostal nerves and in three cases the accessory nerve. Solonen et al (1984) used neurotization with intercostal nerves 2-7 in 12 cases and achieved functional recovery in four cases. The reason for failure in our cases may be the limited number of axons available when using only two intercostal nerves.…”

Section: Discussionmentioning

confidence: 99%

Microsurgery in brachial plexus lesions

Simesen

Haase

1985

Acta Orthopaedica Scandinavica

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“…2 Subsequently, several other surgeons independently adopted this technique for reinnervation of the MCN, but with variable success. [3][4][5][6][7][8][9] Friedman et al 10 used standardized techniques involving transfer of three ICNs (third-fifth) to the distal MCN, without interposed grafts, which led to more consistent results, approaching MRC grade 3 or better function in 50% of the patients. More recently, investigators studying intercostal-MCN transfer have demonstrated significantly improved results, (MRC grade 3 elbow flexion in 64-88% of reported cases).…”

mentioning

confidence: 99%

Intercostal nerve transfer in infants with obstetric brachial plexus palsy

et al. 2008

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The use of intercostal nerve (ICN) transfer to repair brachial plexus lesions associated with root avulsions is a well known procedure in adults. However, there is a paucity of reports on the use of ICN in infants with obstetrical brachial plexus palsy (OBPP). This study included 46 infants with obstetric brachial plexus palsy who underwent 62 neurotization procedures. Clinically, 2 cases had upper trunk injury, 19 had upper-middle trunk injury, 3 had lower trunk injury, and 22 had total palsy. The average age at surgery was 14 months. Twelve patients underwent surgery younger than 6 months of age, 11 patients at 6 to <9 months, 9 patients at 9-12 months, and 14 patients at >12 months. The average follow-up period was 49 months. ICN transfer resulted in 76% satisfactory (good and excellent) outcome, and was best for restoration of elbow flexion (93.5%). Functional results were best when the operation was done before the age of 9 months; however, the difference between age groups was statistically insignificant. Functional results were also independent of the extent of the original injury. Nine children had preoperative and postoperative CT chest scans. All the nine children developed basal pulmonary atelectasis postoperatively. Pulmonary atelectasis was mostly ipsilateral and was not correlated to the patient age (months), or the duration of anesthesia (in minutes). We conclude that, intercostals nerve transfer is an effective procedure for restoration of function in infants with OBPP and root avulsions. The procedure is associated with variable degree of ipsilateral pulmonary atelectasis.

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“…Different series have advocated the advantages of direct method of intercostal nerve coaptation without tension to the recipient nerve vs using nerve graft [10,20,25,27,[30][31][32][33] . None of the patients in series of Friedman et al [20] who had interposed nerve graft between the transferred intercostal nerve and the musculocutaneous nerve obtained useful elbow flexion.…”

Section: Discussionmentioning

confidence: 99%

Use of intercostal nerves for different target neurotization in brachial plexus reconstruction

Lykissas

Kostas-Agnantis²,

Korompilias³

et al. 2013

WJO

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Intercostal nerve transfer is a valuable procedure in devastating plexopathies. Intercostal nerves are a very good choice for elbow flexion or extension and shoulder abduction when the intraplexus donor nerves are not available. The best results are obtained in obstetric brachial plexus palsy patients, when direct nerve transfer is performed within six months from the injury. Unlike the adult posttraumatic patients after median and ulnar nerve neurotization with intercostal nerves, almost all obstetric brachial plexus palsy patients achieve protective sensation in the hand and some of them achieve active wrist and finger flexion. Use in combination with proper muscles, intercostal nerve transfer can yield adequate power to the paretic upper limb. Reinnervation of native muscles (i.e. , latissimus dorsi) should always be sought as they can successfully be transferred later on for further functional restoration.

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Surgery of the brachial plexus

Cited by 44 publications

References 9 publications

Microsurgery in brachial plexus lesions

Microsurgery in brachial plexus lesions

Intercostal nerve transfer in infants with obstetric brachial plexus palsy

Use of intercostal nerves for different target neurotization in brachial plexus reconstruction

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