Neurol. praxi. 2019;20(4):249-258 | DOI: 10.36290/neu.2019.125

Reconstruction possibilities of injured brachial plexus

MUDr. Ivan Humhej, Ph.D., prof. MUDr. Martin Sameš, CSc.
Neurochirurgická klinika FZS UJEP, Masarykova nemocnice v Ústí nad Labem, o. z., Krajská zdravotní, a. s.

Surgical management of brachial plexus (BP) injuries has achieved significant evolution throughout the last decades. Currently, primary techniques of BP reconstruction (grafting, neurotization) along with secondary correction procedures (tendon transfers, free functional muscle transfers, arthrodesis, other bone/joint procedures), allow a high degree of functional recovery of the disabled limbs. The main requirement for achieving ideal therapeutic results, is a complex approach by a team of experienced specialists, tailored to each individual patient accordingly. Adequately planned long-term postoperative care is a crucial component of the therapeutic process. Although patients with severe cases of BP injury have little chance regaining full physical function, even minor functional improvement of the paretic limb results in major improvement in overall quality of life.

Keywords: brachial plexus injury, microsurgical reconstruction, grafting, nerve transfer, secondary correction

Published: September 1, 2019  Show citation

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Humhej I, Sameš M. Reconstruction possibilities of injured brachial plexus. Neurol. praxi. 2019;20(4):249-258. doi: 10.36290/neu.2019.125.
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References

  1. Bishop AT. Functioning free-muscle transfer for brachial plexus injury. Hand Clin. 2005; 21(1): 91-102. Go to original source... Go to PubMed...
  2. Čižmář I, Ehler E, Pilný J, Ira D, Višňa P, Dráč P. Léze radiálního nervu a možnosti pozdní rekonstrukce funkce šlachovým transferem. Cesk Slov Neurol N 2010; 73/106(6): 701-705.
  3. Dengler NF, Antoniadis G, Grolik B, Wirtz CR, König R, Pedro MT. Mechanisms, treatment and patient outcome of iatrogenic injury to the brachial plexus - a retrospective single-center study. World Neurosurg. 2017; 107: 868-876. doi: 10.1016/j.wneu.2017.08.119. Go to original source... Go to PubMed...
  4. Dubuisson A, Kline DG. Indications for peripheral nerve and brachial plexus surgery. Neurol Clin. 1992; 10(4): 935-951. Go to original source... Go to PubMed...
  5. Eppenberger P, Andreisek G, Chhabra A. Magnetic resonance neurography: diffusion tensor imaging and future directions. Neuroimaging Clin N Am. 2014; 24(1): 245-256. doi: 10.1016/j.nic.2013.03.031. Go to original source... Go to PubMed...
  6. Garg R, Merrell GA, Hillstrom HJ, Wolfe SW. Comparison of nerve transfers and nerve grafting for traumatic upper plexus palsy: a systematic review and analysis. J Bone Joint Surg Am. 2011; 93(9): 819-829. doi: 10.2106/JBJS.I.01602. Go to original source... Go to PubMed...
  7. Giuffre JL, Kakar S, Bishop AT, Spinner RJ, Shin AY. Current concepts of the treatment of adult brachial plexus injuries. J Hand Surg Am. 2010; 35(4): 678-688. doi: 10.1016/j.jhsa.2010.01.021. Go to original source... Go to PubMed...
  8. Haninec P, Kaiser R. Operační léčba poranění plexus brachialis. Cesk Slov Neurol N 2011; 74/107(5): 619-630.
  9. Haninec P, Mencl L. Neurochirurgická léčba porodního poranění brachiálního plexu. Bolest 2017; 20: 143-148.
  10. Hems TE. Timing of surgical reconstruction for closed traumatic injury to the supraclavicular brachial plexus. J Hand Surg Eur Vol. 2015; 40(6): 568-572. doi: 10.1177/1753193414540074. Go to original source... Go to PubMed...
  11. Humhej I, Ibrahim I, Sameš M, Tintěra J, Čižmář I. Možnosti zobrazení brachiálního a lumbosakrálního plexu pomocí pokročilých technik magnetické rezonance. Neurol. praxi 2019; 20(1): 49-53. Go to original source...
  12. Humhej I, Sameš M. Poranění periferních nervů u dětí a mladistvých. Čes Slov Pediat. 2015; 70: 20-28.
  13. Krishnan KG, Martin KD, Schackert G. Traumatic lesions of the brachial plexus: an analysis of outcomes in primary brachial plexus reconstruction and secondary functional arm reanimation. Neurosurgery 2008; 62(4): 873-885; discussion 885-6. doi: 10.1227/01.neu.0000318173.28461.32. Go to original source... Go to PubMed...
  14. Lapegue F, Faruch-Bilfeld M, Demondion X, Apredoaei C, Bayol MA, Artico H, Chiavassa-Gandois H, Railhac JJ, Sans N. Ultrasonography of the brachial plexus, normal appearance and practical applications. Diagn Interv Imaging 2014; 95(3): 259-275. doi: 10.1016/j.diii.2014.01.020. Go to original source...
  15. Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994; 19(2): 232-237. Go to original source... Go to PubMed...
  16. Penkert G, Fansa H. Peripheral Nerve Lesions. Nerve Surgery and Secondary Reconstructive Repair. Springer 2004: 145-148. Go to original source...
  17. Ridzoň P. Traumata brachiálního plexu a jeho větví. Neurol. praxi 2008; 9(1): 9-13.
  18. Shin AY, Spinner RJ, Bishop AT. Nerve Transfers for Brachial Plexus Injuries. Operative Techniques in Orthopaedics 2004; 14(3 SPEC. ISS.), 199-212. https://doi.org/10.1053/j.oto.2004.06.003. Go to original source...




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