Comparison between long and lower medial head triceps branches in dual neurotization for shoulder function restoration in upper brachial plexus palsy

Microsurgery ◽  
2020 ◽  
Author(s):  
Mohamed A. Ellabban ◽  
Ahmed Fathy Sadek ◽  
Ayman Galhom ◽  
Ahmed E. Hafez ◽  
Ahmed Ramadan
Keyword(s):  
Brachial Plexus ◽  
Shoulder Function ◽  
Brachial Plexus Palsy ◽  
Medial Head

Congenital brachial plexus palsy

2011 ◽  
Author(s):  
Marco Sinisi
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Hand Function ◽  
Shoulder Function ◽  
Mechanism Of Injury ◽  
Brachial Plexus Palsy ◽  
Surgical Exploration

♦ The congenital brachial plexus palsy is significantly different from the adult injury♦ The mechanism of injury is invariably traction♦ Classifying the lesion at 1–2 weeks of age aids with prognosis and management♦ Surgical exploration and repair is indicated early in selected cases♦ Good shoulder function is essential for a useful upper limb♦ Recovery of hand function is slow and may continue until age 5 years.

EARLY COMBINED NEUROSURGERY AND ORTHOPAEDIC SURGERY IN NEONATAL BRACHIAL PLEXUS PALSY

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 155-159 ◽  
Author(s):  
Ram Palti ◽  
Maxim D. Horwitz ◽  
Nicholas C. Smith ◽  
Michael A. Tonkin
Keyword(s):  
Brachial Plexus ◽  
Neurological Deficit ◽  
Orthopaedic Surgery ◽  
Shoulder Function ◽  
Brachial Plexus Palsy ◽  
Combined Procedure ◽  
Neonatal Brachial Plexus Palsy ◽  
Nerve Surgery ◽  
Plexus Lesion ◽  
Glenohumeral Dislocation

Three cases are presented in which neurosurgical reconstruction of a Neonatal Brachial Plexus Palsy was combined with orthopaedic reconstruction of a posterior glenohumeral dislocation. The authors believe that a combined procedure is indicated if the neurological deficit meets the criteria for neural reconstruction and the complication of a posterior glenohumeral dislocation has occurred prior to nerve surgery. Two children with C5–6 lesions and a third child with a pan-plexus lesion obtained good shoulder function following the combined reconstruction.

scholarly journals Extending the Indications for Primary Nerve Surgery in Obstetrical Brachial Plexus Palsy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Stuart A. Bade ◽  
Jenny C. Lin ◽  
Christine G. Curtis ◽  
Howard M. Clarke
Keyword(s):  
Brachial Plexus ◽  
Surgical Intervention ◽  
External Rotation ◽  
Shoulder Function ◽  
Small Subset ◽  
Brachial Plexus Palsy ◽  
Surgical Indications ◽  
Obstetrical Brachial Plexus Palsy ◽  
Spontaneous Improvement ◽  
Nerve Surgery

Purpose.This study identifies a small subset of patients with obstetrical brachial plexus palsy who, while they do not meet common surgical indications, may still benefit from primary nerve surgery.Methods.Between April 2004 and April 2009, 17 patients were offered primary nerve surgery despite not meeting the standard surgical indications of the authors. The authors performed a retrospective analysis of these 17 patients using prospectively collected data.Results.This group of 17 patients were identified as having poor shoulder function at about 9 months of age despite passing the Cookie Test. Fourteen patients underwent surgical intervention and three families declined surgery. All patients in the operative group regained some active external rotation after surgery. Five patients in this group have required further interventions. Two of the three patients for whom surgery was declined have had no subsequent spontaneous improvement in active external rotation.Discussion.The commonly used indications for primary nerve surgery in obstetrical brachial plexus palsy may not adequately identify all patients who may benefit from surgical intervention. Patients who pass the Cookie Test but have poor spontaneous recovery of active shoulder movements, particularly external rotation, may still benefit from primary nerve surgery.

scholarly journals Obstetric Brachial Plexus Palsy: The Mallet Grading System for Shoulder Function—Revisited

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
M. M. Al-Qattan ◽  
A. A. F. El-Sayed
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Shoulder Function ◽  
Shoulder Abduction ◽  
Grading System ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation

The Mallet grading system is a commonly used functional scoring system to assess shoulder abduction/external rotation deficits in children with obstetric brachial plexus palsy. One feature of the Mallet score is that each grade is translated into certain degrees of deficiencies in both shoulder abduction and external rotation. The aim of the current study is to investigate the percentage of children in which the Mallet score could not be applied because of a discrepancy between the deficiency of shoulder abduction and shoulder external rotation. The study group included 50 consecutive unoperated older children (over 5 years of age) with Erb’s palsy and deficits in shoulder movements. The Mallet score could be applied in 40 cases (80%). In the remaining 10 cases (20%), the Mallet score could not be applied either because shoulder abduction had a better grade than the grade of shoulder external rotation (n=7) or vice versa (n=3). It was concluded that documenting the deficits in shoulder abduction and external rotation are best done separately and this can be accomplished by using other grading systems.

Percutaneous humeral derotational osteotomy in obstetrical brachial plexus palsy: a new technique

2013 ◽  
Vol 39 (5) ◽  
pp. 549-552 ◽  
Author(s):  
A. Aly ◽  
J. Bahm ◽  
F. Schuind
Keyword(s):  
Brachial Plexus ◽  
Plate Fixation ◽  
Significant Proportion ◽  
Shoulder Function ◽  
New Technique ◽  
Open Approach ◽  
Brachial Plexus Palsy ◽  
Obstetrical Brachial Plexus Palsy ◽  
Derotational Osteotomy ◽  
A New Technique

Thirty three per cent of children with obstetrical brachial plexus palsy with incomplete neurological recovery develop shoulder internal contracture associated with osseous deformity. Some of the older children are treated by humeral derotational osteotomy. The classical technique of open approach to the humeral diaphysis and plate fixation imposes a longitudinal scar and carries significant risks (nonunion, nerve palsy); a secondary procedure for plate removal is necessary in a significant proportion of patients. The authors report a new technique of percutaneous humeral osteotomy with osteosynthesis by Hoffmann external fixator. In six cases bone healing was obtained at an average of 45 days, without adverse complication. The postoperative results showed improved shoulder function. This new technique is simple and safe; it represents a new option for the treatment of sequelae of obstetrical brachial plexus palsy.

Evaluation of shoulder function after secondary surgery in children with Neonatal Brachial Plexus Palsy

2015 ◽  
Vol 8 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Menno van der Holst ◽  
Thea P.M. Vliet Vlieland ◽  
Jorit J.L. Meesters ◽  
W. Peter Bekkering ◽  
Jochem Nagels ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Shoulder Function ◽  
Brachial Plexus Palsy ◽  
Secondary Surgery ◽  
Neonatal Brachial Plexus Palsy
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