Histopathological basis of Horner's syndrome in obstetric brachial plexus palsy differs from that in adult brachial plexus injury

2008 ◽  
Vol 37 (5) ◽  
pp. 632-637 ◽  
Author(s):  
Yi-Gang Huang ◽  
Liang Chen ◽  
Yu-Dong Gu ◽  
Guang-Rong Yu
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Horner’S Syndrome ◽  
Brachial Plexus Palsy ◽  
Horner's Syndrome ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

The value of preoperative and intraoperative electromyography in the management of obstetric brachial plexus injury

2010 ◽  
Vol 6 (6) ◽  
pp. 595-599 ◽  
Author(s):  
Kuen F. Chin ◽  
Livio Di Mascio ◽  
Karen Holmes ◽  
V. Peter Misra ◽  
Marco M. Sinisi
Keyword(s):  
Brachial Plexus ◽  
Recent Literature ◽  
Brachial Plexus Injury ◽  
Nerve Graft ◽  
Brachial Plexus Palsy ◽  
Range Of Movement ◽  
Obstetric Brachial Plexus Palsy ◽  
Group 4 ◽  
Obstetric Brachial Plexus ◽  
Obstetric Brachial Plexus Injury

The treatment of obstetric brachial plexus palsy (OBPP) with neuroma-in-continuity is controversial. The recent literature advocates excision of neuroma-in-continuity in OBPP and repair with nerve graft irrespective of its neurophysiological conductivity. This approach risks sacrificing the regenerating axons, and the result has not yet been proven to be superior to neurolysis alone. In this case report, the authors aim to outline their strategy of using the combination of preoperative and intraoperative clinical and neurophysiological findings to aid their decision making. The lack of upper trunk recovery and the unfavorable preoperative neurophysiological findings in a child with Narakas Group 4 OBPP at 5 months of age prompted an urgent exploration with the intention of performing neurotization. This procedure was abandoned and neurolysis was performed due to the favorable intraoperative neurophysiological findings. At 4 years of age, the child scored 12 of 15 on Mallet classification and has an excellent range of movement. No secondary operation was needed. The authors hope to highlight the idea that the surgical option for neurolysis alone should be kept open and that intraoperative electromyography can be a valuable tool to add to the surgeon's armamentarium.

scholarly journals Assessment of upper extremity movement performance of patients with obstetric brachial plexus palsy

2017 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ligia C. S. Fonseca ◽  
Annika K. Nelke ◽  
Jörg Bahm ◽  
Catherine Disselhorst-Klug
Keyword(s):  
Brachial Plexus ◽  
Upper Extremity ◽  
Objective Data ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Movement Performance ◽  
Obstetric Brachial Plexus ◽  
The Individual ◽  
Acceleration Signals ◽  
Upper Extremity Movement

Abstract:Coping strategies of patients with obstetric brachial plexus palsy (OBPP) are highly individual. Up to now, individual movement performance is assessed by visual observations of physicians or therapists - a procedure, which is highly subjective and lacks objective data. However, objective data about the individual movement performance are the key to evidence-based and individualized treatment. In this paper, a new approach is presented, which provides objective information about the upper extremity movement performance of patients with OBPP. The approach is based on the use of accelerometers in combination with a classification procedure. The movement performance of 10 healthy volunteers and 41 patients with OBPP has been evaluated by experienced physiotherapists and has been assigned to one of 4 categories representing the Mallet Scale (MS) IV to I. Three triaxial-accelerometers were placed at chest, upper arm and wrist of the affected side of the patient. Acceleration signals have been recorded during repetitive movements with relevance regarding daily life. Here, especially the results from the “hand to mouth” task are presented. From the 9 recorded acceleration signals 13 relevant features were extracted. For each of the 13 features 4 thresholds have been determined distinguishing best between the 4 patient categories of the MS and the healthy subjects. With respect to the thresholds each feature value has been assigned to the discrete numbers 0, 1, 2, 3 or 4. Afterwards, each discrete number has been weighted by a factor regarding the correlation between the feature’s value and the MS score. The resulting weighted discrete numbers of all 13 features have been added resulting in a score, which quantifies the individual upper extremity movement performance. Based on this score the movement performance of each patient has been assigned to the classes “very good”, “good”, “regular” and “bad”. All movements of the 10 healthy volunteers were classified as “very good”. The movement performance of two patients MS IV were classified as “very good” as well and the movements of the other 16 patients as “good”. The movements of the entire group of MS III patients fell into the class “regular”. Just one MS II patient was assigned to the class “regular” while the others were classified as “bad”. It was not possible to classify the movements of MS I patients. This was mainly due to the fact that none of these patients MS I was able to complete the task successfully. The developed approach demonstrated its ability to quantify the movement performance of upper extremity movements based on accelerometers. This provides an easy to use tool to assess patient’s movement strategies during daily tasks for diagnosis and rehabilitation.

Obstetric brachial plexus palsy: A birth injury not explained by the known risk factors

2008 ◽  
Vol 87 (10) ◽  
pp. 1027-1032 ◽  
Author(s):  
Bjørn Backe ◽  
Elisabeth Balstad Magnussen ◽  
Ole Jakob Johansen ◽  
Gerd Sellaeg ◽  
Harald Russwurm
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Birth Injury ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

Assessment of the Method and Timing of Repair of a Brachial Plexus Traction Injury in an Animal Model for Obstetric Brachial Plexus Palsy

2002 ◽  
Vol 27 (1) ◽  
pp. 13-19 ◽  
Author(s):  
A. C. FULLARTON ◽  
D. V. LENIHAN ◽  
L. M. MYLES ◽  
M. A. GLASBY
Keyword(s):  
Skeletal Muscle ◽  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Nerve Fibres ◽  
Obstetric Brachial Plexus Palsy ◽  
Adult Sheep ◽  
Type Iv ◽  
Traction Injury ◽  
Obstetric Brachial Plexus ◽  
Injury And Repair

A Sunderland type IV traction injury to the C6 root of adult sheep or newborn lamb brachial plexus was used as a model for obstetric traction injury to the C5 root in humans. In one experimental cohort the injury was created and repaired using interfascicular nerve autografts or coaxially aligned freeze-thawed skeletal muscle autografts in a group of adult sheep and in a group of newborn lambs. In a second cohort a similar injury was created and repaired either immediately or after a delay of 30 days, using either interfascicular nerve autografts or coaxially aligned freeze-thawed skeletal muscle autografts in four groups of six newborn lambs. In all cases both functional and morphometric indices of nerve regeneration were poorer in the injured and repaired nerves than in normal nerves. In lambs the method of repair made no difference and no significant differences were found for any of the indices of nerve function or morphology. In sheep the use of muscle grafts was associated with a poorer outcome than the use of nerve autografts. Where a delay of 30 days had elapsed between injury and repair, the results using nerve autografts were not significantly different. Where freeze-thawed muscle autografts had been used, the maturation of the regenerated nerve fibres after delay was significantly poorer than after immediate repair. The electrophysiological variables CVmax and jitter, which may be applied clinically, were found to be good discriminators of recovery in all of the animals and in respect of all procedures.

Obstetric Brachial Plexus Palsy

Hand Clinics ◽  
1986 ◽  
Vol 2 (4) ◽  
pp. 773-786
Author(s):  
J.K. Terzis ◽  
W.T. Liberson ◽  
Ronald Levine
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus
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