Brachial Plexus Injury With Emphasis on Axillary Nerve Paralysis After Thoracoscopic Sympathicotomy for Axillary Hyperhidrosis

2006 ◽  
Vol 16 (6) ◽  
pp. 432-434 ◽  
Author(s):  
Soon-Ho Chon ◽  
Matthew Seung Suk Choi
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Axillary Nerve ◽  
Axillary Hyperhidrosis ◽  
Nerve Paralysis

End-to-side neurorrhaphy in brachial plexus reconstruction

2013 ◽  
Vol 119 (3) ◽  
pp. 689-694 ◽  
Author(s):  
Pavel Haninec ◽  
Libor Mencl ◽  
Radek Kaiser
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Nerve Repair ◽  
Experimental Studies ◽  
Deltoid Muscle ◽  
Axillary Nerve ◽  
Musculocutaneous Nerve ◽  
Biceps Muscle ◽  
Nerve Reconstruction ◽  
Nerve Suture

Object Although a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy (ETSN) have been published to date, there is still a considerable lack of clinical trials investigating this technique. Here, the authors describe their experience with ETSN in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy. Methods From 1999 to 2007, out of 791 reconstructed nerves in 441 patients treated for brachial plexus injury, the authors performed 21 axillary and 2 musculocutaneous nerve sutures onto the median, ulnar, or radial nerves. This technique was only performed in patients whose donor nerves, such as the thoracodorsal and medial pectoral nerves, which the authors generally use for repair of axillary and musculocutaneous nerves, respectively, were not available. In all patients, a perineurial suture was carried out after the creation of a perineurial window. Results The overall success rate of the ETSN was 43.5%. Reinnervation of the deltoid muscle with axillary nerve suture was successful in 47.6% of the patients, but reinnervation of the biceps muscle was unsuccessful in the 2 patients undergoing musculocutaneous nerve repair. Conclusions The authors conclude that ETSN should be performed in axillary nerve reconstruction but only when commonly used donor nerves are not available.

Bilateral Brachial Plexus Injury After MiraDry Procedure for Axillary Hyperhidrosis

2019 ◽  
Vol 124 ◽  
pp. 370-372
Author(s):  
Ross C. Puffer ◽  
Allen T. Bishop ◽  
Robert J. Spinner ◽  
Alexander Y. Shin
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Axillary Hyperhidrosis

Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series

2014 ◽  
Vol 14 (5) ◽  
pp. 518-526 ◽  
Author(s):  
Scott L. Zuckerman ◽  
Ilyas M. Eli ◽  
Manish N. Shah ◽  
Nadine Bradley ◽  
Christopher M. Stutz ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Nerve Injury ◽  
Brachial Plexus Injury ◽  
Tertiary Care ◽  
Case Series ◽  
Deltoid Muscle ◽  
Axillary Nerve ◽  
Surgical Approaches ◽  
Shoulder Abduction ◽  
Older Children

Object Axillary nerve palsy, isolated or as part of a more complex brachial plexus injury, can have profound effects on upper-extremity function. Radial to axillary nerve neurotization is a useful technique for regaining shoulder abduction with little compromise of other neurological function. A combined experience of this procedure used in children is reviewed. Methods A retrospective review of the authors' experience across 3 tertiary care centers with brachial plexus and peripheral nerve injury in children (younger than 18 years) revealed 7 cases involving patients with axillary nerve injury as part of an overall brachial plexus injury with persistent shoulder abduction deficits. Two surgical approaches to the region were used. Results Four infants (ages 0.6, 0.8, 0.8, and 0.6 years) and 3 older children (ages 8, 15, and 17 years) underwent surgical intervention. No patient had significant shoulder abduction past 15° preoperatively. In 3 cases, additional neurotization was performed in conjunction with the procedure of interest. Two surgical approaches were used: posterior and transaxillary. All patients displayed improvement in shoulder abduction. All were able to activate their deltoid muscle to raise their arm against gravity and 4 of 7 were able to abduct against resistance. The median duration of follow-up was 15 months (range 8 months to 5.9 years). Conclusions Radial to axillary nerve neurotization improved shoulder abduction in this series of patients treated at 3 institutions. While rarely used in children, this neurotization procedure is an excellent option to restore deltoid function in children with brachial plexus injury due to birth or accidental trauma.

Axillary nerve repair by fascicle transfer from the ulnar or median nerve in upper brachial plexus palsy

2012 ◽  
Vol 117 (3) ◽  
pp. 610-614 ◽  
Author(s):  
Pavel Haninec ◽  
Radek Kaiser
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Nerve Repair ◽  
Deltoid Muscle ◽  
Axillary Nerve ◽  
Brachial Plexus Palsy ◽  
Nerve Reconstruction ◽  
Long Thoracic Nerve

Object Nerve repair using motor fascicles of a different nerve was first described for the repair of elbow flexion (Oberlin technique). In this paper, the authors describe their experience with a similar method for axillary nerve reconstruction in cases of upper brachial plexus palsy. Methods Of 791 nerve reconstructions performed by the senior author (P.H.) between 1993 and 2011 in 441 patients with brachial plexus injury, 14 involved axillary nerve repair by fascicle transfer from the ulnar or median nerve. All 14 of these procedures were performed between 2007 and 2010. This technique was used only when there was a deficit of the thoracodorsal or long thoracic nerve, which are normally used as donors. Results Nine patients were followed up for 24 months or longer. Good recovery of deltoid muscle strength was seen in 7 (77.8%) of these 9 patients, and in 4 patients with less follow-up (14–23 months), for an overall success rate of 78.6%. The procedure was unsuccessful in 2 of the 9 patients with at least 24 months of follow-up. The first showed no signs of reinnervation of the axillary nerve by either clinical or electromyographic evaluation in 26 months of follow-up, and the second had Medical Research Council (MRC) Grade 2 strength in the deltoid muscle 36 months after the operation. The last of the group of 14 patients has had 12 months of follow-up and is showing progressive improvement of deltoid muscle function (MRC Grade 2). Conclusions The authors conclude that fascicle transfer from the ulnar or median nerve onto the axillary nerve is a safe and effective method for reconstruction of the axillary nerve in patients with upper brachial plexus injury.

scholarly journals Outcome of double nerve transfer close to target muscle both for shoulder abduction and elbow flexion in early C5 –C6 Brachial Plexus injury.

2020 ◽  
Vol 27 (07) ◽  
pp. 1442-1447
Author(s):  
Husnain Khan ◽  
Muhammad Shafique ◽  
Zahid Iqbal Bhatti ◽  
Tehseen Ahmad Cheema
Keyword(s):  
Brachial Plexus ◽  
Posterior Approach ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Suprascapular Nerve ◽  
Axillary Nerve ◽  
Shoulder Abduction ◽  
Motor Branch ◽  
Nerve Transfers

Adult brachial plexus injury is a now a common problem due to high incidence of motorbike accidents. Among all types, C 5 and C6 (upper brachial plexus injury) is the most common. If the patient present within 6 months then nerve transfer is the preferred treatment. However, there are different options for nerve transfer and different approaches for surgery. Objectives: The objective of the study was to share our experience of nerve transfer close to target muscles in upper brachial plexus injury. Study Design: Quaisi experimental study. Setting: National Orthopaedic Hospital, Bahawalpur. Period: January 2015 to June 2018. Material & Methods: Total 32 patients were operated with isolated C5 and C6 injury. In all patients four nerve transfers were done. For shoulder abduction posterior approach was used and accessory to suprascapular nerve and one of motor branch of radial to axillary nerve were transferred. Modified Oberlin transfer was done for elbow flexion. Both shoulder abduction and elbow flexion was graded according to medical research council grading system. Results: After one year follow up more than 75% of the patients showed good to normal shoulder abduction and 87.50% showed good to normal elbow flexion. Residual Median nerve damage was noted only in two patients (6.25%). Conclusion: If there is no evidence of recovery up to three months early nerve transfer should be considered, ideal time is 3-6 months. Nerve transfer close to target muscle yields superior results. The shoulder stabilizers and abductors should ideally be innervated by double nerve transfer through posterior approach. Similarly double fascicular transfer (modified Oberlin) should be done for elbow flexion.

Brachial plexus injury after microwave-based treatment for axillary hyperhidrosis and osmidrosis

2017 ◽  
Vol 19 (7) ◽  
pp. 439-441 ◽  
Author(s):  
Chun-Kai Chang ◽  
Chun-Yu Chen ◽  
Kuo-Feng Hsu ◽  
Han-Ting Chiu ◽  
Tzi-Shiang Chu ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Axillary Hyperhidrosis

scholarly journals Back Pack Palsy as an Unusual Cause of Shoulder Pain and Weakness–A Case Report

2012 ◽  
Vol 23 (3) ◽  
pp. 120-122 ◽  
Author(s):  
S.N Mansoor ◽  
F.A Rathore ◽  
Fahim Muhammad
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Axillary Nerve ◽  
Electrical Muscle Stimulation ◽  
Permanent Disability ◽  
Strengthening Exercises ◽  
Gait Abnormalities ◽  
Postural Disorders ◽  
Electrical Muscle ◽  
Minimal Residual

Abstract Heavy back packs carried for prolonged durations can cause different musculoskeletal and neurological problems especially in the untrained and physically vulnerable individuals. They can cause postural disorders, gait abnormalities, muscular strains, pains and injuries to the brachial plexus and nerves resulting in significant morbidity and at times permanent disability. We report a case of brachial plexus injury in a young soldier wearing back pack for prolonged period. He developed weakness and pain in right shoulder which was not relieved with rest and analgesics. On examination he had weakness in deltoid, biceps and scapular muscles along with numbness in axillary nerve area. Brachial plexus injury (upper trunk) was suspected and confirmed by electrodiagnostic evaluation. His baseline investigations were normal. He was advised rest and avoidance to lift heavy weight. He was managed with electrical muscle stimulation for weak muscles, strengthening exercises and analgesics. He responded well to the treatment and had minimal residual weakness at the end of the six weeks’ treatment Back pack palsy should be suspected in people carrying back packs and presenting with pain, weakness and numbness in the upper limbs. It can be prevented by education in the use of back packs, its weight limits, physical fitness and frequent breaks with changing positions.

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