scholarly journals Total brachial plexus injury: contralateral C7 root transfer to the lower trunk versus the median nerve

2018 ◽  
Vol 13 (11) ◽  
pp. 1968 ◽  
Author(s):  
Jie Lao ◽  
Ye Jiang ◽  
Li Wang ◽  
Xin Zhao
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Lower Trunk

Origination of the Muscular Branches of the Median Nerve

Neurosurgery ◽  
2014 ◽  
Vol 76 (2) ◽  
pp. 196-200 ◽  
Author(s):  
Bin Xu ◽  
Zhen Dong ◽  
Cheng-Gang Zhang ◽  
Yi Zhu ◽  
Dong Tian ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Electrophysiological Study ◽  
Nerve Roots ◽  
Motor Branch ◽  
Lower Trunk ◽  
Pronator Teres ◽  
Finger Flexion ◽  
Flexor Digitorum

ABSTRACT BACKGROUND: In lower brachial plexus injury, finger flexion after brachialis motor branch transfer is relatively weak. We sought to screen potential branches of the median nerve from the upper trunk for strengthening finger flexion in addition to the brachialis motor branch. However, the spinal origin of the muscular branches of the median nerve based on electrophysiological study was unclear. OBJECTIVE: To determine the spinal origin of the muscular branches of the median nerve. METHODS: An intraoperative electrophysiological study was carried out in 18 patients who underwent contralateral C7 nerve transfer. After exposure of the brachial plexus nerve roots on the healthy side, the amplitude of the compound muscle action potential of each median nerve-innervated muscle was recorded while the different nerve roots were stimulated. RESULTS: The pronator teres received fibers from C5, C6, and C7. It had more contribution from C5 and C6 than from C7 (P < .05). The flexor carpi radialis was innervated mainly by C6 and C7. The nerve branches of the palmaris longus and flexor digitorum superficialis stemmed primarily from C7 and the lower trunk, and no significant difference was found between them (P > .05). The flexor digitorum profundus, flexor pollicis longus, pronator quadratus, and abductor pollicis brevis were innervated predominantly by the lower trunk (P < .05). CONCLUSION: This electrophysiological study indicates that the pronator teres branch might be the most feasible alternative donor nerve to supplement the brachialis motor branch and strengthen finger flexion after lower brachial plexus injury.

Role of tacrolimus in return of hand function after brachial plexus injury in a lung transplantation patient

2020 ◽  
Vol 13 (5) ◽  
pp. e233788
Author(s):  
Tiam M Saffari ◽  
Christopher J Arendt ◽  
Robert J Spinner ◽  
Alexander Y Shin
Keyword(s):  
Lung Transplantation ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Hand Function ◽  
Left Hand ◽  
Lower Trunk ◽  
Bilateral Lung Transplantation ◽  
Bilateral Lung ◽  
Transplantation Patient

We report a patient who has been on tacrolimus for bilateral lung transplantation and presented with a brachial plexus injury (BPI), with unusual improvement of lower trunk innervated hand function. The lower trunk injury with resultant left hand paralysis had developed after his sternotomy 18 months ago. He has been treated with tacrolimus as part of his immunosuppression protocol since the surgery, without severe side effects. Physical examination at 18 months demonstrated unusual excellent grip pattern and full opposition of his thumb with slight claw deformity of his ulnar two digits. While the neurotoxic effects of tacrolimus are more emphasised, the neuroregenerative properties have been recently explored. The recovery in this patient is unique and unusual after BPI and is most likely as a result of the low dose tacrolimus treatment.

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 Good sensory recovery of the hand in brachial plexus surgery using the intercostobrachial nerve as the donor

2017 ◽  
Vol 75 (11) ◽  
pp. 796-800 ◽  
Author(s):  
Luciano Foroni ◽  
Mário Gilberto Siqueira ◽  
Roberto Sérgio Martins ◽  
Carlos Otto Heise ◽  
Hugo Sterman Neto ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Sensory Stimuli ◽  
Lateral Cord ◽  
Sensory Recovery ◽  
Intercostobrachial Nerve ◽  
Brachial Plexus Surgery ◽  
Sensory Reconstruction

ABSTRACT Objective: Restoration of the sensitivity to sensory stimuli in complete brachial plexus injury is very important. The objective of our study was to evaluate sensory recovery in brachial plexus surgery using the intercostobrachial nerve (ICBN) as the donor. Methods: Eleven patients underwent sensory reconstruction using the ICBN as a donor to the lateral cord contribution to the median nerve, with a mean follow-up period of 41 months. A protocol evaluation was performed. Results: Four patients perceived the 1-green filament. The 2-blue, 3-purple and 4-red filaments were perceptible in one, two and three patients, respectively. According to Highet's scale, sensation recovered to S3 in two patients, to S2+ in two patients, to S2 in six patients, and S0 in one patient. Conclusion: The procedure using the ICBN as a sensory donor restores good intensity of sensation and shows good results in location of perception in patients with complete brachial plexus avulsion.

Hemi-contralateral C7 transfer to median nerve in the treatment of root avulsion brachial plexus injury

2001 ◽  
Vol 26 (6) ◽  
pp. 1058-1064 ◽  
Author(s):  
Panupan Songcharoen ◽  
Saichol Wongtrakul ◽  
Banchong Mahaisavariya ◽  
Robert J. Spinner
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Root Avulsion

One-fascicle median nerve transfer to biceps muscle in C5 and C6 root avulsions of brachial plexus injury

Microsurgery ◽  
2003 ◽  
Vol 23 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Adisak Sungpet ◽  
Chanyut Suphachatwong ◽  
Viroj Kawinwonggowit
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Biceps Muscle
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