|
KMID : 1141120150010010006
|
|
The Nerve
2015 Volume.1 No. 1 p.6 ~ p.10
|
|
|
Surgical Experience of Brachial Plexus Injury
|
|
Jo Se-Yeong
Hwang Jae-Chan
Heo June-Young
Park Hyung-Ki
Kim Ra-Sun
Chang Jae-Chil
|
|
|
Abstract
|
|
|
Objective: Brachial plexus injuries (BPIs) are complex and challenging injuries that can result in significant loss of functions involved in the upper extremity. The purpose of this study is to provide useful guidance for the management of BPIs.
Methods: Twenty-two patients who underwent intercostal nerve transfer (ICNT) only or ICNT with additional spinal accessory nerve transfer (SANT) by sural nerve graft interposition for traumatic BPIs from 2005 to 2014 were retrospectively studied. The Medical Research Council scale was used for outcome assessment. Follow-up was performed for at least 1 year to confirm neurological outcomes.
Results: Seventy-seven percent of all patients gained motor grade improvements after surgery; however, patients of the combined surgery group, who underwent ICNT and SANT (mean=2.2), showed better motor grade scale improvements than patients of the single-operation group, who underwent only ICNT (mean=1.083) (p=0.030). Moreover, a mean time to surgery of less than 6 months resulted in better outcomes than a mean time to surgery of greater than 6 months. Reinnervation of the musculocutaneous nerve was demonstrated in 92.8% of the patients who underwent surgery within the first 6 months postinjury, in 40% of the patients with a delay of between 6 and 12 months, and none of the patients who underwent surgery after 12 months (p=0.004).
Conclusion: This study validated that ICNT with SANT is more effective for reconstructing musculocutaneous nerves in patients with BPIs, along with the fact that surgery should be performed as soon as possible after injury at least 6 months.
|
|
|
KEYWORD
|
|
|
Brachial plexus, Nerve transfer, Musculocutaneous nerve, Intercostal nerve, Sural nerve, Accessory nerve
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|