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KMID : 0371619980140010055
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Journal of Wonkwang Medical Science
1998 Volume.14 No. 1 p.55 ~ p.62
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Traumatic Preganglionic Leisons of Brachial Plexus in the Adults
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Kim Dong-Chul
Kim Sang-Soo
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Abstract
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In civilian life, motorcycle accidents are the most common cause of traumatic brachial plexus lesions. The lesions can be situated at any level from the nerve roots to the division of the brachial plexus in the axillary region. Preganglionic root avulsion is an irreparable brachial plexus injury. So functional restoration is best achieved by neurotization. But the number of donor nerves available for nerve transfer in the reconstruction of brachial plexus root avulsion injuries is always insufficient. This study was performed to analyze the outcome of neurotization for each donor nerve of 143 donor nerves in 53 patients. Multiple neurotization using the ipsilateral intercostal nerves, phrenic nerve, spinal accessory nerve and supraclavicular nerve is a common procedure in the patients with preganglionic brachial plexus lesions to restore active elbow flexion, shoulder abduction and protective sensation of forearm. As a result, an improvement of motor and sensory score was evident. In the 48 of 143 donor nerve (33.5%), excellent or good results were observed and in the 95 of 143 donor nerve (66.5%), fair or poor results were noted. After surgery, pain was improved grade 1 in 5 patients and more than grade 2 in 20 patients. But, nevertheless surgery, pain was not improved in 10 patients and more aggravated in 2 patients. These results show that the multiple neurotization was partially helpful for the overall functional improvement and improvement of the denervation pain syndrome.
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KEYWORD
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Brachial plexus injury, Preganglionic leisons, Multiple neurotization
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