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Abstract
Introduction
Brachial plexus injury is one of the most devastating damages in upper extremities, usually regardingto traumas as motorcycle accident, and more common in men. Surgical indication is considered the most appropriate intervention in this case.
Methode
From 2013 to 2018, 51 patients were operated and fully evaluated. We evaluated all patients with surgical methods such as: nerve release, nerve graft, nerve transfer, direct coaption, functional tendon transfer, free muscle transfer , wrist fusion and ultimately the most severe is amputation.
We assess the scale of the level of recovery of MRC with 5 degrees. After the follow-up and evaluation surgery, if the recovery for muscle groups achieves M3, the functional effectiveness is assessed as good, M4 or higher is excellent, M2 is poor.
Results
51 patients treated from 2013 to 2018, ages ranging from 7 to 65, with age group from 20 to 40 is dominated with 35 patients accounting for 68.62%, traffic accident accounts for 88.24% (45 cases), domestic accidents 11.76% (6 cases), men (88.24%) is larger than women (11.76%).
Group 1. Nerve release: 9 cases,in which 3 patients were assessed is good, 3 patients had excellent results and 3 patients had poor results.
Group 2. Nerve transfer: 24 cases, with 5 patients (20.83%) had poor results, 19 patients had good and excellent results (10 patients accounted for 41.67% reaching M3, 9 patients achieved M4, M5 accounted for 37.50%).
Group 3. There were 4 cases grafted by sural nerve, resulted in 100% of patients recovering well and excellently.
Group 4. Tendon transfer: 17 cases mainly for shoulder abduction and elbow flexion, including 14 patients with good and excellent results, 3 patients with poor results.
Group 5. Free functional muscular transfer: 6 cases, in which 2 patients had good results, 1 was excellent, and 3 patients had poor results.
Conclusions
The majority of patients with BPI are young men. It is important for both the patient and the surgeon to act and react quickly to achieve the best possible outcome
References
Olawale A.R. Sulaiman, Daniel D. Kim, Clint Burkett, David G. Kline, NERVE TRANSFER SURGERY FOR ADULT BRACHIAL PLEXUS INJURY: A 10-YEAR EXPERIENCE AT LOUISIANA STATE UNIVERSITY, Neurosurgery, Volume 65, Issue suppl_4, October 2009,
Pages A55–A62,
Lanaras, T. I., Schaller, H. and Sinis, N. (2009), Brachial plexus lesions: 10 Years of experience in a center for microsurgery in Germany. Microsurgery, 29: 87-94. doi:10.1002/micr.20583
| Published | 11-01-2025 | |
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| Issue | No. 57 (2019) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.2019.57.8 | |
| Keywords | Từ khoá: Liệt đám rối thần kinh cánh tay, chuyển thần kinh, ghép thần kinh, vạt cơ thon, bàn tay. Keywords: Brachial plexus injury, nerve transfer, nerve graft, free gracillis flap, hand. |
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