Major surgical strategies of the upper and middle trunks of adult brachial plexus injury by Erb — Duchenne palsy type
Journal Title: Український неврологічний журнал - Year 2018, Vol 0, Issue 2
Abstract
Objective — to increase the effectiveness of surgical treatment of patients with injury to the upper and middle trunks of the brachial plexus based on the comprehensive involvement of compensatory regenerative mechanisms by applying original neurotic, autoplastic, long‑term electrostimulation and orthopedic correction of the upper limb function. Methods and subjects. The analysis of the results of surgical treatment of 64 patients with brachial plexus trauma, accompanied by detachment or injury of the C5—C7 spinal nerves, upper and middle trunks, or their anterior and posterior portions, was performed. For the reconstruction of the structures of the shoulder plexus and its long branches, the technique of nerve autoplasty and the method of neurotication were most often used. In the cases of maintaining the anatomical integrity of damaged structures of the brachial plexus, which was manifested during the course of neurology, especially in cases of positive intraoperative diagnostics, the technique of long‑term electrostimulation of damaged structures in the postoperative period was used with the help of domestic electrostimulation systems Ney C 3M (Ukraine). Results. 86.7 % of cases showed good recovery (4 points or higher on 86.7 % MRCS) of the shoulder abduction and elbow flexion with no dependence on applied surgical procedure (whether grafting or nerve transfer). Chronic invasive electrical stimulation of the anatomically preserved structures of the adult brachial plexus led to significant improvement of the shoulder abduction and elbow flexion in 53.9 % of cases. Conclusions. In the absence of signs of regeneration during restorative conservative therapy for two months in cases of damages of the upper and middle trunk of the brachial plexus in the type of Erb — Duchenne paralysis, surgical treatment with the maximum full involvement of compensatory and regenerative properties of the nervous system through the application of original techniques of neuroticisation, long‑term electrostimulation and orthopedic correction of the function of the upper limb. Neuroticisation of the structures of the upper trunk of the brachial plexus in all cases gave satisfactory restoration of flexion in the elbow and shoulder removal.
Authors and Affiliations
I. B. Tretyak
Keywords
Related Articles
- EP ID EP421315
- DOI 10.30978/UNZ2018281
- Views 102
- Downloads 0
Possibilities and prospects of the application of the in vivo and in vitro toxic cuprizone model for demyelination in experimental and clinical neurology (literature review and own research results)
In this article, literature data and research findings obtained from the Experimental modeling laboratory of Institute of Genetic and Regenerative medicine are shown. This review testifies the effectiveness of using the...
The state and ways of improvement of health care for patients with cerebral stroke in Kyiv
Objective — to improve the quality of medical care for patients with cerebral stroke. Methods and subjects. The study included an examination of 1575 patients with acute cerebral stroke (males 42.7 %) aged 26 to 100 yea...
Systems of intraganglia and intraneural control over latent alpha-herpesvirus in sensory ganglia of peripheral nervous system
The article presents modern data on interferon‑dependent mechanisms of control of latent alpha herpesvirus in the sensory nerve ganglia of the peripheral nervous system. The data on intraganglionar control mechanisms pre...
European Board Examination in Neurology. Variants of questions with answers. Examples 3
-
The role of daily blood pressure monitoring parameters and its variability in predicting of an acute ischemic stroke outcome
Objective — to investigate the association between the ascending neurological deficit and outcome of acute stage of ischemic stroke in patients with hypertension and the daily blood pressure (BP) monitoring parameters an...