Document Detail


Minimum 4-Year Follow-Up on Contralateral C7 Nerve Transfers for Brachial Plexus Injuries.
MedLine Citation:
PMID:  22173004     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Contralateral C7 (CC7) transfer for brachial plexus injuries (BPI) can benefit finger sensation but remains controversial regarding restoration of motor function. We report our 20-year experience using CC7 transfer for BPI, all of which had at least 4 years' follow-up. METHODS: A total of 137 adult BPI patients underwent CC7 transfer from 1989 to 2006. Of these patients, 101 fulfilled the inclusion criteria for this study. A single surgeon performed all surgeries. A vascularized ulnar nerve graft, either pedicled or free, was used for CC7 elongation. The vascularized ulnar nerve graft was transferred to the median nerve (group 1, 1 target) in 55 patients, and to the median and musculocutaneous nerves (group 2, 2 targets) in 23 patients. In another 23 patients (group 3, 2 targets, 2 stages), the CC7 was transferred to the median nerve (17 patients) or to the median and musculocutaneous nerve (6 patients) during the first stage, followed by functioning free muscle transplantation for finger flexion. RESULTS: We considered finger flexion strength greater or equal to M3 to be a successful functional result. Success rates of CC7 transfer were 55%, 39%, and 74% for groups 1, 2, and 3, respectively. In addition, the success rate for recovery of elbow flexion (strength M3 or better) in group 2 was 83%. CONCLUSIONS: In reconstruction of total brachial plexus root avulsion, the best option may be to adopt the technique of using CC7 transfer to the musculocutaneous and median nerve, followed by FFMT in the early stage (18 mo or less) for finger flexion. Such a technique can potentially improve motor recovery of elbow and finger flexion in a shorter rehabilitation period (3 to 4 y) and, more importantly, provide finger sensation to the completely paralytic limb. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.
Authors:
David Chwei-Chin Chuang; Catherine Hernon
Related Documents :
21332544 - Efficacy of peg-interferon-α-2a plus ribavirin for patients aged 60 years and older ...
21286854 - Risk factors and outcome of seizures after chronic subdural hematoma.
21435894 - Comparison of aortic root replacement in patients with marfan syndrome.
19379604 - Deleterious effect of smoking and nasal septal deviation on mucociliary clearance and i...
19217364 - A variation in the component separation technique that preserves linea semilunaris: a s...
23558794 - Fractured neck of femur patient care improved by simulated fast-track system.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-13
Journal Detail:
Title:  The Journal of hand surgery     Volume:  -     ISSN:  1531-6564     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Transverse and vortex domain wall structure in magnetic nanowires with uniaxial in-plane anisotropy.
Next Document:  Continuous aqueous two-phase extraction of human antibodies using a packed column.