Document Detail


Transfer of the phrenic nerve to the posterior division of the lower trunk to recover thumb and finger extension in brachial plexus palsy.
MedLine Citation:
PMID:  20672897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Hand function is severely impaired in cases of lower root avulsion. In the present study, the authors investigated the clinical effectiveness and safety of phrenic nerve transfer to the posterior division of the lower trunk of the brachial plexus to recover thumb and finger extension.
METHODS: Between 2004 and 2006, 10 patients with brachial plexus palsy underwent phrenic nerve transfer as part of a strategy for surgical reconstruction of their plexuses. The mean patient age of was 27.2 years (range 18-44 years), and the mean interval from injury to surgery was 5.7 months (range 3-9 months). The phrenic nerve was always transferred to the posterior division of the lower trunk.
RESULTS: The follow-up of the patients ranged from 2.5 to 4.4 years, with an average follow-up length of 3.5 years. There were no major complications related to the surgery. Eight patients recovered to Grade 3 or better (Medical Research Council grade) in extensor digitorum strength, and 7 patients recovered to Grade 3 or better in extensor pollicis strength. None of the patients had any clinical signs or symptoms of respiratory insufficiency.
CONCLUSIONS: Satisfactory thumb and finger extension can be achieved by phrenic nerve transfer to the posterior division of the lower trunk of the brachial plexus. This procedure is simple and less traumatic than that of transferring the phrenic nerve to the radial nerve. It is indicated in cases in which the brachial plexus is relatively intact at the division level.
Authors:
Haodong Lin; Chunlin Hou; Aimin Chen; Zhen Xu
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Publication Detail:
Type:  Journal Article     Date:  2010-07-30
Journal Detail:
Title:  Journal of neurosurgery     Volume:  114     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  212-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopedic Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brachial Plexus / surgery*
Brachial Plexus Neuropathies / surgery*
Female
Fingers / physiology*
Follow-Up Studies
Hand / physiology
Humans
Male
Nerve Transfer / methods*
Paralysis / surgery*
Phrenic Nerve / transplantation*
Recovery of Function / physiology
Retrospective Studies
Thumb / physiology*
Treatment Outcome
Young Adult

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


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