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Direct Repair of ruptured nerve stump to middle trunk for restoration of extrinsic finger extension in total brachial plexus injuries.
Xue, Yunhao; Wang, Shufeng; Hu, Jingjing; Li, Wenjun; Li, Feng; Anil, Bhatia; Li, Pengcheng; Yin, Yaobin; Duan, Fangfang; Wei, Qipei.
Afiliação
  • Xue Y; Department of Hand Surgery.
  • Wang S; Department of Hand Surgery.
  • Hu J; Department of Clinical Epidemiology Research Office. Beijing Jishuitan Hospital, No. 38, Longyu Ring Road, Huilongguan Town, Changping District, Beijing, China, 102208.
  • Li W; Department of Hand Surgery.
  • Li F; Department of Hand Surgery.
  • Anil B; Department of Orthopedics. Beijing Tongan Orthopedics Hospital, No 4, Xingguang Road, Daxing district, Beijing. 100162, P. R. China.
  • Li P; Department of Hand Surgery.
  • Yin Y; Department of Hand Surgery.
  • Duan F; Department of Clinical Epidemiology Research Office. Beijing Jishuitan Hospital, No. 38, Longyu Ring Road, Huilongguan Town, Changping District, Beijing, China, 102208.
  • Wei Q; Department of Hand Surgery.
Plast Reconstr Surg ; 2024 Jan 23.
Article em En | MEDLINE | ID: mdl-38276953
ABSTRACT

BACKGROUND:

Attempts to restore independent hand function in total brachial plexus injuries (TBPI) have often failed due to the inconsistent results of fingers extension reconstruction. An innovative technique is described to achieve this by direct neurorrhaphy of residual (ruptured) roots with the middle trunk.

METHODS:

Direct coaptation of the ruptured roots to the middle trunk and, simultaneously, transferring the anterior division of the middle trunk to the posterior division of lower trunk was performed in 64 patients of TBPI. The return of extension of the elbow, wrist and fingers were monitored.

RESULTS:

The excellent and good muscle strength of finger extension was noted in 45.3% cases. The patients were divided into group A (>32 years) and group B (≤32 years) according to ROC curve analysis. The difference of excellent and good rates of finger and wrist extension muscle strengths between the two groups was statistically significant (χ 2=4.635, P=0.031 χ 2=6.615, P=0.010).

CONCLUSIONS:

Direct neurorrhaphy of ruptured nerve root stumps with the middle trunk could achieve satisfactory results for finger extension in TBPI for patients ≤32 years old. Long nerve defects (4-6.5 cm) could be overcome by freeing the nerve and adducting the arm against the trunk.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article