open access

Vol 45, No 2 (2011)
ARTYKUŁ ORYGINALNY
Submitted: 2010-05-31
Get Citation

Preganglionic injuries in perinatal brachial plexus palsies – results of surgical treatment

Jerzy Gosk, Roman Rutowski, Roman Wiącek, Maciej Urban, Piotr Mazurek
DOI: 10.1016/S0028-3843(14)60025-6
·
Neurol Neurochir Pol 2011;45(2):140-147.

open access

Vol 45, No 2 (2011)
ARTYKUŁ ORYGINALNY
Submitted: 2010-05-31

Abstract

Background and purpose

The authors report their experience in surgical treatment of preganglionic injuries in perinatal brachial plexus palsies.

Material and methods

Clinical material consisted of 16 children, of both sexes, aged from 2.5 to 33 months (mean 6.2 months), treated surgically between 1994 and 2006. The clinical view of the injury and location of preganglionic lesions was analysed and the description of the performed microsurgical techniques is provided. Control clinical examinations included a group of 14 children. The shortest postoperative observation period was 3 years. The currently accepted scales of evaluation of function of particular joints of the upper limb were used.

Results

The following outcome was noted after surgical treatment of perinatal brachial plexus palsies with signs of pre- and postganglionic injuries: good shoulder function in 6 cases, and average in 2 others; good elbow function in 4 cases, and average in 7 patients; functional position of the forearm in 9 cases, and good range of pronation and supination in 1 patient; useful function of wrist (flexion/extension) in 4 cases; good motor hand function in 3 cases, and fair in 6 patients.

Conclusions

In preganglionic perinatal brachial plexus injuries located in the upper-middle part, spinal nerve C7 roots avulsion is the most frequently observed, and in the lower part of the brachial plexus, spinal nerve C8 roots avulsion is the most frequently observed. In preganglionic injuries of the brachial plexus, the number of avulsed spinal nerves has an influence on technical possibilities of performing reconstruction procedures, and then the results of the surgical treatment.

Abstract

Background and purpose

The authors report their experience in surgical treatment of preganglionic injuries in perinatal brachial plexus palsies.

Material and methods

Clinical material consisted of 16 children, of both sexes, aged from 2.5 to 33 months (mean 6.2 months), treated surgically between 1994 and 2006. The clinical view of the injury and location of preganglionic lesions was analysed and the description of the performed microsurgical techniques is provided. Control clinical examinations included a group of 14 children. The shortest postoperative observation period was 3 years. The currently accepted scales of evaluation of function of particular joints of the upper limb were used.

Results

The following outcome was noted after surgical treatment of perinatal brachial plexus palsies with signs of pre- and postganglionic injuries: good shoulder function in 6 cases, and average in 2 others; good elbow function in 4 cases, and average in 7 patients; functional position of the forearm in 9 cases, and good range of pronation and supination in 1 patient; useful function of wrist (flexion/extension) in 4 cases; good motor hand function in 3 cases, and fair in 6 patients.

Conclusions

In preganglionic perinatal brachial plexus injuries located in the upper-middle part, spinal nerve C7 roots avulsion is the most frequently observed, and in the lower part of the brachial plexus, spinal nerve C8 roots avulsion is the most frequently observed. In preganglionic injuries of the brachial plexus, the number of avulsed spinal nerves has an influence on technical possibilities of performing reconstruction procedures, and then the results of the surgical treatment.

Get Citation

Keywords

preganglionic injuries, spinal nerve roots avulsion, perinatal brachial plexus palsy, extra-anatomical extraplexus reconstructions, extra-anatomical intraplexus reconstructions

About this article
Title

Preganglionic injuries in perinatal brachial plexus palsies – results of surgical treatment

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 45, No 2 (2011)

Pages

140-147

DOI

10.1016/S0028-3843(14)60025-6

Bibliographic record

Neurol Neurochir Pol 2011;45(2):140-147.

Keywords

preganglionic injuries
spinal nerve roots avulsion
perinatal brachial plexus palsy
extra-anatomical extraplexus reconstructions
extra-anatomical intraplexus reconstructions

Authors

Jerzy Gosk
Roman Rutowski
Roman Wiącek
Maciej Urban
Piotr Mazurek

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl