A Prospective Study Comparing Single and Double Fascicular Transfer to Restore Elbow Flexion After Brachial Plexus Injury

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Arquivos
art_SIQUEIRA_A_Prospective_Study_Comparing_Single_and_Double_Fascicular_2013.PDF (512 KB)
Citações na Scopus
51
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
Citação
NEUROSURGERY, v.72, n.5, p.709-714, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BACKGROUND: The recovery of elbow flexion in upper brachial plexus injury can be achieved by the reinnervation of the biceps muscle (single reinnervation), but concomitant restoration of brachialis and biceps function (double reinnervation) has been recommended to improve elbow flexion strength. OBJECTIVE: To prospectively compare morbidity and outcomes of single or double muscle reinnervation in restoring elbow flexion following incomplete injury to the brachial plexus. METHODS: Forty consecutive patients were prospectively submitted to single or double muscle reinnervation. Elbow flexion strength was evaluated with a push-and-pull dynamometer 12 months after surgery. Hand morbidity related to the procedures was evaluated by the Semmes-Weinstein monofilaments test, quantification of static 2-point discrimination, and measurements of handgrip and lateral pinch strength in serial evaluations up to the final follow-up. RESULTS: Similar results for the strength of elbow flexion were observed in both groups. A worsening of sensibility, measured by using Semmes-Weinstein monofilaments, was identified in 8 patients, all of whom showed recovery during follow-up. No worsening of 2-point discrimination was observed. A decrease in handgrip and lateral pinch strength was identified in 8 and 9 patients, respectively, which improved during follow-up. There was no difference between the groups in the incidence of hand motor morbidity parameters. CONCLUSION: The strength of elbow flexion did not differ significantly between the groups treated with single or double muscle reinnervation. Deterioration of handgrip, lateral pinch strength, and sensibility measured by using Semmes-Weinstein monofilaments, was temporary, resulting in low morbidity for both techniques.
Palavras-chave
Brachial plexus, Brachial plexus repair, Nerve injury, Upper brachial plexus neuropathy
URI
https://observatorio.fm.usp.br/handle/OPI/1999
Referências
  1. ALTMAN DG, 1983, BRIT MED J, V286, P1489
  2. Bertelli JA, 2004, J HAND SURG-AM, V29A, P131, DOI 10.1016/j.jhsa.2003.10.013
  3. Bertelli JA, 2006, J HAND SURG-AM, V31A, P190, DOI 10.1016/j.jhsa.2005.09.020
  4. BUNGE RP, 1994, J NEUROL, V242, pS19, DOI 10.1007/BF00939235
  5. Carlsen BT, 2011, PLAST RECONSTR SURG, V127, P269, DOI 10.1097/PRS.0b013e3181f95be7
  6. Coulet B, 2010, J HAND SURG-AM, V35A, P1297, DOI 10.1016/j.jhsa.2010.04.025
  7. DAGOSTINO RB, 1990, AM STAT, V44, P316, DOI 10.2307/2684359
  8. Ejeskar A, 2002, HAND CLIN, V18, P449, DOI 10.1016/S0749-0712(02)00083-5
  9. Estrella EP, 2011, J PLAST RECONSTR AES, V64, P1007, DOI 10.1016/j.bjps.2011.02.002
  10. Ferraresi S, 2004, NEUROSURG FOCUS, V16, P1, DOI 10.3171/foc.2004.16.5.7
  11. Garg R, 2011, J BONE JOINT SURG AM, V93A, P819, DOI 10.2106/JBJS.I.01602
  12. Giuffre JL, 2010, J HAND SURG-AM, V35A, P678, DOI 10.1016/j.jhsa.2010.01.021
  13. Goubier Jean-Noël, 2007, Tech Hand Up Extrem Surg, V11, P15, DOI 10.1097/01.bth.0000248360.14448.6b
  14. James MA, 2007, J HAND SURG-AM, V32A, P154, DOI 10.1016/j.jhsa.2006.11.008
  15. Jivan S, 2009, J PLAST RECONSTR AES, V62, P472, DOI 10.1016/j.bjps.2007.11.027
  16. Leechavengvongs S, 1998, J HAND SURG-AM, V23A, P711, DOI 10.1016/S0363-5023(98)80059-2
  17. Leechavengvongs S, 2006, J HAND SURG-AM, V31A, P183, DOI 10.1016/j.jhsa.2005.09.019
  18. Liverneaux PA, 2006, PLAST RECONSTR SURG, V117, P915, DOI 10.1097/01.prs.0000200628.15546.06
  19. Loy S, 1997, Ann Chir Main Memb Super, V16, P275, DOI 10.1016/S0753-9053(97)80040-3
  20. MacAvoy MC, 2007, J HAND SURG-AM, V32A, P149, DOI 10.1016/j.jhsa.2006.10.020
  21. Mackinnon SE, 2005, J HAND SURG-AM, V30A, P978, DOI 10.1016/j.jhsa.2005.05.014
  22. OBERLIN C, 1994, J HAND SURG-AM, V19A, P232, DOI 10.1016/0363-5023(94)90011-6
  23. Ozkan T, 2013, J HAND SURG-EUR VOL, V38E, P14, DOI 10.1177/1753193412444400
  24. Palazzi S, 2006, MICROSURG, V26, P330, DOI 10.1002/micr.20247
  25. Ray WZ, 2011, J NEUROSURG, V114, P1520, DOI 10.3171/2011.1.JNS10810
  26. Revol M, 1999, J HAND SURG-BRIT EUR, V24B, P235, DOI 10.1054/jhsb.1998.0184
  27. Sedain G, 2011, NEUROSURGERY, V69, P822, DOI 10.1227/NEU.0b013e31822848eb
  28. Siqueira MG, 2011, ARQ NEURO-PSIQUIAT, V69, P528, DOI 10.1590/S0004-282X2011000400023
  29. Socolovsky M, 2012, NEUROSURGERY S, V71
  30. Sulaiman OAR, 2009, NEUROSURGERY, V65, pA105, DOI 10.1227/01.NEU.0000358537.30354.63
  31. Sungpet A, 2003, MICROSURG, V23, P10, DOI 10.1002/micr.10079
  32. Teboul F, 2004, J BONE JOINT SURG AM, V86A, P1485
  33. Terzis JK, 2012, J PLAST RECONSTR AES, V65, P72, DOI 10.1016/j.bjps.2011.08.029
  34. Tung TH, 2003, J NEUROSURG, V98, P313, DOI 10.3171/jns.2003.98.2.0313
  35. Wolford Larry M, 2003, Proc (Bayl Univ Med Cent), V16, P152
  36. Zheng XY, 2008, CHINESE MED J-PEKING, V121, P99
  37. Zyaei A, 2010, EUR J ORTHOP SURG TR, V20, P293, DOI 10.1007/s00590-009-0558-z

Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/45