TENG HSIANG WEI
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
4 resultados
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- Comparison between donor nerves to motorize the free functional gracilis muscle transfer for elbow flexion: Retrospective study of 38 consecutive cases in traumatic adult brachial plexus injuries(2019) CHO, Alvaro B.; SILVA, Gustavo Bersani; PISANI, Marina J.; ALVES, Jairo A.; IAMAGUCHI, Raquel B.; WEI, Teng H.; REZENDE, Marcelo R. dePurpose Elbow flexion deficit is a frequent problem in traumatic brachial plexus injuries and reestablishment of this function is the primary treatment goal. When management is delayed, or the initial acute approach fails, free functional transfer of the gracilis muscle for elbow flexion is the treatment of choice. In this report, the authors present the results of a comparison study on different donor nerves (spinal accessory and ulnar) in elbow flexion reconstruction with gracilis flap for traumatic adult brachial plexus injuries. Methods Retrospective analysis of patients with both total or partial traumatic brachial plexus injuries was carried out. Of the 38 patients enrolled, 37 were male (97.4%) with a mean age of 28.3 years. The mean follow-up period was 25 months. Postoperative function of the gracilis muscle flap was recorded and patients were divided into two groups according to donor nerve: spinal accessory nerve (SAN) (18 cases), and motor fascicles of the ulnar (ULNAR) (20 cases). Results Twenty-six cases obtained elbow flexion strength M3 or M4 (68.4%): 0 M0 (0.0%), 4 M1 (10.5%), 8 M2 (21.1%), 9 M3 (23.7%) and 17 M4 (44.7%). The mean interval to first recorded M3 muscular strength was 12.4 months. Functional elbow flexion strength (>= M3) had the following distribution: SAN 83.3% (15/18) and ULNAR 55.0% (11/20) (p = .086). Conclusion No statistical difference for final muscle strength was found between donor nerve groups.
- INTERCOSTAL NERVE TRANSFER TO THE BICEPS MOTOR BRANCH IN COMPLETE TRAUMATIC BRACHIAL PLEXUS INJURIES(2015) BAIK, Alvaro; IAMAGUCHI, Raquel Bernardelli; SILVA, Gustavo Bersani; PAULOS, Renata Gregorio; KIYOHARA, Leandro Yoshinobu; SORRENTI, Luiz; MENEZES, Klicia de Oliveira Costa Riker Teles de; REZENDE, Marcelo Rosa de; WEI, Teng Hsiang; MATTAR JUNIOR, RamesThe purpose of this report is to critically evaluate our results of two intercostal nerve transfers directly to the biceps motor branch in complete traumatic brachial plexus injuries. From January 2007 to November 2012, 19 patients were submitted to this type of surgery, but only 15 of them had a follow-up for >= 2 years and were included in this report. The mean interval from trauma to surgery was 6.88 months (ranging from 3 to 9 months). Two intercostals nerves were dissected and transferred directly to the biceps motor branch. The mean follow-up was 38.06 months (ranging from 24 to 62 months). Ten patients (66.6%) recovered an elbow flexion strength >= M3. Four of them (26.66%) recovered a stronger elbow flexion >= M4. One patient (6.25%) recovered an M2 elbow flexion and four patients (26.66%) did not regain any movement. We concluded that two intercostal nerve transfers to the biceps motor branch is a procedure with moderate results regarding elbow flexion recovery, but it is still one of the few options available in complete brachial plexus injuries, especially in five roots avulsion scenario. (C) 2015 Wiley Periodicals, Inc.
- A REINFORCEMENT OF THE SUTURED MICROVASCULAR ANASTOMOSIS WITH FIBRIN GLUE APPLICATION: A RETROSPECTIVE COMPARATIVE STUDY WITH THE STANDARD CONVENTIONAL TECHNIQUE(2017) CHO, Alvaro Baik; PAULOS, Renata Gregorio; BERSANI, Gustavo; IAMAGUCHI, Raquel Bernardelli; TORRES, Luciano Ruiz; WEI, Teng Hsiang; RESENDE, Marcelo Rosa De; MATTAR JUNIOR, RamesPurpose: Although a reasonable number of studies report satisfactory results with fibrin glue application in microvascular anastomosis since 1977, its utilization in the clinical setting has being scant in the literature. The aim of this study was to report the cumulated experience with the fibrin glue in free flaps over a period of 10 years, comparing the survival rate with the standard sutured anastomosis. Patients and methods: From August 2001 through November 2014, 83 consecutive free flaps were performed by a team of surgeons from two hospitals. About 56 flaps were performed in 56 patients using the fibrin glue augmented microvascular anastomosis and 27 flaps were performed in 27 patients using the conventional anastomosis technique. The decision on whether or not the fibrin glue should be used at the anastomoses was based on its availability and whose surgeon was performing the anastomoses. About approximately 60% of sutures stitches were used that would be used in a conventional anastomosis, when fibrin glue application was anticipated (ranging from 5 to 7 sutures in the arteries and 5 to 8 in the veins). Results: The overall survival rate of the flaps performed with fibrin glue application was 92.85%. In one case, a revision of the venous anastomosis was required due to early flap congestion. Four cases (7.14%) had failure of the first free flap and two of them were submitted to another free flap without fibrin glue application. In the flaps performed with the conventional anastomosis technique the survival rate was 92.59%. This difference was not statistically significant (P=0.97). Conclusion: The application of fibrin glue in microvascular anastomoses did not increase the rate of flap loss and had a potential to reduce the number of sutures required to complete an anastomosis by its sealing effect. (C) 2016 Wiley Periodicals, Inc.
- MEDIAN NERVE FASCICLE TRANSFER VERSUS ULNAR NERVE FASCICLE TRANSFER TO THE BICEPS MOTOR BRANCH IN C5-C6 AND C5-C7 BRACHIAL PLEXUS INJURIES: NONRANDOMIZED PROSPECTIVE STUDY OF 23 CONSECUTIVE PATIENTS(2014) CHO, Alvaro Baik; PAULOS, Renata Gregorio; RESENDE, Marcelo Rosa de; KIYOHARA, Leandro Yoshinobu; SORRENTI, Luiz; WEI, Teng Hsiang; BOLLIGER NETO, Raul; MATTAR JUNIOR, RamesThe purpose of this study was to observe whether the results of the median nerve fascicle transfer to the biceps are equivalent to the classical ulnar nerve fascicle transfer, in terms of elbow flexion strength and donor nerve morbidity. Twenty-five consecutive patients were operated between March 2007 and July 2013. The patients were divided into two groups. In Group 1 (n=8), the patients received an ulnar nerve fascicle transfer to the biceps motor branch. In Group 2 (n=15), the patients received a median nerve fascicle transfer to the biceps motor branch. Two patients with follow-up less than six months were excluded. Both groups were similar regarding age (P=0.070), interval of injury (P=0.185), and follow-up period (P=0.477). Elbow flexion against gravity was achieved in 7 of 8 (87.5%) patients in Group 1, versus 14 of 15 (93.3%) patients in Group 2 (P=1.000). The level of injury (C5-C6 or C5-C7) did not affect anti-gravity elbow flexion recovery in both the groups (P=1.000). It was concluded that the median nerve fascicle transfer to the biceps is as good as the ulnar nerve fascicle transfer, even in C5-C7 injuries. (C) 2014 Wiley Periodicals, Inc.