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Orthop Traumatol Surg Res 2022 Jun 29:103358. Epub 2022 Jun 29.

Service de Chirurgie Orthopédique et Traumatologique, Hôpitaux Bichat et Beaujon, Assistance Publique des Hôpitaux de Paris, Université de Paris, France.

Introduction: The wide awake local anesthesia no tourniquet (WALANT) is a local anesthetic technique that theoretically cuts costs and shortens surgical waiting times, but this has yet to be demonstrated in France. The main objective of this study was to assess and compare the comprehensive care pathways and costs of performing carpal tunnel release (CTR) procedures in the ambulatory surgery unit using WALANT and axillary brachial plexus block (ABPB).

Methods: A total of 72 CTRs in 66 patients were reviewed after a minimum follow-up of 6 months. Read More

BMC Neurol 2022 Jul 1;22(1):241. Epub 2022 Jul 1.

Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Japan.

Background: Allogeneic hematopoietic stem cell transplantation is a potentially curative treatment for acute myeloid leukemia. However, extramedullary relapse of acute myeloid leukemia can occur after hematopoietic stem cell transplantation, causing treatment failure. Extramedullary relapse rarely involves the peripheral nerves, and it is not influenced by the effect of the graft on leukemia. Read More

Reg Anesth Pain Med 2022 Jul 1. Epub 2022 Jul 1.

University of Lausanne, Lausanne, Switzerland

Introduction: Hemidiaphragmatic paresis after ultrasound-guided supraclavicular brachial plexus block is reported to occur in up to 67% of patients. We tested the hypothesis that an injection outside the brachial plexus sheath reduces the incidence of hemidiaphragmatic paresis compared with an intrafascial injection while providing similar analgesia.

Methods: Fifty American Society of Anesthesiologists I-III patients scheduled for elective upper limb surgery received a supraclavicular brachial plexus block using 30 mL of 1:1 mixture of mepivacaine 1% and ropivacaine 0. Read More

Afr J Paediatr Surg 2022 Jul-Sep;19(3):189-191

Service of Paediatric Surgery, Albert Royer National Children's Hospital, Université Cheikh Anta Diop, Dakar, Senegal.

Children's schwannoma is a rare condition, generally occurring in a sporadic way. Its aetiology is still not fully understood. We report the case of a 10-year old girl who presented a left shoulder mass, along motility reduction of the left upper limb for 24 months before presentation at our service. Read More

Cureus 2022 May 28;14(5):e25430. Epub 2022 May 28.

Radiation, Robotic Radiosurgery Center, San Jose, CRI.

Introduction Up to 30% of terminally ill cancer patients experiencing intense pain might be refractory to opioid treatment. Complex cancer pain can be a mixture of somatic, visceral, and neuropathic pain with few or no effective alternatives to ameliorate pain. Radiosurgery to treat refractory pain in cancer has been reported with different degrees of success. Read More

Pediatr Neurol 2022 Jun 16;134:11-17. Epub 2022 Jun 16.

Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

Background: Obstetric brachial plexus palsy (OBPP) is a birth injury that affects upper extremity performance. However, some children with OBPP might have central nervous system disorder or developmental disabilities. This study aimed to investigate (1) the early spontaneous movements using General Movements Assessment (GMA) in infants with OBPP according to the Narakas classification, (2) the differences from typical infants, and (3) the relationship between the GMA and the affected upper extremity movements score. Read More

Stem Cells Cloning 2022 22;15:29-42. Epub 2022 Jun 22.

Department of Orthopaedics and Traumatology, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia.

Background: Brachial plexus injury is an advanced and devastating neurological injury, for which both nerve surgery and tendon transfers sometimes remain insufficient in restoring normal movement. Stem cell therapy may be applicable to rescue the injured motor neurons from degeneration which potentially improves muscle strength.

Study Design: Systematic Review; Level of evidence V. Read More

Int J Spine Surg 2022 Jun 28. Epub 2022 Jun 28.

Brachial Plexus and Peripheral Nerve Injury Center, Rasht, Iran.

Background: Iatrogenic cervical nerve root injury may occur during cervical spine surgeries, which leads to upper limb palsy. The question of how a permanent iatrogenic upper limb palsy would be managed remains unclear. Recent developments of nerve transfer have led to a considerable interest in its applications. Read More

CMAJ 2022 Jun;194(25):E883-E888

Départements de médecine physique et de réadaptation (Miller, Hooper) et de médecine interne (Sharma), Faculté de médecine, Université du Manitoba, Winnipeg (Man.).

CMAJ 2022 Jun;194(25):E897-E898

Rédacteur en chef adjoint, JAMC.

Int J Gen Med 2022 18;15:5673-5680. Epub 2022 Jun 18.

Department of Radiology, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, People's Republic of China.

Purpose: To investigate the value of high-resolution MRI based on 3D-short inversion time inversion recovery sampling perfection with application-optimized contrasts (3D-STIR SPACE) sequence for the diagnosis of brachial plexus injury in infants and young children.

Methods: Physical examination, electromyography (EMG) and MRI data of 26 children with brachial plexus injury were retrospectively analyzed. Sensitivity, specificity, and accuracy were calculated for the three tests. Read More

Med Image Anal 2022 Jun 18;80:102511. Epub 2022 Jun 18.

Center of Anaesthesia surgery, Sichuan Provincial Hospital for Women and Children/Affilated Women and Children's Hospital of Chengdu Medical College, Chengdu, China. Electronic address:

Ultrasound-guided injection is widely used to help anesthesiologists perform anesthesia in peripheral nerve blockade (PNB). However, it is a daunting task to accurately identify nerve structure in ultrasound images even for the experienced anesthesiologists. In this paper, a Multi-object assistance based Brachial Plexus Segmentation Network, named MallesNet, is proposed to improve the nerve segmentation performance in ultrasound image with the assistance of simultaneously segmenting its surrounding anatomical structures (e. Read More

J Orthop Surg (Hong Kong) 2022 May-Aug;30(2):10225536221109914

Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, 587171Eulji University School of Medicine, Uijeongbu, Korea.

Purpose: The aim of this study was to suggest treatment guidline for primary elbow OA with ulnar nerve neuropathy or high-grade stiffness by evaluating the effect of ulnar nerve decompression on the outcome of osteocapsular arthroplasty.

Methods: A total of 30 patients who underwent primary osteocapsular arthroplasty for elbow OA were retrospectively reviewed. The surgical outcomes were evaluated for pain score (visual analog scale; VAS), range of motion (ROM), and Mayo Elbow Performance Score (MEPS). Read More

Yonsei Med J 2022 Jul;63(7):657-664

Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

Purpose: We aimed to analyze changes in suprascapular nerve (SSN) position within the suprascapular notch during in vivo shoulder abduction.

Materials And Methods: Three-dimensional models of the shoulder complex were constructed based on magnetic resonance imaging of the brachial plexus (BP-MR) in a patient diagnosed with SSN dysfunction but normal scapular movement. Using BP-MR in neutral position and computed tomography data on shoulder abduction, shoulder abduction was simulated as the transition between two positions of the shoulder complex with overlapping of a neutral and abducted scapula. Read More

Medicina (Kaunas) 2022 Jun 15;58(6). Epub 2022 Jun 15.

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

Pediatric Outcome Data Collection Instrument (PODCI) is among the most described scales developed to evaluate the physical status of children and adolescents with various musculoskeletal disorders. We aimed to translate PODCI from English to Serbian, culturally adopt items and domains, evaluate the temporal stability, internal consistency and the test-retest reliability of PODCI in children with obstetrical brachial plexus lesion (OBPL), and finally, to test the construct validity of PODCI against muscular manual test (MMT) The study included 48 eligible participants aged between 2 and 10 years with OBPL. The MMT was used to test the construct validity. Read More

Disabil Rehabil 2022 Jun 23:1-7. Epub 2022 Jun 23.

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

Purpose: The pediatric upper extremity motor activity log-revised (PMAL-R) is a structured interview that measures use of the affected arm in daily life in children with unilateral pathologies like hemiparetic cerebral palsy (CP) or birth brachial plexus injury (BBPI). This study investigated validity and test-retest reliability of the PMAL-R in children with BBPI.

Materials And Methods: The PMAL-R was administered to parents of 132 children with BBPI between 5 and 9 years for validity, also 98 parents were re-interviewed after 3 weeks to establish test-retest reliability. Read More

J Anesth 2022 Jun 22. Epub 2022 Jun 22.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.

Purpose: Remifentanil is useful in balanced anesthesia; however, there is concern regarding opioid-induced hyperalgesia. The effect of remifentanil on rebound pain, characterized by hyperalgesia after peripheral nerve block has rarely been studied. This study evaluated whether intraoperative remifentanil infusion may increase postoperative analgesic requirement in patients receiving preoperative interscalene brachial plexus block (IBP). Read More

J Vet Med Sci 2022 Jun 21. Epub 2022 Jun 21.

Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Jeju National University.

A 12-year-old mixed-breed dog presented with a 2-month history of abdominal distension. Radiographic examination, abdominal ultrasonography, and computed tomography revealed a mass in the cecum (15.0 × 11. Read More

Reg Anesth Pain Med 2022 06 21. Epub 2022 Jun 21.

Department of Anesthesia, McGill University, Montreal, Quebec, Canada.

Background: This randomized trial compared perineural dexamethasone with combined perineural dexamethasone-dexmedetomidine for ultrasound-guided infraclavicular block. We hypothesized that the combination of perineural adjuvants would result in a longer motor block.

Methods: Fifty patients undergoing upper limb surgery with ultrasound-guided infraclavicular block (using 35 mL of lidocaine 1%-bupivacaine 0. Read More

Childs Nerv Syst 2022 Jun 20. Epub 2022 Jun 20.

Peripheral Nerve Surgery Unit, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, SP, Brazil.

Purpose: Self-biting behavior in patients with neonatal brachial plexus palsy (NBPP) has been associated with finger amputation. Our objective is to describe the incidence of this complication, risk factors, and clinical management.

Methods: We retrospectively analyzed 612 patients with NBPP. Read More

Disabil Rehabil 2022 Jun 18:1-7. Epub 2022 Jun 18.

School of Health Sciences, University of East Anglia, Norwich, UK.

Purpose: A traumatic brachial plexus injury (BPI) has life-changing consequences for patients and their families. Despite advancements in treatments final outcome is unpredictable depending on factors including time to treatment, injury severity, neural regeneration, and available interventions. The final outcome may not be seen for up to four years. Read More

Ann Geriatr Med Res 2022 Jun 20. Epub 2022 Jun 20.

Department of Anaesthesiology and Pain medicine, Konyang University Hospital, Myunggok Medical Research Center, Konyang University College of Medicine, Daejeon, Republic of Korea.

Background: Older patients are more vulnerable to inadvertent perioperative hypothermia. Prewarming contributes to the prevention of inadvertent perioperative hypothermia in patients under general or neuraxial anesthesia. However, the effects of brachial plexus block (BPB) on thermoregulation and the efficacy of prewarming in the prevention of hypothermia in older patients undergoing surgery with BPB remain unclear. Read More

Front Vet Sci 2022 3;9:869082. Epub 2022 Jun 3.

Linnaeus Veterinary Limited, Neurology and Neurosurgery Service, Southfields Veterinary Specialists, Essex, United Kingdom.

This case report describes the diagnosis, management and outcome of three dogs with peripheral nerve sheath tumors (PNSTs) involving the brachial plexus, C7 (case 1), C8 (case 2), and C8 and T1 (case 3) spinal nerves and nerve roots with intrathoracic invasion. Surgical resection required thoracic limb amputation and removal of the first rib, facilitating a novel lateral approach to the spinal nerves and foramina in all cases. This was followed by hemilaminectomy and rhizotomy in cases 1 and 2. Read More

Cureus 2022 May 17;14(5):e25079. Epub 2022 May 17.

Anesthesiology, Perioperative Medicine, and Pain management, Henry Ford Health System, Detroit, USA.

Anatomical variations of the brachial plexus are very common. Knowledge of the possible anatomical variations encountered in ultrasound imaging is crucial for the safe and effective practice of regional anesthesia. The interscalene block (ISB) targets the brachial plexus roots in the interscalene groove, between the anterior and middle scalene muscles (MSM), at the level of the sixth cervical vertebra. Read More

Anat Cell Biol 2022 Jun 20;55(2):130-134. Epub 2022 Jun 20.

Department of Anatomy, Katihar Medical College, Katihar, India.

Median nerve is formed by lateral root from lateral cord and medial root from medial cord of brachial plexus. Formation of median nerve occur in front or lateral to axillary artery in axilla. In the present study we observed anatomical variations of median nerve formation in the brachial plexus. Read More

Neurosurg Clin N Am 2022 Jul 25;33(3):311-321. Epub 2022 May 25.

Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, United Kingdom.

Deep brain stimulation (DBS) is a neurosurgical intervention well known for the treatment of movement disorders as well as epilepsy, Tourette syndrome, and obsessive-compulsive disorders. DBS was pioneered in the 1950s, however, as a tool for treating facial pain, phantom limb pain, post-stroke pain, and brachial plexus pain among other disease states. Various anatomic targets exist, including the sensory thalamus (ventral posterior lateral and ventral posterior medial), the periaqueductal gray and periventricular gray matter, and the anterior cingulate cortex. Read More

J Vasc Interv Radiol 2022 Jun 16. Epub 2022 Jun 16.

Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medicine Sciences, Beijing, P.R. China; Graduate School of Peking Union Medical College; Chinese Academy of Medical Sciences, Beijing, P.R. China. Electronic address:

Purpose: This study aimed to prove the hypothesis that neurolysis based on ethanol injection in combination with iodine-125 (I) radioactive seed implantation could prolong nerve regeneration time compared with ethanol injection alone. Moreover, we assessed the grade of nerve injury using both methods.

Materials And Methods: Twenty female rabbits (mean 2. Read More

Vasc Specialist Int 2022 Jun 17;38:14. Epub 2022 Jun 17.

Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, México City, México.

Chronic limb-threatening ischemia is rarely associated with previous traumatic injury. We present a case of a 28-year-old male with progressive digit ulcers, a weak pulse, cyanosis, and a cold limb. Eight months prior, he had a motorcycle accident resulting in a right clavicle fracture and brachial plexus injury. Read More

Radiol Case Rep 2022 Aug 11;17(8):2859-2862. Epub 2022 Jun 11.

Department of Radiology, Baoding Children's Hospital, Baoding 071051, China.

Neonatal obstetric brachial plexus palsy is common in newborns with fetal macrosomia, especially those who are delivered vaginally with shoulder dystocia or breech delivery. The anatomical structure of brachial plexus in newborns is thin, and it is neither collinear nor coplanar in space; The location, the type and degree of neonatal brachial plexus injury need to be comprehensively judged by clinical history, neurological and imaging examination. Conventional MR imaging is not sufficient to diagnose brachial plexus injury. Read More

J Bodyw Mov Ther 2022 Jul 28;31:30-36. Epub 2022 Mar 28.

Department of Neuroscience, University of Padova, Italy. Electronic address:

The integrity of connective tissue sheaths surrounding the nerves influences both the severity and the potential for recovery of brachial plexus lesions. This study presents an innovative, early onset, multidisciplinary approach to obstetric brachial plexus palsy. This approach is aimed at functional recovery of the nerve lesion and includes mobilization of the fascia using the Fascial Manipulation® method. Read More