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Arch Plast Surg 2019 Apr 26. Epub 2019 Apr 26.

Department of Plastic and Reconstructive Surgery, University Hospital South Manchester NHS Foundation Trust, Manchester, UK.

Overall complication rates of 9.1% have been reported following implantable cardioverter defibrillator (ICD) placement. Brachial plexus injury is infrequently reported in the literature. Read More

J Hand Ther 2019 Apr 19. Epub 2019 Apr 19.

Medical Faculty of Cerrahpasa, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Bakirkoy, Istanbul, Turkey.

Study Design: Randomized controlled trial.

Introduction: Juvenile idiopathic arthritis (JIA), cerebral palsy (CP), and brachial plexus birth injury (BPBI) are the most common disorders that cause upper extremity impairments in children and adolescents. Leap Motion Controller-based training (LMCBT) is a novel therapeutic method for upper extremity rehabilitation. Read More

J Pediatr Rehabil Med 2019 ;12(1):75-86

Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.

Purpose: To synthesize the evidence on the prevalence and etiology of elbow flexion contractures secondary to brachial plexus birth injury (BPBI).

Methods: Using Arksey and O'Malley's scoping review framework, MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched, followed by a comprehensive grey literature search. Articles and abstracts of studies of all level of evidence on the prevalence, natural history, clinical presentation, etiology, and treatment of elbow flexion contractures in BPBI were included. Read More

Plast Reconstr Surg 2019 Apr 11. Epub 2019 Apr 11.

Background: Elbow flexion after upper brachial plexus injury may be restored by a nerve transfer from the ulnar nerve to the biceps motor branch with an optional nerve transfer from the median nerve to the brachialis motor branch (single and double fascicular nerve transfer). This meta-analysis assesses the effectiveness of both techniques and the added value of additional reinnervation of the brachialis muscle.

Methods: Comprehensive searches were performed identifying studies concerning restoration of elbow flexion through single and double fascicular nerve transfers. Read More

Neurosurg Rev 2019 Apr 17. Epub 2019 Apr 17.

Emory University School of Medicine, 1365-B Clifton Rd NE, Suite B6200, Atlanta, GA, 30322, USA.

Brachial plexus palsy is a surgically manageable condition. Re-animating the shoulder is a high priority for restoring upper extremity function. Methods for reinnervating injured nerves include the transfer of a healthy nerve or fascicle distal to the site of injury, or grafting a healthy sensory nerve to restore motor function. Read More

Reg Anesth Pain Med 2019 Apr 16. Epub 2019 Apr 16.

Anesthesia, Dalhousie University - Faculty of Health Professions, Halifax, Nova Scotia, Canada.

Case Reports Plast Surg Hand Surg 2019 2;6(1):43-46. Epub 2019 Apr 2.

Department of Anesthesiology and Perioperative Medicine, Jacksonville, FL, USA.

Avulsion of C5 and C7 nerve roots was confirmed intraoperatively in a 21 year old male presenting after motor vehicle accident with confirmed absence of somatosensory evoked potentials upon stimulation via ultra-high-frequency ultrasound (70 MHz). Ultra-high-frequency ultrasound can be used as a reliable tool to directly visualise nerve injury. Read More

An Pediatr (Barc) 2019 Apr 10. Epub 2019 Apr 10.

Servicio de Neonataologia B, Maternidade Bissaya Barreto, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Introduction: The purpose of this study was to assess the neonatal morbidity and mortality associated with vacuum-assisted vaginal deliveries compared to all other vaginal deliveries, and to identify the associated risk factors.

Material And Methods: We conducted a retrospective case-control study in a level iii maternity hospital between 2012 and 2016, including 1,802 vacuum-assisted vaginal deliveries and 2control groups: 1802 spontaneous deliveries and 909 forceps-assisted deliveries. We considered minor complications (soft tissue trauma, cephalohaematoma, jaundice, intensive phototherapy, transient brachial plexus injury) and major complications (hypoxic-ischaemic encephalopathy, intracranial and subgaleal haemorrhage, seizures, cranial fracture, permanent brachial plexus injury), admission to the neonatal intensive care unit and death. Read More

J Hand Ther 2019 Apr 8. Epub 2019 Apr 8.

Department of Physiotherapy, School of Physiotherapy D.Y.Patil University, Navi Mumbai, India.

Study Design: This is a qualitative case study.

Introduction: Considering individual patient's perception is an important aspect of rehabilitation according to International Classification of Functioning model (Geneva, 2002).

Purpose Of Study: The report highlights the importance of patient education and considering individual's perception to achieve rehabilitation outcomes. Read More

Indian J Orthop 2019 Mar-Apr;53(2):353-356

Department of Orthopaedics, Ramaiah Medical College, Bengaluru, Karnataka, India.

Background: The loss of elbow flexion is a routinely encountered problem in clinical practice. There is no literature on ulnar nerve innervation to triceps in addition to the radial nerve which is dual nerve innervation to triceps in the Indian population. We intend to study the incidence of ulnar nerve innervation to the medial head of triceps in Indian population and also the clinical feasibility of transfer of long and medial head of triceps tendon to biceps around the medial aspect of humerus. Read More

Neural Regen Res 2019 Aug;14(8):1449-1454

Department of Hand Surgery, Huashan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Health; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.

Contralateral C7 nerve transfer surgery is one of the most important surgical techniques for treating total brachial plexus nerve injury. In the traditional contralateral C7 nerve transfer surgery, the whole ulnar nerve on the paralyzed side is harvested for transfer, which completely sacrifices its potential of recovery. In the present, novel study, we report on the anatomical feasibility of a modified contralateral C7 nerve transfer surgery. Read More

J Neurosurg Spine 2019 04 5:1-6. Epub 2019 Apr 5.

1Christian Doppler Laboratory for Restoration of Extremity Function, Department of Surgery, Medical University of Vienna.

Objective: Spinal accessory nerve palsy is frequently caused by iatrogenic damage during neck surgery in the posterior triangle of the neck. Due to late presentation, treatment regularly necessitates nerve grafts, which often results in a poor outcome of trapezius function due to long regeneration distances. Here, the authors report a distal nerve transfer using fascicles of the upper trunk related to axillary nerve function for reinnervation of the trapezius muscle. Read More

Ultrasound Obstet Gynecol 2019 Apr 2. Epub 2019 Apr 2.

Fetal Medicine Unit, Medway NHS Foundation Trust, United Kingdom.

Objectives: To determine accurate estimates of maternal and neonatal risks of fetal macrosomia by undertaking a systematic review and meta-analysis METHODS: A search of MEDLINE, EMBASE, CINHAL and The Cochrane Library was performed to review relevant citations reporting maternal and neonatal complications of pregnancies with macrosomia with birthweight (BW) >4,000g and >4,500g. We selected prospective and retrospective cohort and population studies that provided data regarding both, cases and controls. Meta-analysis using random effects model was used to estimate weighted pooled estimates of summary statistics (odds ratio (OR) [95% confidence intervals (CI)]). Read More

Ultrasound Obstet Gynecol 2019 Apr 2. Epub 2019 Apr 2.

Fetal Medicine Unit, Medway NHS Foundation Trust, United Kingdom.

Objective: To estimate risks of maternal and neonatal complications in pregnancies with macrosomia.

Method: This was a retrospective cohort study undertaken at a large maternity unit in United Kingdom between January 2009-December 2016. We compared the incidence of complications in pregnancies with macrosomia, defined by birthweight (BW)>4,000 g and severe macrosomia with BW>4,500 g, to those in pregnancies with normal BW 2,500-4,000 g. Read More

Asian J Neurosurg 2019 Jan-Mar;14(1):286-288

Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Spontaneous cervical epidural hematoma (SCEH), which is a rare disease, is manifested as by a sudden quadriplegia or paraplegia and other neurological deficits. SCEH can compress the spinal cord resulting in its clinical manifestations. The reported etiological risk factors are anticoagulants, coagulopathies, vascular malformations, infections, and herniated discs. Read More

Shoulder Elbow 2019 Apr 14;11(2):113-115. Epub 2018 Jun 14.

Rotherham District General Hospital, Rotherham, UK.

We report a case of 30-year-old lady presenting with a suprascapular nerve (SSN) injury in the postpartum period. Two days following normal delivery, the patient experienced progressive weakness in her left shoulder, of spontaneous onset. Initially thought to be a rotator cuff tear, further imaging indicated a lesion in the SSN. Read More

Childs Nerv Syst 2019 Mar 28. Epub 2019 Mar 28.

Department of Neurosurgery, School of Medicine, Emory University Hospital, 101 Woodruff Circle, Suite 6204, Atlanta, GA, 30322, USA.

Background: Functional elbow flexion recovery is one of the main goals of neonatal brachial plexus palsy (NBPP) reconstruction. The current neurosurgical treatment options include nerve grafting and nerve transfer.

Objective: The present study sought to examine the literature for comparison of functional elbow flexion recovery in NBPP following nerve grafting or nerve transfer. Read More

Pan Afr Med J 2018 20;31:39. Epub 2018 Sep 20.

Traumatologie-Orthopédie Aile 4, CHU Ibn Rochd, Casablanca, Maroc.

Carpal tunnel syndrome is one of the the most common reasons for consultation in hand surgery with an annual incidence of 300 per 100 000 inhabitants and, in France, of 80 000 surgical interventions. In most cases, carpal tunnel syndrome is idiopathic occurring without a recognizable cause. However, beyond these forms, the merging of several mechanisms can explain the cause-and-effect relationship of this pathology . Read More

Br J Anaesth 2019 Feb 8. Epub 2019 Feb 8.

Department of Anaesthesia, Pain Management and Perioperative Medicine, Halifax, NS, Canada.

Background: Multi-injection targeted intracluster injection ultrasound-guided supraclavicular brachial plexus block has been advocated to provide a faster onset of anaesthesia compared with a double injection technique. By placing the needle within clusters of hypoechoic structures, corresponding to neural tissue, this technique may increase needle trauma and the incidence of nerve injury. This study assessed the rate of sub-perineural needle placement with a single intracluster brachial plexus injection in the supraclavicular fossa of human cadavers. Read More

Emerg Radiol 2019 Mar 25. Epub 2019 Mar 25.

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

The coracoid process of the scapula is in close proximity to major neurovascular structures, including the brachial plexus and the axillary artery and vein. In addition, it serves as a major site of attachment for multiple tendons and ligaments about the shoulder. Isolated coracoid fractures are rare; however, they can be easily overlooked on routine shoulder radiographs. Read More

Pediatr Phys Ther 2019 04;31(2):155

St Louis Children's Hospital St Louis, Missouri.

World Neurosurg 2019 Mar 18. Epub 2019 Mar 18.

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: The restoration of shoulder function after brachial plexus injury is a high priority. Shoulder abduction and stabilization can be achieved by nerve transfer procedures including spinal accessory nerve (SAN) to suprascapular nerve (SSN) and radial to axillary nerve transfer. The objective of this study is to compare functional outcomes after SAN to SSN transfer versus the combined radial to axillary and SA to SSN transfer. Read More

J Hand Surg Am 2019 Mar 18. Epub 2019 Mar 18.

Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, affiliated with Cincinnati University, Cincinnati, OH.

Purpose: The results of a spinal accessory nerve-to-suprascapular (SAN-SSN) nerve transfer for brachial plexus birth injuries (BPBIs) have thus far been presented only in limited case series. Our study evaluates the recovery of shoulder function of patients who underwent an SAN-SSN for BPBI as an isolated procedure or as part of a multinerve reconstruction (MNR) surgery.

Methods: We retrospectively reviewed the medical records of patients at a single institution who underwent an SAN-SSN after BPBI. Read More

Insights Imaging 2019 Mar 20;10(1):37. Epub 2019 Mar 20.

Department of Orthopaedics, SMS Medical College, Jaipur, Rajasthan, India.

The ulnar nerve is a branch of the C8 and T1 nerve roots and arises from the medial cord of the brachial plexus. It supplies the intrinsic muscles of the hand and assists the median nerve in functioning of the flexors. Also known as the musician's nerve, it is the second most common nerve involved in compressive neuropathy following the median nerve. Read More

J Pediatr Rehabil Med 2019 ;12(1):87-100

Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.

Purpose: To conduct a systematic review of studies on non-surgical and surgical interventions for elbow flexion contractures secondary to brachial plexus birth injury (BPBI).

Methods: MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched for randomized controlled trials, observational studies, and case series studies on treatment of elbow flexion contractures secondary to BPBI. Study quality was evaluated using the Effective Public Health Practice Project tool. Read More

J Pediatr Rehabil Med 2019 03 6. Epub 2019 Mar 6.

Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.

Purpose: To synthesize the evidence on the prevalence and etiology of elbow flexion contractures secondary to brachial plexus birth injury (BPBI).

Methods: Using Arksey and O'Malley's scoping review framework, MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched, followed by a comprehensive grey literature search. Articles and abstracts of studies of all level of evidence on the prevalence, natural history, clinical presentation, etiology, and treatment of elbow flexion contractures in BPBI were included. Read More

Plast Reconstr Surg Glob Open 2019 Feb 5;7(2):e2118. Epub 2019 Feb 5.

Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Colorado, Anschutz Medical Center, Aurora, Colo.

Background: Brachial plexus injuries have devastating effects on upper extremity function, with significant pain, psychosocial stress, and reduced quality of life. The aim of this study is to identify socioeconomic disparities in the receipt of brachial plexus repair in the emergent versus elective setting, and in the use of supported services on discharge.

Methods: Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample Database was performed for the years 2009-2014. Read More

Acta Neurochir (Wien) 2019 Mar 15. Epub 2019 Mar 15.

Department of Orthopedic Trauma and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.

Background: Traumatic brachial plexus injuries are severe lesions, and the incidence of these injuries has been increasing in recent years.

Methods: The clinical data of 510 operated patients with brachial plexus injury recruited from 74 hospitals in Guangxi from 2004 to 2016 were retrospectively studied.

Results: Our study included 447 males and 63 females, with an average age of 29. Read More

Br J Neurosurg 2019 Mar 12:1-6. Epub 2019 Mar 12.

a Department of Hand Surgery, Huashan Hospital, Shanghai Medical College , Fudan University , Shanghai , China.

Objective: The objective of the study was to investigate the feasibility of CUBE-SITR MRI and high-frequency ultrasound for the structural imaging of the brachial plexus to exclude neoplastic brachial plexopathy or structural variation and measure the lengths of anterior and posterior divisions of the C7 nerve, providing guidelines for surgeons before contralateral cervical 7 nerve transfer.

Methods: A total of 30 patients with CNS and 20 with brachial plexus injury were enrolled in this retrospective study. All patients underwent brachial plexus CUBE-STIR MRI and high-frequency ultrasound, and the lengths of the anterior and posterior divisions of C7 nerve were measured before surgery. Read More

Plast Reconstr Surg Glob Open 2019 Jan 22;7(1):e1998. Epub 2019 Jan 22.

Texas Nerve and Paralysis Institute, Houston, Tex.

Aim: To evaluate whether obstetric brachial plexus injury (OBPI) children who had mod Quad and triangle tilt surgeries maintained their recovered upper extremity functional movements over 10 years.

Background: The short-term outcomes of surgery in OBPI patients are well documented. However, only a few publications with results over 10-year postoperative follow-up exist. Read More

J Phys Ther Sci 2019 Feb 7;31(2):206-210. Epub 2019 Feb 7.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.

[Purpose] Obstetric brachial plexus injuries are accompanied by co-contractions due to misdirection of regenerated nerve fibers. The result is inhibition of arm movement necessary for activities of daily living. Rehabilitation is important to prevent joint contracture and muscle atrophy in such cases. Read More

J Orthop Sci 2019 Mar 8. Epub 2019 Mar 8.

Department of Orthopaedic Surgery, Chiba University After Graduate School of Medicine, Japan.

Background: Massive rotator cuff tears have a high rate of re-injury because of severe fatty infiltration. Our data showed that injuries proximal to the suprascapular nerve may be one cause of massive rotator cuff tears. The purpose of this study was to evaluate, using a rat model, how brachial plexus injury associated with a massive rotator cuff tear influences healing of the rotator cuff repair. Read More

Neuroreport 2019 Apr;30(6):452-456

Laboratory of Analysis and Control of Upper Extremity Function, Institute of Biomedical and Health Sciences, Hiroshima University.

The purpose of this study was to examine motor imagery ability in patients with peripheral nerve disorder using the hand mental rotation task. Five patients with left total avulsion brachial plexus palsy (BPP) and 16 healthy age-matched adults participated in this study. The mean±SD time from the injury was 103. Read More

Muscle Nerve 2019 Mar 7. Epub 2019 Mar 7.

Department of Physiatry, Hospital for Special Surgery, 535 E 70th Street, New York, New York 10021, USA.

Introduction: Brachial plexus trauma related to gunshot (GS) injury requires early examination and characterization to ensure appropriate treatment. Magnetic resonance imaging (MRI) may be contraindicated when there are metal fragments in a patient's body. Ultrasound (US) may present an alternative to imaging GS-related brachial plexus injury. Read More

J Neurosurg 2019 Mar;130(3):675-685

2Neurosurgery, University Medical Center, Lubbock, Texas.

In this review article, the authors offer their perspective on nerve surgery for nerve injury, with a focus on recent evolution of management and the current surgical management. The authors provide a brief historical perspective to lay the foundations of the modern understanding of clinical nerve injury and its evolving management, especially over the last century. The shift from evaluation of the nerve injury using macroscopic techniques of exploration and external neurolysis to microscopic interrogation, interfascicular dissection, and internal neurolysis along with the use of intraoperative electrophysiology were important advances of the past 50 years. Read More

Nat Commun 2019 03 4;10(1):1030. Epub 2019 Mar 4.

Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK.

Carpal tunnel syndrome (CTS) is a common and disabling condition of the hand caused by entrapment of the median nerve at the level of the wrist. It is the commonest entrapment neuropathy, with estimates of prevalence ranging between 5-10%. Here, we undertake a genome-wide association study (GWAS) of an entrapment neuropathy, using 12,312 CTS cases and 389,344 controls identified in UK Biobank. Read More

PM R 2018 Dec 16. Epub 2018 Dec 16.

Department of Surgery, Division of Plastic Surgery, University of Washington, Seattle, WA.

Neonatal brachial plexus palsy is a complex disorder that requires evaluation of the primary nerve injury and associated sequelae. There is no standardized approach to management, and many treatment options are available. We present a case of Erb palsy with a unique multidisciplinary approach to nonsurgical and surgical management. Read More

J Long Term Eff Med Implants 2018 ;28(3):233-237

Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece.

Scapulothoracic dissociation is the traumatic separation of the scapula from the thoracic wall. It is the outcome of rare, high-energy trauma to the shoulder girdle and may include vascular and neurologic damage of the upper extremity. Of the few cases presented in the literature, the majority refer to polytrauma patients. Read More

Neurosurgery 2019 Feb 25. Epub 2019 Feb 25.

Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Background: Deep brain stimulation (DBS) has been considered for patients with intractable pain syndromes since the 1950s. Although there is substantial experience reported in the literature, the indications are contested, especially in the United States where it remains off-label. Historically, the sensory-discriminative pain pathways were targeted. Read More

J Biomech 2019 Mar 2;86:48-54. Epub 2019 Feb 2.

Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, United States. Electronic address:

Children affected with brachial plexus birth injury (BPBI) undergo muscle paralysis. About 33% of affected children experience permanent osseous deformities of the glenohumeral joint. Recent evidence suggests that some cases experience restricted muscle longitudinal growth in addition to paralysis and reduced range of motion at the shoulder and elbow. Read More

PLoS Biol 2019 Feb 22;17(2):e3000159. Epub 2019 Feb 22.

Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America.

Microglia are central nervous system (CNS)-resident cells. Their ability to migrate outside of the CNS, however, is not understood. Using time-lapse imaging in an obstetrical brachial plexus injury (OBPI) model, we show that microglia squeeze through the spinal boundary and emigrate to peripheral spinal roots. Read More

Acta Neurochir (Wien) 2019 Apr 20;161(4):673-678. Epub 2019 Feb 20.

Department of Hand Surgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Jing An District, Shanghai, 200040, People's Republic of China.

Objective: The purpose of this study was to compare the effects of single and dual nerve transfer for the repair of shoulder abduction in patients with upper or upper and middle trunk root avulsion.

Methods: We carried out a retrospective analysis of 20 patients with C5-C6 or C5-C7 root avulsion treated by nerve transfer in our hospital. The patients were divided into two groups according to the different operation methods. Read More

BMJ 2019 02 20;364:l344. Epub 2019 Feb 20.

Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands

Objective: To compare induction of labour at 41 weeks with expectant management until 42 weeks in low risk women.

Design: Open label, randomised controlled non-inferiority trial.

Setting: 123 primary care midwifery practices and 45 hospitals (secondary care) in the Netherlands, 2012-16. Read More

J Clin Neurosci 2019 May 15;63:227-230. Epub 2019 Feb 15.

Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan.

Surgery in the prone position is associated with a variety of complications due to the positioning, including the widely recognized peripheral nerve compression injuries and brachial plexus neuropathy. Previous studies have reported that thin body habitus is a predisposing risk factor for the compressive peripheral nerve injuries due to the prone position surgery. However, prone-position-related brachial plexus injury in patients who are overweight due to hypertrophic muscles have never been reported. Read More

Acta Ortop Bras 2018 ;26(6):394-396

Irmandade da Santa Casa de Misericórdia de Sao Paulo, Department of Orthopaedics and Traumatology, Sao Paulo, SP, Brazil.

Objective: To determine the relationship between the functional outcome achieved following Oberlin transfer, the cognitive level of the patient, and the time elapsed between the trauma event and surgery.

Methods: Eighteen patients with a traumatic injury to the brachial plexus (C5-C6 and C5-C7) were evaluated. Seventeen (94. Read More

Am J Obstet Gynecol 2019 Feb 12. Epub 2019 Feb 12.

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR.

Background: A large, recent multicenter trial found that induction of labor at 39 weeks for low-risk nulliparous women was not associated with an increased risk of cesarean delivery or adverse neonatal outcomes.

Objective: We sought to examine the cost-effectiveness and outcomes associated with induction of labor at 39 weeks vs expectant management for low-risk nulliparous women in the United States.

Study Design: A cost-effectiveness model using TreeAge software was designed to compare outcomes in women who were induced at 39 weeks vs expectantly managed. Read More

Neural Regen Res 2019 Jun;14(6):1069-1078

Institute of Stem Cells and Regenerative Medicine, Department of Physiology, Guangdong Medical University, Dongguan, Guangdong Province, China.

Brachial plexus avulsion often results in massive motor neuron death and severe functional deficits of target muscles. However, no satisfactory treatment is currently available. Hypoxia-inducible factor 1α is a critical molecule targeting several genes associated with ischemia-hypoxia damage and angiogenesis. Read More

Microsurgery 2019 Feb 13. Epub 2019 Feb 13.

Department of Orthopaedics and Traumatology, Division of Hand Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

Introduction: Posttraumatic brachial plexus (BP) palsy was used to be treated by reconstruction with nerve grafts. For the last two decades, nerve transfers have gained popularity and believed to be more effective than nerve grafting. The aim of this systematic review was to compare elbow flexion restoration with nerve transfers or nerve grafting after traumatic BP injury. Read More

J Hand Surg Asian Pac Vol 2019 Mar;24(1):118-122

1 Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.

A 25-year-old man sustained a right-sided brachial plexus injury from a high-velocity motocross accident. Physical examination and electromyography were consistent with a pan-brachial plexopathy with no evidence of axonal continuity. The patient underwent a spinal accessory to suprascapular nerve transfer and an intercostal to musculocutaneous nerve transfer with interpositional sural nerve grafts. Read More