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J Hand Ther 2020 Mar 7. Epub 2020 Mar 7.

Occupational Therapy, Alfred Health, Melbourne, Victoria, Australia.

Study Design: Prospective longitudinal cohort study.

Introduction: Traumatic brachial plexus injuries (BPIs) can be devastating and negatively impact daily function and quality of life. Occupational therapists play an important role in rehabilitation; however, studies identifying outcomes are lacking. Read More

Clin Neurol Neurosurg 2020 Apr 23;191:105693. Epub 2020 Jan 23.

The Hand and Microsurgery Center of El Paso, 10175 Gateway West Suite 230, El Paso, Texas, 79925, United States; Clinical Professor, Burrell Osteopathic College of Medicine, Las Cruces, New Mexico, United States. Electronic address:

Objectives: Peripheral neuropathic pain is a common and disabling problem after traumatic brachial plexus injury with global plexopathy secondary to C5 rupture and avulsion of C6, C7, C8, and T1. The purpose of this paper is to evaluate restoration of sensation and pain levels before and after targeted muscle reinnervation to the hand using contralateral C7 nerve transfers in patients who have traumatic brachial plexus injuries with C5 rupture and avulsion of C6, C7, C8, and T1.

Patients And Methods: This paper presents a retrospective review of the outcomes of the surgical management of 11 patients with global plexopathy with C5 rupture and avulsion from C6 to T1 roots. Read More

J Ayub Med Coll Abbottabad 2019 Oct-Dec;31(4):640

Peripheral Nerve & Brachial Plexus Surgery Program, Department of Orthopaedics, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.

We have meticulously read the article titled "Outcome of dynamic compression plate with dorsal radial sliding graft technique for wrist arthrodesis in brachial plexus injury patients". We would like to comment on some aspects of the study and set forth our experience in wrist arthrodesis performed to improve functional outcome in the scenarios cited above. This manuscript aims to highlight the following. Read More

J Peripher Nerv Syst 2020 Mar 29;25(1):27-31. Epub 2020 Jan 29.

Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

Brachial plexus neuropathy is often seen in the military population, especially due to pressure (backpack palsy, BPP) or idiopathic (neuralgic amyotrophy, NA). We aimed to gain insight in the disease characteristics of soldiers with brachial plexus neuropathies in the Dutch military population and to compare disease characteristics between patients with BPP and NA. In this retrospective chart review study we aimed to include all patients with brachial plexus neuropathy, who presented in the Joint Military Hospital between 1 January, 2011 and 31 December, 2016. Read More

Turk J Phys Med Rehabil 2019 Jun 22;65(4):411-414. Epub 2019 Nov 22.

Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey.

Peripheral nervous system complications such as acute demyelinating polyradiculopathy and mononeuropathy may rarely develop after substance use. A 27-year-old man used illegal drugs the day before his admission to the emergency service. Initially, he was suspected for rhabdomyolysis, due to elevated blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, myoglobin, and creatine kinase levels. Read More

BMJ Case Rep 2019 Dec 23;12(12). Epub 2019 Dec 23.

Camden Musculoskeletal Service, University College London Hospitals NHS Foundation Trust, London, UK.

We report a 28-year-old man admitted postmotorcycle versus car in September 2017. The patient sustained multiple injuries in both the upper and lower limbs. He sustained a complex brachial plexus injury on his left side and was transferred immediately to Stanmore Hospital to undergo specialist surgery (supraclavicular brachial plexus exploration and neurolysis) to repair his brachial plexus injury. Read More

Rinsho Shinkeigaku 2020 Jan 17;60(1):41-45. Epub 2019 Dec 17.

Department of Orthopaedic Surgery, Kyoto First Red Cross Hospital.

A 66-year-old woman was admitted to our institution with sudden-onset weakness of her left upper limb. Neurological examination revealed monoplegia and sensory loss of the limb. A brain MRI did not find evidence of an acute ischemic stroke. Read More

World Neurosurg 2020 Mar 16;135:e350-e357. Epub 2019 Dec 16.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:

Objective: To investigate functional outcome from reconstructive surgery in adult traumatic brachial plexus injury (AT-BPI) with associated vascular lesions.

Methods: A retrospective review was performed of 325 patients with AT-BPI who underwent reconstructive surgery between 2001 and 2012. Patients with (vascular group) and without (control group) vascular injuries were identified by review of medical documentation. Read More

Muscle Nerve 2020 03 24;61(3):390-395. Epub 2019 Dec 24.

Department of Orthopaedic Surgery, University of California, Irvine, California.

Introduction: After traumatic nerve injury, neuromuscular junction remodeling plays a key role in determining functional outcomes. Immunohistochemical analyses of denervated muscle biopsies may provide valuable prognostic data regarding clinical outcomes to supplement electrodiagnostic studies.

Methods: We performed biopsies on nonfunctioning deltoid muscles in two patients after gunshot wounds and visualized the neuromuscular junctions using two-photon microscopy with immunohistochemistry. Read More

Niger J Clin Pract 2019 Sep;22(9):1301-1303

Department of Anaesthesia and Intensive Care, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

Neuropathic pain responds poorly to common analgesics that effectively control nociceptive pain because its pathophysiology is different and it is usually associated with co-morbidities such as sleep disturbance, depression and anxiety. Patients with this chronic pain are sometimes left with neurolysis as the last resort. A 65-year-old male multiply-injured retiree presented with disabling pain following traumatic brachial plexus injury sustained from road traffic accident 5 years earlier. Read More

J Bone Joint Surg Am 2019 Aug;101(16):e80

Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery (T.S.H., A.T., R.S., D.M.B., and C.J.D.), Department of Neurosurgery (W.Z.R.), and Division of Public Health Sciences, Department of Surgery (C.J.D.), Washington University School of Medicine, Saint Louis, Missouri.

Background: Traumatic brachial plexus injuries (BPIs) disproportionately affect young, able-bodied individuals. Beyond direct costs associated with medical treatment, there are far-reaching indirect costs related to disability and lost productivity. Our objective was to estimate per-patient indirect cost associated with BPI. Read More

BMJ Case Rep 2019 Jul 17;12(7). Epub 2019 Jul 17.

Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

The result of combined agonist and antagonist muscle innervation in traumatic brachial plexus injury through the intraplexal fascicle nerve transfers with the same donor function has not yet been reported. We describe a patient with a C5-C7 traumatic brachial plexus injury who had a combined transfer of the flexor carpi radialis (FCR) fascicle to the musculocutaneous nerve and the flexor carpi ulnaris (FCU) fascicle to the radial nerve of the triceps. The patient returned for his follow-up visit 2 years after his surgery. Read More

Biomed Res 2019 ;40(3):115-123

Division of Gross Anatomy and Morphogenesis, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences.

Nerve transfer involves the use of a portion of a healthy nerve to repair an injured nerve, and the process has been used to alleviate traumatic brachial plexus injuries in humans. Study of the neural mechanisms that occur during nerve transfer, however, requires the establishment of reliable experimental models. In this study, we developed an ulnar-musculocutaneous nerve-transfer model wherein the biceps muscle of a mouse was re-innervated using a donor ulnar nerve. Read More

J Altern Complement Med 2019 Aug 18;25(8):861-867. Epub 2019 Jun 18.

1Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia.

The study aims to assess, evaluate, and compare the efficacy of acupressure and hypnotherapy in the management of pain in patients presenting with chronic brachial neuralgia (CBN). Randomized controlled trial. Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia. Read More

Curr Treat Options Neurol 2019 Apr 27;21(5):24. Epub 2019 Apr 27.

Methodist Neurological Institute, Houston Methodist Hospital, 6560 Fannin St., Houston, TX, 77030, USA.

Purpose Of Review: Brachial plexopathies (BPs) are a heterogeneous group of diseases which can profoundly affect person's function and quality of life. This review targets current approaches to treatment of different BP types.

Recent Findings: Although there are multiple BP etiologies, non-traumatic causes are particularly unrecognized by clinicians, leading to misdiagnoses and delay in appropriate therapies. Read More

Acta Neurochir (Wien) 2019 05 15;161(5):899-906. 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

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

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

J Am Acad Orthop Surg 2019 Sep;27(18):677-684

From the Emory University Department of Orthopaedics, (Dr. Ahearn and Dr. Seiler), and Georgia Hand, Shoulder and Elbow (Dr. Starr and Dr. Seiler), Atlanta, GA.

Traumatic upper trunk brachial plexopathy, also known as a stinger or burner, is the most common upper extremity neurologic injury among athletes and most commonly involves the upper trunk. Recent studies have shown the incidence of both acute and recurrent injuries to be higher in patients with certain anatomic changes in the cervical spine. In addition, despite modern awareness, tackling techniques, and protective equipment, some think the incidence to be slowly on the rise in contact athletes. Read More

J Am Acad Orthop Surg 2019 Oct;27(19):705-716

From the Mayo Clinic, Phoenix, AZ (Dr. Noland), and the Mayo Clinic, Rochester, MN (Dr. Bishop, Dr. Spinner, and Dr. Shin).

Adult traumatic brachial plexus injuries are devastating life-altering injuries occurring with increasing frequency. Evaluation includes a detailed physical examination and radiologic and electrodiagnostic studies. Critical concepts in surgical management include knowledge of injury patterns, timing of surgery, prioritization in restoration of function, and management of patient expectations. Read More

Neurol India 2019 Jan-Feb;67(Supplement):S118-S124

Department of Plastic Surgery, King George Medical University, Lucknow, Uttar Pradesh, India.

Magnetic resonance neurography (MRN) is recognized as the imaging modality of choice in the evaluation of patients with brachial plexopathy. It adds vital information to the results of the clinical evaluation and electrodiagnostic tests and facilitates patient management. Its indications include both trauma and non-traumatic forms of plexopathy such as inflammatory, neoplastic and compressive. Read More

Microsurgery 2019 Jul 22;39(5):400-404. Epub 2019 Jan 22.

Hand and Microsurgery Unit, Department of Orthopaedic Surgery, São Paulo University, São Paulo, Brazil.

Purpose: 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. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2018;118(10):10-13

Medical Center 'Motus', Yaroslavl, Russia.

Aim: To describe the sonographic phenomenon of the focal 'hourglass-like constriction' of the peripheral nerves (FCPN).

Material And Methods: The authors described 7 patients meeting the criteria for the diagnosis of neuralgic amyotrophy with unilateral FCPN identified with ultrasound in 4 cases and detected intraoperatively in 3 cases (preliminary ultrasound was not performed). The US scanner Sonoscape Pro mode gray scale in the transverse and longitudinal scanning, linear probe 8-15 MHz and Logiq9 scanner with elastography were used. Read More

Eur J Orthop Surg Traumatol 2019 Feb 27;29(2):255-262. Epub 2018 Nov 27.

Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, Ioannina, Greece.

Brachial plexus injuries are major injuries of the upper limb resulting in severe dysfunction usually in young patients. Upper trunk injuries of the brachial plexus account for approximately 45% of brachial plexus injuries. Treatment options for upper trunk brachial plexus injuries include exploration of the plexus and microsurgical repair using nerve grafts or nerve transfers. Read More

Plast Reconstr Surg 2019 01;143(1):151-158

Rochester, Minn. From the Department of Orthopedic Surgery, Mayo Clinic.

Background: There is controversy regarding the effectiveness of brachial plexus reconstruction for elbow function in older patients, as reported outcomes are generally poor. The purpose of this study was to evaluate elbow function outcomes in patients older than 50.

Methods: Fifty-eight patients older than 50 years underwent nerve grafting, transfers, or free functioning muscle transfer to improve elbow function after traumatic brachial plexus injury. Read More

J Plast Reconstr Aesthet Surg 2019 Jan 20;72(1):12-19. Epub 2018 Sep 20.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address:

Purpose: There is controversy regarding the effectiveness of brachial plexus reconstruction in older patients, as outcomes are thought to be poor. The aim of this study is to determine the outcomes of shoulder abduction obtained after nerve reconstruction in patients over the age of 50 years and factors related to success.

Methods: Forty patients over the age of 50 years underwent nerve surgery to improve shoulder function after a traumatic brachial plexus injury. Read More

AJR Am J Roentgenol 2018 12 24;211(6):1319-1331. Epub 2018 Sep 24.

5 Department of Radiology and Orthopedic Surgery, University of Texas Southwestern, Dallas, TX.

Objective: Nonobstetric traumatic brachial plexus injuries can result in significant morbidity and chronic disability if not managed in a timely manner. Functional arm recovery is possible, but it requires a multidisciplinary approach toward the diagnosis and management of such injuries.

Conclusion: This article provides an overview of the clinical, electrophysiology, and diagnostic imaging knowledge needed for accurate imaging interpretation and to participate in multidisciplinary discussions aimed at expediting optimal patient management. Read More

Acta Ortop Bras 2018 Mar-Apr;26(2):131-134

. Hand and Microsurgery Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Objective: To compare magnetic resonance imaging and intraoperative findings in patients diagnosed with traumatic injury to the brachial plexus.

Methods: Patients with a diagnosis of traumatic injury to the brachial plexus admitted to the hand and microsurgery outpatient consult of the Hospital das Clínicas at the University of São Paulo were selected during December 2016. A total of three adult patients with up to six months of injury who underwent surgical treatment were included in the study. Read More

Spinal Cord Ser Cases 2018 21;4:44. Epub 2018 May 21.

1Department of Physical Medicine, Rehabilitation and Sport Medicine, University of Puerto Rico-School of Medicine, San Juan, Puerto Rico.

Introduction: Brown-Séquard Syndrome (BSS) is one of the rarest incomplete spinal cord syndromes. The combination of injuries to peripheral nerves and the central nervous system result in an array of symptoms that can result in overlapping clinical presentations and delayed diagnosis. Early detection of spinal cord injury in patients with peripheral nerve injury has been observed to have a positive effect on outcomes. Read More

Br J Neurosurg 2019 Jun 10;33(3):315-319. Epub 2018 May 10.

b Peripheral nerve injury service, Birmingham Hand Centre , Queen Elizabeth Hospital , Birmingham , UK.

Motor nerve transfer surgery involves re-innervation of important distal muscles using either an expendable motor branch or a fascicle from an adjacent functioning nerve. This technique is established as part of the reconstructive algorithm for traumatic brachial plexus injuries. The reproducible outcomes of motor nerve transfer surgery have resulted in exploration of the application of this technique to other paralysing conditions. Read More

World Neurosurg 2018 Jul 11;115:128-133. Epub 2018 Apr 11.

Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA. Electronic address:

Background: Traumatic cervical pseudomeningoceles (TCPs) occur secondary to traction of the cervical nerve roots resulting in violation of the dura. Surgical repair is not necessary in most cases because pseudomeningoceles have a high propensity to spontaneously resolve with conservative management alone. Currently, there are a limited number of cases of large TCPs (large is defined as ≥6 cm in greatest diameter), and there is no established guideline for the management of such lesions. Read More

J Hand Surg Am 2018 09 9;43(9):872.e1-872.e6. Epub 2018 Apr 9.

International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD. Electronic address:

Voluntary elbow extension is essential for optimal upper limb positioning required for daily living activities, particularly above-shoulder maneuvers. The authors present a case of traumatic brachial plexus injury in which paralysis of the musculature selectively supplied by the posterior cord was based on magnetic resonance imaging and nerve conduction studies. An attempt at a radial nerve graft at another center was not effective. Read More

Plast Reconstr Surg 2018 04;141(4):949-959

Los Angeles, Calif. From the Division of Plastic and Maxillofacial Surgery, University of Southern California Keck School of Medicine, Children's Hospital Los Angeles.

Background: In late presentation of brachial plexus trauma, it is unclear whether donor nerves should be devoted to nerve reconstruction or reserved for free functional muscle transfer. The authors systematically reviewed recovery of elbow flexion after nerve reconstruction versus free functional muscle transfer for late, traumatic brachial plexus palsy.

Methods: A systematic review was performed using the PubMed, Embase, and Cochrane databases to identify all cases of traumatic brachial plexus palsy in patients aged 18 years or older. Read More

J Hand Surg Eur Vol 2018 Jul 16;43(6):596-608. Epub 2018 Mar 16.

1 Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Japan.

The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3-17) who were followed-up over a mean period of 6 years (range 2-16). Read More

NeuroRehabilitation 2018 ;42(1):113-119

Department of Physical Therapy and Special Motility, West University of Timişoara, Timişoara, Romania.

Introduction: Lower motor neurons are the only neurons of the central nervous system (CNS) with the ability to regenerate without any intervention after an axotomy.

Aim: This present study was conducted to analyze clinical and electrophysiological parameters in four groups of upper limb peripheral neuropathies, before and after treatment, comparing the results obtained after three cures of complex rehabilitation therapy.

Materials And Methods: We selected a number of 107 patients (66 women and 41 men) aged between 29 and 77 years (mean age = 49. Read More

Eur Radiol 2018 Jun 9;28(6):2417-2424. Epub 2018 Jan 9.

Department of Plastic Surgery, King George Medical University, Shah Meena Road, Chowk, Lucknow, 226003, India.

Objectives: Many studies have elaborated on the role of magnetic resonance neurography (MRN) in evaluating traumatic brachial plexopathies. Most of these deal with MR findings in adult traumatic plexopathies or children with obstetric brachial plexus palsy (OBPP). Hence, the authors felt the need for this particular study, which focuses on MRN findings in children with non-obstetric traumatic brachial plexus palsy, to find out the distribution and severity of injuries in these patients. Read More

J Neurosurg 2018 10 8;129(4):1041-1047. Epub 2017 Dec 8.

Departments of1Orthopedic Surgery, Division of Hand Surgery, and.

Despite continuous improvement and expansion of reconstructive options for traumatic brachial plexus injury, options to reinnervate the triceps muscle remain somewhat sparse. This study describes a novel option, using a spinal accessory nerve transfer to the long head of the triceps muscle with an intervening autologous nerve graft. The resulting quality of elbow extension and factors that influence outcome are discussed. Read More

Neurosurgery 2018 09;83(3):323-332

Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

Background: Traumatic brachial plexus injury (BPI) can result in debilitating sequelae of the upper extremity. Presently, therapeutic decisions are based on the mechanism of injury, serial physical examination, electromyography, nerve conduction, and imaging studies. While magnetic resonance imaging is the current imaging modality of choice for BPI, ultrasound is a promising newcomer that is inexpensive, accessible, and available at point of care. Read More

Arq Neuropsiquiatr 2017 Sep;75(9):667-670

Universidade de São Paulo, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia do Nervo Periférico, São Paulo SP, Brasil.

The treatment of complete post-traumatic brachial plexus palsy resulting in a flail shoulder and upper extremity remains a challenge to peripheral nerve surgeons. The option of upper limb amputation is controversial and scarcely discussed in the literature. We believe that elective amputation still has a role in the treatment of select cases. Read More

Arq Neuropsiquiatr 2017 Sep;75(9):631-634

Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Unidade de Cirurgia de Nervo Periférico, São Paulo, SP, Brasil.

Objective: To establish the correlation between clinical evaluation of motor function recovery and daily living activities in 30 patients with upper traumatic brachial plexus injury submitted to surgery.

Methods: The score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Louisiana State University Health Sciences Center (LSUHSC) scale were determined in 30 patients. Epidemiologic factors were also examined and correlations were determined. Read More

Oper Neurosurg (Hagerstown) 2018 07;15(1):15-24

Department of Neurosurgery, Hospital Juarez de México, Mexico City, Mexico.

Background: Among other factors, like the time from trauma to surgery or the number of axons that reach the muscle target, a patient's age might also impact the final results of brachial plexus surgery.

Objective: To identify (1) any correlations between age and the 2 outcomes: elbow flexion strength and shoulder abduction range; (2) whether childhood vs adulthood influences outcomes; and (3) other baseline variables associated with surgical outcomes.

Methods: Twenty pediatric patients (under age 20 yr) who had sustained a traumatic brachial plexus injury were compared against 20 patients, 20 to 29 yr old, and 20 patients, 30 yr old or older. Read More

Plast Reconstr Surg 2017 Aug;140(2):307e-317e

Rochester, Minn. From the Department of Orthopedic Surgery, Division of Hand Surgery, and the Department of Neurosurgery, Mayo Clinic.

Background: In adults with lower trunk brachial plexus injury, proximal nerve surgery for restoration of prehension demonstrates poor outcomes secondary to long distances required for nerve regeneration and time-dependent degradation of motor endplates. Options for reconstruction are limited to distal tendon or nerve transfers and free-functioning muscle transfers. In this article, the authors describe the long-term outcomes of brachialis muscle-to-flexor digitorum profundus transfer to restore prehension in patients with traumatic lower trunk brachial plexus injuries. Read More

J Hepatol 2017 11 20;67(5):925-932. Epub 2017 Jul 20.

Department of Neurology and Immunology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.

Background & Aims: Hepatitis E virus (HEV) has been associated with a number of neurological syndromes, but causality has not yet been established. The aim of this study was to explore the relationship between HEV and neurological illness by prospective HEV testing of patients presenting with acute non-traumatic neurological injury.

Methods: Four hundred and sixty-four consecutive patients presenting to hospital with acute non-traumatic neurological illnesses were tested for HEV by serology and PCR from four centres in the UK, France and the Netherlands. Read More

Neurosurg Focus 2017 Jul;43(1):E3

Department of Orthopaedics, Aswan University, Aswan, Egypt.

It is not uncommon for a severe traumatic brachial plexus injury to involve all 5 roots, resulting in a flail upper limb. In such cases, surgical reconstruction is often palliative, providing only rudimentary function. Nerve transfers are the mainstay of reconstructive strategies due to the predominance of root avulsions. Read More

J Reconstr Microsurg 2017 Oct 21;33(8):592-595. Epub 2017 Jun 21.

Plastic, Hand and Faciomaxillary Surgery Unit, The Alfred Hospital, Melbourne, Australia.

BMJ Case Rep 2017 May 22;2017. Epub 2017 May 22.

Department of Plastic Surgery, Salisbury NHS Foundation Trust, Salisbury, UK.

Traumatic injuries to the brachial plexus are typically high impact and can be debilitating, life-changing injuries. Backpack palsy is a rare but well-established cause of brachial plexus injury, arising as a result of heavy backpack use. We present an unusual case of backpack palsy with Horner's syndrome. Read More