Contemporary Treatment of Peripheral Nerve and Brachial Plexus Lesions

Overview

Journal Neurosurg Rev

Specialty Neurosurgery

Date 1986 Jan 1

PMID 3016606

Authors

V V Dolenc

Affiliations

Soon will be listed here.

Abstract

The paper outlines modern microsurgical techniques utilized in the repair of injured peripheral motor and sensory neurons. The diagnostic evaluation and its timing, which depend on the level and the extent of the lesion, are proposed. The author stresses the need during the operation for close monitoring, which is a prerequisite of proper coaptation of the severed nerve structures. A technically perfect microsurgical repair provides optimal conditions for regeneration of the divided peripheral nerves and/or brachial plexus. The repair of avulsion injuries of the brachial plexus still poses many technical problems; the author proposes the use of intercostal nerves as new sources for grafts. Pain, which is one of the major problems occurring with peripheral nerve injuries, especially with lesions to the brachial plexus, is not dealt with in detail. The author maintains that the contemporary treatment of peripheral nerve injuries as a rule yields good results, while this is not yet true of the management of brachial plexus lesions.

References

Samii M, Scheinpflug W . [Clinical, electromyographic and quantitative histological investigations following nerve transplants--an experimental study (author's transl)]. Acta Neurochir (Wien). 1974; 30(1-2):1-29. DOI: 10.1007/BF01405752. View

Millesi H . Brachial plexus injuries. Management and results. Clin Plast Surg. 1984; 11(1):115-20. View

NARAKAS A . Surgical treatment of traction injuries of the brachial plexus. Clin Orthop Relat Res. 1978; (133):71-90. View

Mansat M . [Surgical topographic anatomy of the brachial plexus]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):20-6. View

Bonney G, Birch R, Jamieson A, Eames R . Experience with vascularized nerve grafts. Clin Plast Surg. 1984; 11(1):137-42. View

Allieu Y, Privat J, Bonnel F . Paralysis in root avulsion of the brachial plexus. Neurotization by the spinal accessory nerve. Clin Plast Surg. 1984; 11(1):133-6. View

Alnot J, Huten B . [Systematization of the brachial plexus]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):27-34. View

NARAKAS A . [Indications and results of direct surgical treatment in lesions caused by stretching of the brachial plexus. I. Indications for direct surgical treatment]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):88-106. View

Kline D, Judice D . Operative management of selected brachial plexus lesions. J Neurosurg. 1983; 58(5):631-49. DOI: 10.3171/jns.1983.58.5.0631. View

10.

Sunderland S, Bradley K . The cross-sectional area of peripheral nerve trunks devoted to nerve fibers. Brain. 1949; 72(3):428-49. DOI: 10.1093/brain/72.3.428. View

11.

Alnot J . [Surgical technic in paralysis of the brachial plexus]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):75-81. View

12.

Millesi H . [On the problem of overbridging defects of the peripheral nerves]. Wien Med Wochenschr. 1968; 118(9):182-7. View

13.

Frot B . [Opaque cervical myelography in traumatic paralysis of the brachial plexus]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):67-72. View

14.

Cadre N . [Electromyographic study of traumatic paralysis of the brachial plexus]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):65-6. View

15.

Bonnel F . [Traumatic paralysis of the brachial plexus in the adult. III. Internal histophysiologic configuration]. Rev Chir Orthop Reparatrice Appar Mot. 1977; 63(1):35-8. View

16.

Dolenc V, Janko M . Nerve regeneration following primary repair. Acta Neurochir (Wien). 1976; 34(1-4):223-34. DOI: 10.1007/BF01405877. View

17.

Millesi H . Surgical management of brachial plexus injuries. J Hand Surg Am. 1977; 2(5):367-78. DOI: 10.1016/s0363-5023(77)80046-4. View

18.

Dolenc V, Trontelj J, Janko M . Neurophysiological evaluation of microsurgically implanted grafts bridging peripheral nerve defects. Acta Neurochir Suppl (Wien). 1979; 28(2):608-12. View

19.

Sunderland S . The intraneural topography of the radial, median and ulnar nerves. Brain. 2010; 68:243-99. DOI: 10.1093/brain/68.4.243. View

20.

Dolene V . Microsurgical treatment of peripheral nerve injuries. Zentralbl Neurochir. 1977; 38(2):185-90. View