Long-term functional recovery in C5-C6 avulsions treated with distal nerve transfers
BACKGROUND: In patients suffering from traction lesions of the brachial plexus, complete C5 and/or C6 root avulsion patients with C7 root preservation are relatively uncommon occurrences, but represent excellent candidates for surgical treatment, with satisfactory results. Shoulder abduction and extra-rotation, elbow flexion and forearm supination are lost functions restorable with surgical treatment.
METHODS: This single-center, prospective observational study involved a series of 27 young adults with C5 and/or C6 root complete avulsion and C7 preservation, which underwent surgical repair with double or triple nerve transfer.
RESULTS: Patients recovered a useful elbow flexion. Electromyographic and clinical signs of biceps reinnervation were observed in each UN-MC nerve transfer. The abduction strength recovery was M5 in 10 patients, M4 in 14 patients and M3 in 3 patients. The external rotation strength recovery was M5 in 4 patients, M4 in 18 patients, M3 in 3 patients and M2 in 2 patients. The elbow flection strength was M5 in 5 patients, M4 in 15 patients and M3 in 7 patients. Elbow extension was preserved in all cases.
CONCLUSIONS: The concept of 'peripheral rewiring procedures' represents an advance in the repair of the peripheral nerve injuries. Triple nerve transfer can be nowadays considered a standard treatment for isolated C5-C6 avulsions. We report our experience with the second-biggest casuistry in the literature on patients treated with this technique. We consider our outcome concerning functional recovery to be satisfying and comparable to data reported in the literature.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Neurological research - 45(2023), 9 vom: 02. Sept., Seite 867-873 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fasce, Irene [VerfasserIn] |
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| Links: |
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| Themen: |
Arm function restoration |
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| Anmerkungen: |
Date Completed 11.08.2023 Date Revised 11.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/01616412.2021.1942410 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327398450 |
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| 500 | |a Date Completed 11.08.2023 | ||
| 500 | |a Date Revised 11.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: In patients suffering from traction lesions of the brachial plexus, complete C5 and/or C6 root avulsion patients with C7 root preservation are relatively uncommon occurrences, but represent excellent candidates for surgical treatment, with satisfactory results. Shoulder abduction and extra-rotation, elbow flexion and forearm supination are lost functions restorable with surgical treatment | ||
| 520 | |a METHODS: This single-center, prospective observational study involved a series of 27 young adults with C5 and/or C6 root complete avulsion and C7 preservation, which underwent surgical repair with double or triple nerve transfer | ||
| 520 | |a RESULTS: Patients recovered a useful elbow flexion. Electromyographic and clinical signs of biceps reinnervation were observed in each UN-MC nerve transfer. The abduction strength recovery was M5 in 10 patients, M4 in 14 patients and M3 in 3 patients. The external rotation strength recovery was M5 in 4 patients, M4 in 18 patients, M3 in 3 patients and M2 in 2 patients. The elbow flection strength was M5 in 5 patients, M4 in 15 patients and M3 in 7 patients. Elbow extension was preserved in all cases | ||
| 520 | |a CONCLUSIONS: The concept of 'peripheral rewiring procedures' represents an advance in the repair of the peripheral nerve injuries. Triple nerve transfer can be nowadays considered a standard treatment for isolated C5-C6 avulsions. We report our experience with the second-biggest casuistry in the literature on patients treated with this technique. We consider our outcome concerning functional recovery to be satisfying and comparable to data reported in the literature | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Nerve transfer | |
| 650 | 4 | |a arm function restoration | |
| 650 | 4 | |a brachial plexus lesions | |
| 650 | 4 | |a cervical avulsion | |
| 650 | 4 | |a nerve repair | |
| 700 | 1 | |a Fiaschi, Pietro |e verfasserin |4 aut | |
| 700 | 1 | |a Bianconi, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Sacco, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Staffa, Guido |e verfasserin |4 aut | |
| 700 | 1 | |a Capone, Crescenzo |e verfasserin |4 aut | |
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