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Neural Regeneration Research 2011年第14期6卷 1097-1102页

作者： Dianxiu Ning Meiyu Sun Bo Sun Li Zhao Weisheng Zhang Lijun Wang Shaowu Wang Ailian Liu Jianlin Wu Zhijin Lang Di Ning Guanfu Liu Xiaochen Ji Xiufeng Wang Department of Radiology the First Affiliated Hospital of Dalian Medical University Dalian 116011 Liaoning Province China Department of Mathematics Nanjing University Nanjing 210093 Jiangsu Province China Department of Medical Imaging Dalian Medical University Dalian 116044 Liaoning Province China

There is a large amount of fat in the postganglionic segment of the brachial plexus nerve.The use of short T1 inversion recovery pulse sequence may improve signal strength of the brachial plexus postganglionic segment.The present study revealed that the combination of three-dimensional fast imaging employing steady-state acquisition with phase-cycled and short T1 inversion recovery pulse sequence clearly displayed the anatomical morphology and structure of the brachial plexus nerve,together with maximum intensity projection,volume rendering and other three-dimensional reconstruction techniques.Our results suggested that this method is also suitable for providing accurate assessment and diagnosis of the site,severity and scope of brachial plexus injury.

关键词： brachial plexus i-njury magnetic resonance imaging pulse sequence reconstruction

Effects of brachial plexus injury anastomosis simulation on biomechanical properties of adult brachial plexus

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Neural Regeneration Research 2010年第6期5卷 471-475页

作者： Xuhui Hou Xinying Li Songbai Yang Jian Yin Hongshun Ma China-Japan Friendship Hospital Jilin University Changchun 130031 Jilin Province China Department of Engineering Mechanics Nanling Campus Jilin University Changchun 130022 Jilin Province China

BACKGROUND： Previous studies of peripheral nerve mechanical properties in animals have utilized one-dimensional drawing methods. OBJECTIVE： To analyze the effects of brachial plexus injury anastomosis simulation on biomechanical properties of adult brachial plexus by observing tensile mechanical properties, stress relaxation, and creep deformation of the brachial plexus in normal human cadavers and brachial plexus from simulated brachial plexus injury anastomosis samples. DESIGN, TIME AND SETTING： The in vitro experiment was performed at the Mechanics Experimental Center, Jilin University, China from April to May 2007. MATERIALS： A total of six adult, male cadavers, who had died from acute trauma, and were aged 20-29 years, were supplied by the Research Room of Anatomy, Medical Department, Jilin University, China. AG-10TA Universal Material Testing Machine （Shimadzu, Japan） was used in this study. METHODS： A total of 36 samples of fresh brachial plexus were collected from the cadavers, comprising 12 C5 nerve roots, 12 C6 nerve roots at the left and right sides of the superior truck, and 12 C7 nerve roots at the middle truck. The C5 and C6 nerve roots were processed into 50 samples and the C7 nerve roots into 24 samples. A total of 36 C5 and C6 nerve root samples were randomly assigned to a non-surgery control group （n = 18） and brachial plexus injury anastomosis simulation group （n = 18）. brachial plexus injury simulation anastomosis samples underwent an incision in the middle, and then received anastomosis. Samples in both groups underwent a tension test at 5 mm/min on the AG-10TA universal material testing machine. A total of 24 samples from the C6 superior trunk and C7 middle trunk of the brachial plexus were subjected to stress relaxation and creep tests. Test duration was 7 200 seconds. A total of 100 data points were collected and analyzed using a normalization method. MAIN OUTCOME MEASURES： The following parameters were measured： tension maximum displacement, maximum load, maximum stress, maximum strain an

关键词： brachial plexus injury anastomosis mechanical property stress relaxation creep deformation neural regeneration

Obstetric brachial plexus Palsy of Newborns and Infants: Functional Outcomes after Rehabilitation by Their Own Parents

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Open Journal of Orthopedics 2022年第4期12卷 212-224页

作者： Ngo Yamben Marie-Ange Manga Alexandre Muluem Kennedy Mvondo Obama Serge Arnaud Nseme Etouckey Eric Nana Chunteng Theophile Tsiagadigui Tsiagadigui Jean-Gustave Mosoh Franklin Muluh Mbassi Awa Ibrahima Farikou Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaounde Cameroon National Centre for the Rehabilitation of Persons with Disabilities in Yaoundé Yaounde Cameroon Yaoundé General Hospital Yaounde Cameroon Faculty of Health Sciences University of Buea Cameroon Mother-Children Center of the Chantal Biya Foundation of Yaoundé Yaounde Cameroon

Introduction: Obstetric palsy of the brachial plexus (OPBP) is a paralytic lesion common to obstetric trauma, whose clinical presentation varies according to the severity and extent of the root lesions at birth. Early and appropriate rehabilitation is necessary in order to improve the functional prognosis of the injured limb. Under special conditions, parents could carry out this physiotherapy themselves. Objective: The aim of this work was to assess limb functional recovery in newborns and infants with OPBP after rehabilitation by their parents. Patients and Methods: We conducted a prospective study at the NCRDP in Yaoundé over a period of 18 months. We included all patients aged 0 to 2 years with OPBP, isolated or associated with other lesions and followed at least two (02) years at the NCRDP. Results: We recruited 69 cases. The hospital frequency of OPBP was estimated at 1.02%. The age at first consultation was [0 - 28 d] in 50.8% of cases. The sex ratio was 0.68. The right side was reached in 54.4% of cases. The Erb’s palsy predominated in 79.7% of cases. The risk factors for OPBP were vaginal delivery, cephalic presentation, shoulder dystocia and macrosomia. Physiotherapy was performed as prescribed in 94.9% of cases allowing excellent and good functional recovery in 76.81% of cases. Conclusion: In the care of their children’s OPBP rehabilitation by sensitized, actively involved and supervised parents would be a good alternative to professional physiotherapy in all situations where the latter would not be possible.

关键词： Obstetric Palsy brachial plexus Functional Rehabilitation Macrosomia Childbirth Dystocia

Calcitonin gene-related peptide in anterior and posterior horns of spinal cord after brachial plexus injury

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Neural Regeneration Research 2007年第4期2卷 211-216页

作者： Longju Chen Peijun Wang Feng Li Wutian Wu Department of Anatomy Yunyang Medical College Shiyan 442000 Hubei Province China Department of Anatomy Basic Medical College Sun Yat-sen University Guangzhou 510080 Guangdong Province China Department of Anatomy Medical College University of Hong Kong Hong Kong

BACKGROUND： The changes of calcitonin gene-related peptide （CGRP） expression are closely associated with peripheral nerve injury, whereas it should be further investigated whether the damage of central nerve can lead to the changes of CGRP expression, and whether it is associated with the neural regeneration and repair. OBJECTIVE： To observe the changing law of CGRP expression in the anterior and posterior horns of spinal cord following brachial plexus injury. DESIGN： A randomized controlled trial. SETTINGS： Department of Anatomy, Yunyang Medical College; Department of Anatomy, Basic Medical College, Sun Yat-sen University. MATERIALS： Sixty-five adult male SD rats of clean degree, weighing 180 - 220 g, provided by the experimental animal center of the Basic Medical College, Sun Yat-sen University, were randomly divided into control group （n =5） and experimental group （n =60）, and the latter was subdivided into three damage groups： avulsion of anterior root group （n =20）, disjunction of posterior root group （n =20） and transection of spinal cord group （n =20）. Diaminobenzidine （DAB） chromogen, rabbit anti-CGRP polyclonal antibody were the products of Sigma Company; Leica image analytical apparatus was produced by QUIN Company （Germany）; Histotome by Sigma Company. METHODS： The experiments were carried out in the Department of Anatomy, Basic Medical College, Sun Yat-sen University from September 2004 to March 2005. Three kinds of models of brachial plexus injury were established： In the avulsion of anterior root group, right C7 anterior root was avulsed, and the distal nerve residual root was transected. In the disjunction of posterior root group, right C7 anterior root was avulsed and right C5 - T1 posterior horns were cut to block the sensory afferent pathway. In the transection of spinal cord group, right C7 anterior root was avulsed and C5-6 segments of right spinal cord were semi-transected to block the cortical descending pathway. In the control group, C5 - T1 vertebral plates were prayed open, and

关键词： brachial plexus nerve regeneration spinal cord calcitonin gene-related peptide

Direct anastomosis of contralateral C_7 nerve root transfer with affected-side inferior trunk for repair of brachial plexus avulsion injury

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Neural Regeneration Research 2006年第6期1卷 566-568页

作者： Houjun Yan Changqing Hu Yingli Jia Chunjie Cui Xuefeng Li Jingyang Zhang Department of Hand Surgery the 252 Hospital of Chinese PLA Baoding 071000 Hebei Province China

AIM： To observe the effect of direct anastomosis of contralateral C7 nerve root transferred through prespina route with affected-side infedor trunk for repair of brachial plexus avulsion injury, and investigate its feasibility. METHODS ： Two male patients, with the age of 24 and 41 years respectively, were retrieved. When admitted to the hospital, they were diagnosed as brachial plexus avulsion injury. They subjected the operation in the 252 Hospital of Chinese PLA in March 2006 and May 2006 respectively. The proximal end of contralateral C7 nerve root was dissociated to nerve root pore and the distal end was dissociated to anterior and posterior divisions of middle trunk. The injured C7 nerve root was widely dissociated to inferior trunk, medial cord, ulnar nerve and medial head of median nerve. When elbow and shoulder joints were in flexion, the injured C7 nerve root was directly anastomosed with contralateral C7 nerve root in the gap between affected-side cervical vagina vasorum and esophagus with no tensions. RESULTS： During 3 to 5 hours of operation, little hemorrhage was found, nerves were not used for connection. Dyspnea, hoarse voice and other complications did not appear, either. In the postoperative 7^th to 8^th months, electromyogram examination showed that the growth velocity of anastomosed nerve was normal. CONCLUSION ： Direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk can be used for repair of brachial plexus avulsion injury with satisfying therapeutic effects.

关键词： brachial plexus nerve root therapeutic effects median nerve velocity of the growth

Anatomy of the brachial plexus:A Rare Variation in the Laboratory of Anatomy of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2019年第1期7卷 8-12页

作者： Babou Ba Abdoulaye Kanté Drissa Traoré Bréhima Bengaly Mariam Daou Bréhima Coulibaly Drissa Ouattara Siaka Diallo Siaka Diakité Moumouna Koné Tata Touré Cheickh Tidiane Diallo Ousmane Ibrahim Touré Birama Togola Nouhoum Ongoiba Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of Surgery B.CHU Point G BamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

The brachial plexus (BP), established by the lap twigs of the last four cervical nerves and the first thoracic nerve, assures the driving and sensory innervation of the thoracic member. We bring back a case of rare anatomical variation of the brachial plexus. It is a 34-year-old corpse dissected in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in September 2017. The lap twig of the fourth cervical root (C4) participated in the constitution of the brachial plexus. The superior trunk was normally constituted. The average trunk was formed by the cervical roots C7 and C8 instead of only C7. And consequently the inferior trunk was constituted by the thoracic root T1. The posterior beam was only formed by the posterior branches of the superior and more average trunk. The medial beam was formed by all of the inferior trunk which did not give posterior branch for the formation of the posterior beam. The variations of the brachial plexus could entrain failures in the loco regional anesthesia of the brachial plexus.

关键词： Anatomy brachial plexus Variation Anesthesia Surgery

Transfer of upper trapezius with clavicular segment for restoration of shoulder movements following injury to the brachial plexus

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Plastic and Aesthetic Research 2015年第1期2卷 346-349页

作者： Neeraj Kant Agrawal Department of Plastic Surgery Institute of Medical SciencesBanaras Hindu UniversityVaranasi 221005Uttar PradeshIndia

Aim:Most brachial plexus palsies occur following high-velocity trauma.The shoulder joint is a large proximal joint which influences the motion of the hand.Transfer of the trapezius muscle is an effective alternative for palsy of the deltoid and supraspinatus muscles.Methods:Between 2009 and 2014,32 patients were treated with modified trapezius muscle transfer in which only the descending fibers along with their attachment to the lateral third of clavicle were used.The clavicle was fixed to the anterolateral surface of the humerus by cancellous screws.The arm was immobilized for 6 weeks.Results:All the 32 patients had improved function with stability of the shoulder.The average increase in active abduction was from 7.5°(range:0°-30°)to 85°(range:45°-140°),and the mean forward flexion increased from 5.63°(range:0°-15°)to 55.2°(range:40°-90°)after a mean follow-up of 8.25 months.Twenty-four of the 32 patients rated the result as good to excellent and were satisfied with the improvement in stability and function.Fifty nine point thirty eight percent patients had Medical Research Council Muscle power 4 after the surgery.Conclusion:Transfer of the upper trapezius muscle with a segment of the clavicle segment for a flail shoulder can provide satisfactory function and stability with fewer complications.

关键词： brachial plexus shoulder arthrodesis trapezius transfer

Injury　of　brachial　plexus　by　Oven-dose　Radiation　from　Electron　Beam:A　Report　Of　8　Cases　and　Their　EMG　Analysis

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The Journal of Biomedical Research 1994年第1期18卷 45-48页

作者：沈鸣九丁新生蔡昭许康雄杨志祥

Eight cases of brachial plexus nerve damage caused by overdose radiation from linear accelerator are reported. Hyperesthesia and sharp pain were the early clinical manifestations, subsequently the limbs were numb and disfunctional.The symptoms aggravated progressively in 3 years after the radiation.Three yearo later,the patients's conditions became stable and recovered partially.The degree ofdamage was related to the dosage of radiation. The changes of EMG included appearance of spontaneous potentials,average prolonged duration, increased polyphasic potentials, average low amplitude and peak voltage, simple and mixed patterns, electrical silence or few low amplitude motor unit potentials,while the MCV became slower or disap eared in some injured muscles. The changes of EMG and MCV were proved to be useful both in the assessment of the degree and site of the damage and in the prediction of the prognosis.

关键词： high energy clectron beam irradiation brachial plexus electromyography

Regional anesthesia for orthopedic procedures:What orthopedic surgeons need to know

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World Journal of Orthopedics 2022年第1期13卷 11-35页

作者： Ihab Kamel Muhammad F Ahmed Anish Sethi Department of Anesthesiology Lewis Katz School of Medicine at Temple UniversityPhiladelphiaPA 19140United States

Regional anesthesia is an integral component of successful orthopedic surgery.Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia.Patient evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological assessments.Neuraxial blocks include spinal,epidural,and combined spinal epidural.Upper extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and axillary.Lower extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus block.The choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit assessment.The choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical therapy.Regional anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic reactions.Ultrasound should be used for regional anesthesia procedures to improve the efficacy and minimize complications.LAST treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.

关键词： Orthopedic surgery Regional anesthesia Spinal Epidural Combined spinal epidural Peripheral nerve blocks Neuraxial blocks Upper extremity Lower extremity Interscalene Supraclavicular Infraclavicular Axillary Femoral Fascia iliaca Popliteal Sciatic Saphenous Adductor canal Lumbar plexus brachial plexus Ankle iPACK Complication Local anesthetic systemic toxicity Nerve injury Block failure Continuous nerve block catheters

Late brachial plexopathy after a mid-shaft clavicle fracture:A case report

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World Journal of Orthopedics 2023年第10期14卷 776-783页

作者： Mohammad M Alzahrani Department of Orthopaedic Surgery College of MedicineImam Abdulrahman Bin Faisal UniversityDammam 31441Saudi Arabia

BACKGROUND Clavicle fractures can rarely be associated with brachial plexus injury.These are commonly caused by tractional injury at the time of trauma,but unfrequently can be caused by compression of the brachial plexus from excessive callus or granulation tissue formation.CASE SUMMARY We report a rare case of an adult male who sustained a mid-shaft clavicle fracture and had a late presentation of brachial plexus palsy due to compression from excessive callus formation.CONCLUSION We reported a case of a rare occurrence of delayed brachial plexus palsy due to compression from excessive callus formation in a midshaft clavicle fracture.Early diagnosis and surgical decompression of the brachial plexus is critical,as when managed efficiently,a full recovery of the brachial plexus palsy can be expected in these patients.

关键词： Clavicle Fracture brachial plexus Palsy Case report