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Brachial Plexus Injuries Peripheral Nerve Injuries

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Children's Orthopaedics and Fractures

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Abstract

Evolving microsurgical techniques have significantly changed our attitude to surgical reconstruction of peripheral nerve lesions, including those of the brachial plexus. However, because of the considerable distance the nerves have to regenerate after restoring anatomical continuity in the brachial plexus, the results in adults have been modest, despite the more sophisticated methods available. In contrast, similar methods in children give better results because of their superior capacity for regeneration and the shorter distances involved. The potential for regeneration diminishes gradually after birth, remaining fairly good until adolescence and then deteriorating rapidly after the cessation of growth.

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References

  1. Bennet GC, Harrold AJ. Prognosis and early management of birth injuries to the brachial plexus. Br Med J 1976; 1:1520–1521.

    Article  PubMed  CAS  Google Scholar 

  2. Wickstrom J, Haslam ET, Hutchinson RH. The surgical management of residual deformities of the shoulder following birth injuries of the brachial plexus. J Bone Joint Surg 1958; 47A:27–36.

    Google Scholar 

  3. Tassin JL. Paralyses obstétricales du plexus brachial, evolution spontanée, resultats des interventions reparatrices precrées. Thése 1984, Université Paris VIII.

    Google Scholar 

  4. Gilbert A, Tassin JL. Réparation chirurgicale du plexus brachial dans la paralysie obstétricale. Chirurgie 1984; 110:76–75.

    Google Scholar 

  5. Gilbert A, Brockman R, Carlioz H. Surgical treatment of brachial plexus birth palsy. Clin Orth 1989; 264:39–47.

    Google Scholar 

  6. Gilbert A, Whitaker I. Obstetrical brachial plexus lesions. J Hand Surg 1991; 16B:489–491.

    Google Scholar 

  7. Dailiana ZH, Mehdian H, Gilbert A. Surgical anatomy of spinal accessory nerve: is trapezius functional deficit inevitable after division of the nerve? J Hand Surg Br 2001; 26(2):137–141.

    Article  PubMed  CAS  Google Scholar 

  8. Oberlin C, Beal D, Leechavengvongs S, et al. (1994). Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg [Am] 19(2): 232–237.

    Google Scholar 

  9. Witoonchart K, Leechavengvongs S, Uerpairojkit C, et al. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study. J Hand Surg Am 2003; 28(4):6.

    Article  Google Scholar 

  10. Chuang DC, Lee GW, Hashem F, Wei FC. Restoration of shoulder abduction by nerve transfer in avulsed brachial plexus injury: evaluation of 99 patients with various nerve transfers. Plast Reconstr Surg 1995; 96(1):122–128.

    Article  PubMed  CAS  Google Scholar 

  11. Yang Y, Gu YD, Hu SN, Zhang H. Long-term impact of transfer of phrenic nerve on respiratory system of children: a clinical study of 34 cases. Zhonghua Yi Xue Za Zhi 2006; 86(17):1179–1182.

    PubMed  Google Scholar 

  12. Gu YD, Chen DS, Zhang GM. Long term functional results of contralateral C7 transfer. Reconstr Microsurg 1998; 14:57– 59.

    Article  CAS  Google Scholar 

  13. Taylor AS. Brachial birth palsy and injuries of similar type in adults. Surg Gynecol Obstetr 1920; 30:434–502.

    Google Scholar 

  14. Gilbert A, Razaboni R, Amar-Khodja S. Indications and results of brachial plexus surgery in obstetrical palsy. Orthop Clin North Am 1988; 19:91–105.

    PubMed  CAS  Google Scholar 

  15. Gilbert A. Long-term evaluation of brachial plexus surgery in obstetrical palsy. Rand Clin 1995; 11:583–587.

    CAS  Google Scholar 

  16. Mallet J. Paralysie obstetricale. Rev Chirurgie Orthaped 1972; 58(suppl 1):115.

    Google Scholar 

  17. Evans-Jones G, Kay SPJ, Weindling AM, et al. Congenital brachial palsy: incidence, causes and outcome in the United Kingdom and Republic of Ireland. Arch Dis Fetal Neonatal 2003; 88 F185–F189.

    Article  CAS  Google Scholar 

  18. Bisinella G, Birch R. Obstetric brachial plexus lesion: A study of 74 children registered with the British Surveillance Unit. J Hand Surg Br 2002; 28B:1:40–45.

    Google Scholar 

  19. Giddins GEB, Birch R, Singh D, Taggart M. Risk factors for obstetric brachial plexus palsies. J Bone Joint Surg 1994; 76B:Supps. II and III 156.

    Google Scholar 

  20. Tavakkolizadeh A. Risk factors associated with obstetric brachial plexus palsy. Dissertation. University of Brighton for degree of M Sc. 2007.

    Google Scholar 

  21. Becker MHJ, Lassner F, Bahm J, et al. The cervical rib. A pre disposing factor for obstetric brachial plexus lesions. J Bone Joint Surg 2002; 84:740–743.

    Article  CAS  Google Scholar 

  22. Strömbeck C, Rehmal S, Krum Linde-Sundholm L, Sejersen T. (a) Long term functional follow up of a cohort of children with obstetric brachial plexus palsy: I; Functional aspects: Dev Med Child Neurol 2007; 49:198–203.

    Article  PubMed  Google Scholar 

  23. Strömbeck C, Rehmal S, Krum Linde-Sundholm L, Sejersen T. (b) Long term functional follow up of a cohort of children with obstetric brachial plexus palsy: II: Neurophysiological aspects. Dev Med Child Neurol 2007; 49:204–209.

    Article  PubMed  Google Scholar 

  24. Yang LJ, Anand P, Birch R. Limb preference in children with obstetric brachial plexus palsy. Paediatr Neurol 2005; 33:46–49.

    Article  Google Scholar 

  25. Bellew M, Kay SPJ, Webb F, Ward A. Developmental and behavioural outcome in obstetric brachial plexus palsy J Hand Surg 2000; 25B:49–51.

    Google Scholar 

  26. Fraher JP. The CNS PNS transitional zone. In: Dyke PJ, Thomas PK, eds. Peripheral Neuropathy, 4th ed. Philadelphia: Elsevier Saunders; 2005:67–91.

    Google Scholar 

  27. McManis PG, Low PA, Lagerlund TD. Nerve blood flow and microenvironment. In: Dyke PJ, Thomas PK, eds. Peripheral Neuropathy, 4th ed. Philadelphia: Elsevier Saunders; 2005:67:1.

    Google Scholar 

  28. Groves MJ, Scaravilli F. Pathology of peripheral neurone cell bodies. In: Dyke PJ, Thomas PK, eds. Peripheral Neuropathy, 4th ed. Philadelphia: Elsevier Saunders; 2005:683–732.

    Chapter  Google Scholar 

  29. Fullarton AC, Lenihan DV, Myles LM, Glasby MA. Obstetric brachial plexus palsy: a large animal for traction injury and its repair. Part 1: the age of the recipient. J Hand Surg 2000; 25B:52–57.

    Google Scholar 

  30. Fullarton AC, Myles LM, Lenihan DV, et al. Obstetric brachial plexus palsy: a comparison of the degree of recovery after repair of 16 ventral root avulsions in newborn and adult sheep. Brit J Plas Surg 2001; 54:697–704.

    Article  CAS  Google Scholar 

  31. Birch R, Ahad N, Kono H, Smith S. Repair of obstetric brachial plexus palsy. Results in 100 children. J Bone Jt Surg 2005; 87B:1089–1095.

    Google Scholar 

  32. Blaauw G, Slooff ACJ, Muhlig S. Results of surgery after breech delivery. In: Gilbert A, ed. Brachial Plexus Injuries. London: Martin Dunitz; 2001: 217–224.

    Google Scholar 

  33. Birch R, Bonney G, Wynnparry CB. Surgical Disorders of the Peripheral Nerves, 1st ed. Edinburgh: Churchill Livingstone; 1998.

    Google Scholar 

  34. Narakas AO. Obstetrical brachial plexus injuries. In: Lamb DW, ed. The Paralyzed Hand. Edinburgh: Churchill Livingstone; 1987:116.

    Google Scholar 

  35. Brunelli GA, Brunelli GR. A fourth type of brachial plexus lesion: the intermediate (C7) palsy. J Hand Surg 1991; 16B:492–494.

    Google Scholar 

  36. Smith SJM. The role of neurophysiological investigation in traumatic brachial plexus injuries in adults and children. J Hand Surg 1996; 21B:145–148.

    Google Scholar 

  37. Smith SJM. Electrodiagnosis. In: Birch R, Bonney G, Wynn Parry C. Surgical Disorders of the Peripheral Nerves. Edinburgh: Churchill Livingstone; 1998:467–490.

    Google Scholar 

  38. Bisinella G, Birch R, Smith SJM. Neurophysiological predictions of outcome in obstetric lesions of the brachial plexus J Hand Surg 2003; 28B:148–152.

    Google Scholar 

  39. Gilbert A, Tassin JL. Réparation chirurgicale de plexus brachial dans la paralysie obstétricale. Chirurgie (Paris) 1984; 110:70–75.

    Google Scholar 

  40. Nehme A, KANY J, Sales-De-Gauzy J, et al. Obstetrical brachial plexus palsy, predictions of outcome in upper root injuries. J Hand Surg 2001; 27B:9–12.

    Google Scholar 

  41. Clarke HM, Curtis C. Examination and prognosis. In: Gilbert A, ed. Brachial Plexus Injuries. London: Martin Dunitz; 2001:159–172.

    Google Scholar 

  42. MacNamara P, Yam A. The false tumour of the biceps—a birth injury. An analysis of 40 cases. Manuscript in preparation: data kindly released by Mr. MacNamara. 2008

    Google Scholar 

  43. Gilbert A. Indications et résultats de la chirurgie du plexus brachial dans la paralysie obstétricale. In: Alnot JY, Narakas A, eds. Les Paralysie du Plexus Brachiale. Monographies du groupe d’étude de la main. Paris: Expansion Scientifique Française; 1995.

    Google Scholar 

  44. Anand P, Birch R. Restoration of sensory function and lack of long-term chronic pain syndromes after brachial plexus injury in human neonates. Brain 2002; 125:113–122.

    Article  PubMed  CAS  Google Scholar 

  45. Iyer VG. Developmental maturation of the nervous system In: Gupta A, Kay SPJ, Scheker LR, eds. The Growing Hand. London: Mosby; 2000:47–52.

    Google Scholar 

  46. Erhard RP, Lindley SG. functional development of the hand. In: Gupta A, Kay SPJ, Scheker LR, eds. The Growing Hand. London: Mosby; 2000:71–82.

    Google Scholar 

  47. Fairbank HAT. Subluxation of shoulder joint in infants and young children. Lancet 1913; I:1217–1223.

    Google Scholar 

  48. Scaglietti O. the obstetrical shoulder trauma. Surg Gynae Obstet 1938; 66:868–877.

    Google Scholar 

  49. Putti V. Analisi della triada radiosintomatica degli stati di prelussazione. Chir Organi Mov 1932; XVII:453–459.

    Google Scholar 

  50. Waters PM, Smith GR, Jaramillo D. Gleno humeral deformity secondary to brachial plexus birth palsy. J Bone Jt Surg 1998; 80A:668–677.

    Google Scholar 

  51. Pearl ML, Edgerton BW. Glenoid deformity secondary to brachial plexus birth palsy. J Bone Jt Surg 1998; 80A:659–667.

    Google Scholar 

  52. Sluijs JA, Van Ouwerkerk WJR, De Gast A, et al. Retroversion of the humeral head in children with obstetric brachial plexus lesion. J Bone Jt Surg 2002; 84B 583–587.

    Article  Google Scholar 

  53. Sluisz JA, van Ouwerkerk WJR, de Gast A, et al. Deformities of the shoulder in infants younger than 12 months with an obstetric lesion of the brachial plexus. J Bone Jt Surg 2001; 83B:551–555.

    Google Scholar 

  54. Hoeksma AF, Steeg AMT, Dijkstra P, et al. Shoulder contracture and osseous deformity in obstetrical brachial plexus injuries. J Bone Jt Surg 2003; 85A:316–322.

    Google Scholar 

  55. Kambhampati SLS, Birch R, Cobiella C, Chen L. Posterior subluxation and dislocation of the shoulder in obstetric brachial plexus palsy. J Bone Jt Surg 2006; 88B:213–219.

    Google Scholar 

  56. Pearl ML, Edgerton BW, Kazimiroff PA, et al. Arthroscopic release and latissimus dorsi transfer for shoulder internal rotation contractures and glenohumeral deformity secondary to brachial plexus birth palsy. J Bone Jt Surg 2006; 88A:564–574.

    Article  Google Scholar 

  57. Nath RK, Paizi M. Improvement in abduction of the shoulder after reconstructive soft tissue procedures in obstetric brachial plexus palsy. J Bone Jt Surg 2007; 89B:620–626.

    Google Scholar 

  58. Seddon HJ. (a) Common causes of nerve injury. In: Seddon HJ, ed. Surgical Disorders of Peripheral Nerves, 2nd ed. Edinburgh: Churchill Livingstone; 1975:67–88.

    Google Scholar 

  59. Kato N, Birch R. Peripheral nerve palsies associated with closed fractures and dislocations. Injury 2006; 37:507–512.

    Article  PubMed  Google Scholar 

  60. Harkess JW. Acquired deformities of the upper extremity. In: Gupta A, Kay SPJ, Scheker LR, eds. The Growing Hand. London: Mosby; 2000:725–752.

    Google Scholar 

  61. Klenerman L. The evolution of the compartment syndrome since 1948 as recorded in the JBJS (B). J Bone Jt Surg 2007; 89B:1280–1282.

    Google Scholar 

  62. Barros D’Sa AAB, Harkin DW. Pathophysiology of acute vascular insufficiency. In: Barros d’Sa AAB, Chant ADB, eds. Emergency Vascular and Endovascular Surgical Practice, 2nd ed. London: Hodder, Arnold; 2005:19–27.

    Google Scholar 

  63. Wajcberg E, Thoppil N, Patel S, et al. Comprehensive assessment of post-ischemic vascular reactivity in Hispanic children and adults with and without diabetes mellitus. Paediatr Diabetes 2006; 7: 329–335.

    Article  Google Scholar 

  64. Burton AC, Yamada S. Relation between blood pressure and flow in human forearm. J. Applied Physiol 1951; 4:329–339.

    CAS  Google Scholar 

  65. Parkes AR. Ischemic effects of external and internal pressure on the upper limb. Hand 1973; 5:105–112.

    Article  PubMed  CAS  Google Scholar 

  66. Birch R, Bonney G. Pain. In: Birch R, Bonney G, Wynn Parry CB. Surgical Disorders of the Peripheral Nerves. London: Churchill Livingstone; 1998:373–404.

    Google Scholar 

  67. Oaklander AL, Rismiller JG, Gelman LB, et al. Evidence of focal small-fibre axonal degeneration in complex regional pain syndrome-1 (reflex sympathetic dystrophy). Pain 2006; 120:235–243.

    Article  PubMed  Google Scholar 

  68. Barnes R. Causalgia: a review of 48 cases. In: Seddon, HJ, ed. Peripheral Nerve Injuries by the Nerve Injuries Committee of the Medical Research Council. Medical Research Council Special Report series 282. London: HMSO; 1954:156–185.

    Google Scholar 

  69. Ramachandran M, Birch R, Eastwood D. Clinical outcome of nerve injuries associated with supracondylar fractures in of the humerus in children. J Bone Jt Surg 2006; 88B:90–94.

    Google Scholar 

  70. Birch R, Achan P. Peripheral Nerve Repairs and their Results in Children. Hand Clin 2000; 16:579–597.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Institut de la Main, Clinique Jouvenet, Paris, France

    Alain L. Gilbert

  2. Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Stanmore, UK

    Rolfe Birch

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  1. Alain L. Gilbert
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  2. Rolfe Birch
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Editor information

Editors and Affiliations

  1. Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, United Kingdom

    Michael Benson

  2. Sick Children, Great Ormond Street Hospital for, Greater Ormond Street, London, WC1N 3JH, United Kingdom

    John Fixsen

  3. Orthopaedic Hospital, Princess Margaret Rose, Frogston Road West 41-43, Edinburgh, EH10 7ED, United Kingdom

    Malcolm Macnicol

  4. Orthopädie, Olgahospital, Bismarckstr. 8, Stuttgart, 70176, Germany

    Klausdieter Parsch

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Gilbert, A.L., Birch, R. (2010). Brachial Plexus Injuries Peripheral Nerve Injuries. In: Benson, M., Fixsen, J., Macnicol, M., Parsch, K. (eds) Children's Orthopaedics and Fractures. Springer, London. https://doi.org/10.1007/978-1-84882-611-3_23

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  • DOI: https://doi.org/10.1007/978-1-84882-611-3_23

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