Abstract
The surgical repair strategy after a nerve injury consists of several stages, which will be explained in this chapter: exploration and visualization of the injury site with scar removal as well as morphological and electrophysiological evaluation, the actual restoration of nerve continuity (suture, graft interposition, nerve transfer) in a timely or late manner as well as “secondary” surgery on the target tissues (muscle, tendon and joint). The achievable functional results are also discussed.
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References
Bahm J, Becker M, Disselhorst-Klug C, Williams C, Meinecke L, Müller H, Sellhaus B, Schröder JM, Rau G. Surgical strategy in obstetric brachial plexus palsy: the Aachen experience. Semin Plast Surg. 2004;18:285–99.
Blaauw G, Muhlig RS, Vredeveld JW. Management of brachial plexus injuries. In: Advances and technical standards in neurosurgery, vol 33. Berlin, Heidelberg/New York: Springer; 2008. p. 201–31.
Bahm J. Die kindliche Armplexusparese-Übersicht zur Klinik, Pathophysiologie und chirurgischen Behandlungsstrategie. Handchir Mikrochir Plast Chir. 2003;35(2):83–97.
Kline DG, Hudson AR, Kim DH. Atlas of peripheral nerve surgery. Philadelphia: Saunders; 2001.
Millesi H. Neurolysis. In: Boome RS, editor. The brachial plexus. The hand and upper extremity, vol 14. Livingstone, New York: Churchill; 1997.
Bahm J, El Kazzi W, Schuind F. Nerve transfers. Rev Med Brux. 2011;32(6 Suppl):54–7.
Oberlin C, Ameur NE, Teboul F, Beaulieu JY, Vacher C. Restoration of elbow flexion in brachial plexus injury by transfer of ulnar nerve fascicles to the nerve to the biceps muscle. Tech Hand Up Extrem Surg. 2002;6:86–90.
Oberlin C, Durand S, Belheyar Z, Shafi M, David E, Asfazadourian H. Nerve transfers in brachial plexus palsies. Chir Main. 2008;25:S1297–302.
Leechavengvongs S, Witoonchart K, Uerpairojkit C, Thuvasethakul P. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps. Part II a report of 7 cases. J Hand Surg [Am]. 2003;28:633–8.
Leechavengvongs S, Witoonchart K, Uerpairojkit C, Thuvasethakul P, Malungpaishrope K. Combined nerve transfers for C5 and C6 brachial plexus avulsion injury. J Hand Surg [Am]. 2006;31:183–9.
Malessy MJ, de Ruiter GC, de Boer KS, Thomeer RT. Evaluation of suprascapular nerve neurotisation after nerve graft or transfer in the treatment of brachial plexus traction lesions. J Neurosurg. 2004;101:377–89.
Bahm J, Noaman H, Becker M. The dorsal approach to the suprascapular nerve. Plast Reconstr Surg. 2005;115:240–4.
Narakas AO. Neurotization in the treatment of brachial plexus injuries. In: Gelberman RH, editor. Operative nerve repair and reconstruction. Philadelphia: Lippincott; 1991. p. 1329–58.
Malessy MJ, Thomeer RT, van Dijk JG. Changing central nervous system control following intercostals nerve transfer. J Neurosurg. 1998;89:568–74.
Malungpaishrope K, Leechavengvongs S, Uerpairojkit C, Witoonchart K, Jitprapaikulsarn S, Chongthammakun S. Nerve transfer to deltoid muscle using the intercostal nerves through the posterior approach: an anatomic study and two case reports. J Hand Surg [Am]. 2007;32:218–24.
Liverneaux PA, Diaz LC, Beaulieu JY, Durand S, Oberlin C. Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies. Plast Reconstr Surg. 2006;117:915–9.
Pet MA, Ray WZ, Yee A, Mackinnon SE. Nerve transfer to the triceps after brachial plexus injury: report of four cases. J Hand Surg Am. 2011;36(3):398–405.
Mackinnon SE, Roque B, Tung TH. Median to radial nerve transfer for treatment of radial nerve palsy. Case report. J Neurosurg. 2007;107:666–71.
Bertelli JA, Ghizoni MF. Transfer of supinator motor branches to the posterior interosseous nerve in C7-T1 brachial plexus palsy. J Neurosurg. 2010;113:129–32.
Colbert SH, Mackinnon S. Posterior approach for double nerve transfer for restoration of shoulder function in upper brachial plexus palsy. Hand. 2006;1:71–7.
Bertelli JA, Santos MA, Kechele PR, Ghizoni MF, Duarte H. Triceps motor nerve branches as a donor or receiver in nerve transfers. Neurosurgery. 2007;61:333–8.
Palazzi S, Palazzi JL, Caceres JP. Neurotization with the brachialis muscle motor nerve. Microsurgery. 2006;26:330–3.
Uerpairojkit C, Leechavengvongs S, Witoonchart K, Malungpaishorpe K, Raksakulkiat R. Nerve transfer to serratus anterior muscle using the thoracodorsal nerve for winged scapula in C5 and C6 brachial plexus root avulsions. J Hand Surg [Am]. 2009;34:74–8.
Gu YD, Wu MM, Zhen YL, et al. Phrenic nerve transfer for treatment of brachial plexus root avulsion. Lausanne: Report at Brachial Plexus Symposium; 1989.
Gu YD, Zhang GM, Chen DS, et al. Cervical nerve root transfer from healthy side for treatment of brachial plexus root avulsion. Lausanne: Report at Brachial Plexus Symposium; 1989.
Siqueira MG, Martins RS. Phrenic nerve transfer in the restoration of elbow flexion in brachial plexus avulsion injuries: how effective and safe is it? Neurosurgery. 2009;65:A125–31.
Sinis N, Boettcher M, Werdin F, Kraus A, Schaller HE. Restoration of shoulder abduction function by direct muscular neurotization with the phrenic nerve fascicles and nerve grafts: a case report. Microsurgery. 2009;29:552–5.
Gu YD, Wu MM, Zhen YL, et al. Microsurgical treatment for root avulsion of the brachial plexus. Chin Med J. 1987;100:519–22.
Terzis JK, Kokkalis ZT. Selective contralateral c7 transfer in posttraumatic brachial plexus injuries: a report of 56 cases. Plast Reconstr Surg. 2009;123:927–38.
Becker MHJ, Ingianni G, Lassner F, Atkins D, Schröder JM. Intraoperative Schnellschnittdiagnostik bei der geburtstraumatischen Plexusläsion-Gegenüberstellung von Makroskopie, HE-Schnellschnitten und Semidünnschnitten mit Toluidinblau-Färbung. Handchir Mikrochir Plast Chir. 2003;35:112–6.
Gilbert A, Hentz VR, Tassin FL. Brachial plexus reconstruction in obstetric palsy: operative indications and postoperative results. In: Urbaniak JR, editor. Microsurgery for major limb reconstruction. St Louis: Mosby; 1987.
Gilbert A, Pivato G, Kheiralla T. Long-term results of primary repair of brachial plexus lesions in children. Microsurgery. 2006;26(4):334–42.
Maricq C, Jeunehomme M, Mouraux D, Rémy P, Brassinne E, Bahm J, Schuind F. Objective evaluation of elbow flexion strength and fatigability after nerve transfer in adult traumatic upper brachial plexus injuries. Hand Surg. 2014;19(3):335–41.
Malessy MJ, Thomeer RT. Evaluation of intercostals to musculocutaneous nerve transfer in reconstructive brachial plexus surgery. J Neurosurg. 1998;88:266–71.
Merrell GA, Barrie KA, Katz DL, Wolfe SW. Results of nerve transfer techniques for restoration of shoulder and elbow function in the context of a meta-analysis of the English literature. J Hand Surg [Am]. 2001;26:303–14.
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Bahm, J. (2021). Reconstruction of Traumatized Nerves. In: Bahm, J. (eds) Movement Disorders of the Upper Extremities in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-53622-0_15
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