English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Tools annual

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Presents the access of premium content as premium feature

Premium Content

Global: Zendy Plus annual

Global: Zendy Free Plan

Background: For managing of upper brachial plexus palsy in adult patients, many strategies should be discussed with the patient. Primary plexus repair, nerve transfer, functional muscle transfer and other musculoskeletal approaches may be followed according the suitability, merits and disadvantages of each. Time factorsare very crucial for the sound management for these patients as time delay can result in a non-achievable chance loss with the neuromuscular end plates loss within two years following muscle denervation and progressive musculoskeletal changes as well. Patients and Methods: Between March 2013 and June 2015, six adult patients suffering from upper brachial plexus injuries were referred to Zagazig University Hospital and operated upon in two stages. In the first stage, two nerve transfers were performed in the same setting; neurotization of suprascapular nerve (using a branch of spinal root of the accessory nerve to the suprascapular nerve) and Oberlin nerve transfer (nerve fascicular transfer from the ulnar nerve to biceps branch of the musculocutaneous nerve to reinnervate the biceps muscle). After three to four months of the first stage, the patients were operated upon in the second stage for combined muscles transfers in the same setting i.e. trapezius transfer to the humerus and latissimus dorsi with teres major transfer to rotator calf of the shoulder. Results: By the end of the tenth month of the first stage, half of patients have regained M4 elbow flexion and the remaining patients have been M3. These improvements have been primarily noticed by the end of the third month postoperatively. The range of elbow flexion has been gradually improved to (100 to 120 degree against resistance) (mean 112 degree) with no noticeable deficit in the hand function as a donor site morbidity. The second stage was done 3 to 4 months from the first stage. Within 6 months of the second stage, shoulder abduction ranged from 80 to 120 degree (mean 98) with the mean of shoulder flexion 77 and externa rotation 47 degrees. Conclusion: Multimodal association between distal nerves transfer and combined transfer of trabezius, latissimus dorsi and teres major muscles provides an effective and relatively a short management scenario for upper brachial plexus injuries in adult patients.

egyptian journal of plastic and reconstructive surgery

A Short Scenario for Restoration of Reasonable Limb Function in Adults after Upper Brachial Plexus Injuries Using Neurotization and Combined Muscle Transfers