WHAT CAN BE PERFORMED FOR THE TREATMENT OF OLD, PERMANENT BRACHIAL PLEXUS PALSY?

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GOUSHEH JAMAL

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Journal: Iranian Journal of Surgery Year:2004 | Volume:12 | Issue:32 Page(s): 9-15

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Title

WHAT CAN BE PERFORMED FOR THE TREATMENT OF OLD, PERMANENT BRACHIAL PLEXUS PALSY?

Author(s)

GOUSHEH JAMAL | Issue Writer Certificate

Keywords

BRACHIAL PLEXUSQ4

OLD BRACHIAL PLEXUS PALSYQ4

CROSS C7 ROOTQ4

CROSS PECTORAL NERVE TRANSFERQ4

Abstract

Introduction & Objective: BRACHIAL PLEXUS palsy that does not recover within three months is operated on. If the palsy persists more than two years, and recovery dose not take place without reparative surgery, the nerves of the plexus territory will not recover, and the paralysis is considered permanent. This article is discussing what can be done with these cases.Materials and Methods: Since the nerves of the paralyzed side have completely lost their function, the nerves of the contralteral side must be used. The transfer of C7 root of the healthy side to the paralyzed region followed by transfer of a suitable muscle as a free flap has been suggested since 1994, and was performed for a while. It was found however that the severing, of the C7 root has some complications. We have performed the procedure in a few cases and have observed some complications as well.The best procedure for the treatment of the condition is the transfer of Medial Pectoral Nerve form the healthy to the paralyzed side by the use of Sural nerve which is followed by the transfer of gracilis muscle transfer to the arm, neurotized by the transferred Sural nerve, one year after the primary operation. Elbow flexion is achieved with the recovery of transferred gracilis muscle.After complete recovery of elbow flexion, the biceps tendon is transferred to the digits flexors by a tensor fascia lata. After the procedure elbow digits contraction is achieved by the contraction of the elbow.Results: This procedure has been performed for the fIrst time in Iran. This procedure been performed on 23 patients and digits flexion attained by the procedure has been satisfactory. The treated patient can carry a medium weigh bag.Conclusions: Functional Neuro-vascularization of the paralyzed limb is attained by the transfer of the healthy side pectoral nerve to the paralyzed side, followed by the transfer of gracilis muscle.

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APA: Copy

GOUSHEH, JAMAL. (2004). WHAT CAN BE PERFORMED FOR THE TREATMENT OF OLD, PERMANENT BRACHIAL PLEXUS PALSY?. IRANIAN JOURNAL OF SURGERY, 12(32), 9-15. SID. https://sid.ir/paper/113003/en

Vancouver: Copy

GOUSHEH JAMAL. WHAT CAN BE PERFORMED FOR THE TREATMENT OF OLD, PERMANENT BRACHIAL PLEXUS PALSY?. IRANIAN JOURNAL OF SURGERY[Internet]. 2004;12(32):9-15. Available from: https://sid.ir/paper/113003/en

IEEE: Copy

JAMAL GOUSHEH, “WHAT CAN BE PERFORMED FOR THE TREATMENT OF OLD, PERMANENT BRACHIAL PLEXUS PALSY?,” IRANIAN JOURNAL OF SURGERY, vol. 12, no. 32, pp. 9–15, 2004, [Online]. Available: https://sid.ir/paper/113003/en

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