Operative Brachial Plexus Surgery: Clinical Evaluation and Management Strategies

ISBN-13: 9783030695163 / Angielski / Twarda / 2021 / 644 str.

Alexander Y. Shin; Nicholas Pulos

Spis treści

Adult Brachial Plexus Injuries: A Historical Perspective

Part 1 SURGICAL ANATOMY

Surgical Anatomy of the Brachial Plexus

Mechanisms of Injury 

Biology of Nerve Injury

Epidemiology of Adult Traumatic Brachial Plexus Injuries 

Associated Concomitant Injuries

EVALUATION

Examination of the Adult Brachial Plexus Patient

Neurodiagnostic Evalution:  EMG and NCS

Neurodiagnostic Evalution:  Intraoperative Monitoring

Adult Brachial Plexus Injuries: Evaluation—Radiologic Evaluation

ADULT BRACHIAL PLEXUS INJURIES: DETERMINANTS OF TREATMENT (TIMING, INJURY TYPE, INJURY PATTERN)

Priorities of Treatment and Rationale in Adult BPI

TREATMENT OPTIONS IN ADULTS

Root Grafting in Adult Brachial Plexus Injuries

Nerve Transfers to Shoulder and Elbow

Free-Functioning Muscle Transfer

Tendon Transfers of the Shoulder, Elbow, Wrist and Hand

Glenohumeral arthrodesis in brachial plexus palsy

Reconstructive Options for the Thumb Axis in a Brachial Plexus Injury

Wrist arthrodesis in the adult brachial plexus patient

SURGICAL APPROACHES

Supraclavicular Exposure of the Brachial Plexus

Infraclavicular Exposure of the Brachial Plexus

Posterior Approach for Spinal Accessory to Suprascapular Nerve

Surgical Approach: Axillary Posterior

Anterior Approach for Axillary Nerve Reconstruction

Upper brachium approach: the “Ulnar-Biceps Median-Brachialis” double nerve transfer

Intercostal nerve harvest in brachial plexus injuries

Sural Nerve Harvest

Contralateral C7 nerve transfer in the Treatment of Adult Brachial plexus Injuries and Spastic Hemiplegia

The harvest of a free innervated functional gracilis muscle and its use in brachial plexus injuries

MANAGEMENT OF SPECIFIC INJURY PATTERNS

Management of C5-6 Injuries

Management of C5-7 Injuries

Strategies for Pan Brachial Plexus Reconstruction:  The Mayo Clinic Brachial Plexus Team Approach

Lower type injuries of the brachial plexus (C6-T1, C7-T1 and C8-T1 root involvement)

RESTORATION OF HAND FUNCTION IN PAN PLEXUS INJURY

Restoration of Hand Function in Pan Plexus Injury - Double Free Functioning Muscle Transfer

Restoration of hand function in total brachial plexus avulsion injury 

Intercostal nerve transfer for sensory reconstruction of the hand following complete avulsion of the brachial plexus

Management of Neuropathic Pain

Role of Amputation and Prosthetic Fitting

The Role of Therapy: Pre and Post-Surgery Protocols

PEDIATRIC BRACHIAL PLEXUS INJURY

Historical Perspectives

Mechanism of Injury

The Biology of Brachial Plexus Birth Injuries

Epidemiology of Obstetrical Brachial Plexus Injuries

Associated Concomitant Injuries

Clinical Examination of the Child with Brachial Plexus Birth Injury

Operative Brachial Plexus Surgery: Brachial Plexus Birth Injury - Neurodiagnostic Evaluation

Pediatric Brachial Plexus Injuries: Evaluation—Radiologic Evaluation

Priorities of Treatment and Rationale (Babies Are Not Small Adults)

Treatment Options in Babies

Surgical Approaches

Management of Specific Patterns of Injury-Erbs and Extended Erbs Palsy

Management of Specific Patterns of Injury-Pan Plexus 

Expected Outcomes

Late Complications and Treatment

O autorze

Alexander Y. Shin, MD, Professor of Orthopedic Surgery and Neurosurgery, Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, MN, USA

Nicholas Pulos, MD, Assistant Professor of Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, MN, USA

Blurb

Fully illustrated and enhanced with accompanying video clips, this comprehensive text presents the clinical evaluation and management of brachial plexus injuries and reconstruction, both for adult patients and birth injuries. Divided into two main sections, part one covers adult brachial plexus injuries, discussing the relevant anatomy and biology, epidemiology, and associated injuries. The main focus, however, is on diagnosis – the clinical exam as well as neurodiagnostic and radiographic evaluation – and surgical management approaches and techniques, including nerve grafting and transfers, tendon and muscle transfers, and joint fusion. Related topics are presented in chapters on sensory reinnervation, neuropathic pain management, the role of amputation and prosthetics, and pre- and post-surgical therapy protocols. Brachial plexus birth injury is described in part two, also focusing mainly on diagnosis and management but with an emphasis on the fact that babies are not small adults and special considerations are warranted. This section concludes with chapters on the management of late complications and long-term sequelae.

A comprehensive surgical text on brachial plexus injuries has not been previously attempted. Filling a large gap in the literature, Operative Brachial Plexus Surgery is the go-to resource for adult and birth related brachial plexus reconstruction for orthopedic surgeons, neurosurgeons, plastics surgeons, and their trainees.