2007
Direct repair (nerve grafting), neurotization, and end-to-side neurorrhaphy in the treatment of brachial plexus injury
HANINEC, Pavel; Filip ŠÁMAL; Robert TOMÁŠ; Ladislav HOUŠŤAVA; Petr DUBOVÝ et al.Základní údaje
Originální název
Direct repair (nerve grafting), neurotization, and end-to-side neurorrhaphy in the treatment of brachial plexus injury
Název česky
Přímá reparace poškozeného brachiálního plexu neurotizací a end-to-side anastomózou
Autoři
HANINEC, Pavel; Filip ŠÁMAL; Robert TOMÁŠ; Ladislav HOUŠŤAVA a Petr DUBOVÝ
Vydání
Journal of Neurosurgery, 2007, 0022-3085
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30000 3. Medical and Health Sciences
Stát vydavatele
Nizozemské království
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 1.990
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/07:00028062
Organizační jednotka
Lékařská fakulta
UT WoS
000244864700006
Klíčová slova anglicky
brachial plexus; end-to-side neurorrhaphy; neurotization; nerve graft; electromyography; peripheral nerve
Štítky
Změněno: 26. 6. 2009 11:24, prof. RNDr. Petr Dubový, CSc.
V originále
Object. The authors present the long-term results of nerve grafting and neurotization procedures in their group of patients with brachial plexus injuries and compare the results of "classic" methods of nerve repair with those of end-to-side neurorrhaphy. Methods. Between 1994 and 2006, direct repair (nerve grafting), neurotization, and end-to-side neurorrhaphy were performed in 168 patients, 95 of whom were followed up for at least 2 years after surgery. Successful results were achieved in 79% of cases after direct repair and in 56% of cases after end-to-end neurotization. The results of neurotization depended on the type of the donor nerve used. In patients who underwent neurotization of the axillary and the musculocutaneous nerves, the use of intraplexal nerves (motor branches of the brachial plexus) as donors of motor fibers was associated with a significantly higher success rate than the use of extraplexal nerves (81% compared with 49%, respectively, p = 0.003). Because of poor functional results of axillary nerve neurotization using extraplexal nerves (success rate 47.4%), the authors used end-to-side neurorrhaphy in 14 cases of incomplete avulsion. The success rate for end-to-side neurorrhaphy using the axillary nerve as a recipient was 64.3%, similar to that for neurotization using intraplexal nerves (68.4%) and better than that achieved using extraplexal nerves (47.4%, p = 0.19). Conclusions. End-to-side neurorrhaphy offers an advantage over classic neurotization in not requiring sacrifice of any of the surrounding nerves or the fascicles of the ulnar nerve. Typical synkinesis of muscle contraction innervated by the recipient nerve with contraction of muscles innervated by the donor was observed in patients after end-to-side neurorrhaphy.
Česky
Autoři prezentují dlouhodobé výsledky rekonstrukčních operací poškozeného brachiálního plexu metodou přímé neurotizace nebo end-to-side anastomózou. End-to-side anastomóza poskytuje nové možnosti při rekonstrukci brachiálního plexu.
Návaznosti
| MSM0021622404, záměr |
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| NF6658, projekt VaV |
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