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Khirurgii

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Year 2011 Vol. 19 No 4

NEUROSURGERY

R.R. SIDOROVICH, A.F. SMEYANOVICH

AUTONEUROPLASTY METHOD IN TREATMENT OF BRACHIAL PLEXUS POSTTRAUMATIC DEFECTS

Objectives. The study of the effectiveness of autoneuroplasty operations of the brachial plexus (BP) structures with the use of advanced techniques depending on the level of the brachial plexus damage, the length of diastasis and timing of the injury.
Methods. Autoneuroplasty was carried out in 13 patients with the outcomes of the brachial plexus damage; according to a standard technique in 8 (61,5%) patients, according to an advanced technique in 5 (38,5%) patients. Following differentiated approach to the implementation of the method depending on the length of diastasis at certain levels of BP, on the localization of fasciculi of the separate nerves in the BP trunks, prevention of dehiscence at the level of anastomosis were the main differences of the advanced technique.
Results. Use of the advanced technique permitted to increase the results of autoneuroplasty from 22,8% up to100%. Autoneuroplasty efficacy was higher at diastasis from 2,3 to 7,0cm and didn,t depend on the level of the operative intervention. Autoneuroplasty surgeries are to be carried out more appropriately in terms up to 6 months after traumas.
Conclusions. Advanced autoneuroplasty of BP structures is an effective method of surgical treatment of outcomes of its traumatic injury with the disturbance of its integrity on the extension.

Keywords: brachial plexus, traumatic injury, operative treatment, autoneuroplasty of brachial plexus
p. 83 – 88 of the original issue
References
  1. Dubuisson, A. S. Brachial plexus injury: a survey of 100 consecutive cases from a single service / A. S. Dubuisson, D. O. Kline // Neurosurgery. – 2002. – Vol. 51. – P. 673-683.
  2. Nerve grafting in brachial plexus injuries / N. Ochiai [et al.] // J. Bone. J. Surg. – 1996. – Vol. 76B. – P. 754-758.
  3. Kline, D. G. Axillary nerve repair in 99 patients with 101 stretch injuries / D. G. Kline, D. H. Kim // J. Neurosurg. – 2003. – Vol. 99, N 4. – P. 630-636.
  4. Spinner, R. J. Surgery for peripheral nerve and brachial plexus injuries or other nerve lesions / R. J. Spinner, D. G. Kline // Muscle Nerve. – 2000. – Vol. 23. – Is. – P. 680-695.
  5. Дольницкий, О. В. Атлас микрохирургических операций на периферических нервах / О. В. Дольницкий, Ю. О. Дольницкий. – Киев, 1991. – 182 с.
  6. Infraclavicular brachial plexus stretch injury / D. H. Kim [et al.] // Neurosurg. Focus. – 2004. – Vol. 16, N 5. – P. 1-6.
  7. Mechanisms of injury in operative brachial plexus lesions / D. H. Kim [et al.] // Neurosurg. Focus. – 2004. – Vol. 16, N 5. – Art. – P. 1-8.
  8. Penetrating injuries due to gunshot wounds involving the brachial plexus / D. H. Kim [et al.] // Neurosurg. Focus. – 2004. – Vol. 16, N 5. – Art. 3.
  9. Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases / J. A. Kandenwein [et al.] // J. Neurosurg. – 2005. – Vol. 103, N 4. – P. 614-621.
  10. Chuang, D. C. Functional restoration of elbow flexion in brachial plexus injuries: results in 167 patients (excluding obstetric brachial plexus injury) / D. C. Chuang [et al.] // J. Hand Surg. Am. – 1993. – Vol. 18, N 2. – P. 285-291.
  11. Chuang, D. C. Nerve transfers in adult brachial plexus injuries: my methods / D. C. Chuang // Hand Clin. – 2005. – Vol. 21. – P. 71-81.
  12. Renner, A. Late results after nerve transplantation on the upper extremities / A. Renner, F. Cserkuti, J. Hankiss // Handchir. Mikrochir. Plast Chir. – 2004. – Vol. 36. – P. 13-18.
  13. Ricardo, M. Surgical treatment of brachial plexus injuries in adults / M. Ricardo // Int. Orthop. – 2005. – Vol. 29, N 6. – P. 351-354.
  14. Surgical reconstruction of the musculocutaneous nerve in traumatic brachial plexus injuries / M. Samii [et al.] // J. Neurosurg. – 1997. – Vol. 87, N 6. – P. 881-886.
  15. Хiрургiчне лiкування ушкоджень плечевого сплетення / В. I. Цимбалюк [и др.]. – Тернопiль: Укрмедкнига, 2001. – 212 с.
  16. Шевелев, И. Н. Травматические поражения плечевого сплетения (диагностика, микрохирургия) / И. Н. Шевелев. – М., 2005. – 384 с.
  17. Борода, Ю. И. Хирургия дефектов нервных стволов конечностей / Ю. И. Борода, В. П. Берснев // Материалы III съезда нейрохирургов России, 4–8 июня 2002 г. / Ю. И. Борода, В. П. Берснев; под ред. Б. В. Гайдара. – СПб., 2002. – С. 524-525.
  18. Злотник, Э. И. Некоторые вопросы аутотрансплантации при травме периферических нервов конечностей / Э. И. Злотник, Е. А. Короткевич // Вопр. нейрохирургии. – 1986. – № 1. – С. 52-58.
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