Brachial Plexus Injuries Edited by
Alain Gilbert
MD
Institut de la Main Paris, France Published in association with the Federation of European Societies for Surgery of the Hand
MARTIN j DUNITZ
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CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2001 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20130325 International Standard Book Number-13: 978-0-203-21640-8 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the drug companies’ printed instructions, and their websites, before administering any of the drugs recommended in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright. com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-forprofit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com
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CONTENTS
List of contributors I
v
8
Complete palsy Chantal Bonnard and Dimitri J Anastakis 67
9
Update on the treatment of adult brachial plexus injuries Hanno Millesi 77
THE BRACHIAL PLEXUS 1
Anatomy of the brachial plexus Alexandre Muset i Lara, Carlos Dolz, and Alfonso Rodríguez-Baeza 3
2
Physical examination Türker Özkan and Atakan Aydın
3
4
II 5
6
7
17
Radiological and related investigations Albert (Bart) CJ Slooff, Corneleus (Cees) WM Versteege, Gerhard Blaauw, and Willem JR van Ouwerkerk 31 Clinical neurophysiological investigations Jan W Vredeveld 39
THE ADULT TRAUMATIC BRACHIAL PLEXUS Etiology Panupan Songcharoen
47
Surgical techniques: neurolysis, sutures, grafts, neurotizations Michel Merle and Aymeric Lim 51 Supraclavicular plexus injuries Jean Y Alnot 57
10
Injuries of the terminal branches of the brachial plexus Rolfe Birch 91
11
The place of arthrodesis Giorgio A Brunelli 107
12
Palliative surgery: tendon transfers to the shoulder in adults Aydın Yücetürk 115
13
Palliative surgery: the elbow and forearm Alfred C Berger, Robert Hierner, and Lutz Kleinschmidt 123
14
Palliative surgery: the hand Jamal Gousheh 131
15
Palliative surgery: free muscle transfers Kazuteru Doi 137
III
OBSTETRICAL PARALYSIS
16
Aetiology JM Hans Ubachs and Albert (Bart) CJ Slooff
151
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iv
CONTENTS
17
Examination and prognosis Howard M Clarke and Christine G Curtis 159
25
Medial rotation contracture and posterior dislocation of the shoulder Rolfe Birch 249
18
Conservative treatment of obstetrical brachial plexus palsy (OBPP) and rehabilitation Robert S Muhlig, Gerhard Blaauw, Albert (Bart) CJ Slooff, Jan W Kortleve, and Alfons J Tonino 173
26
Palliative surgery: elbow paralysis Vincent R Hentz 261
27
Palliative surgery: pronosupination in obstetrical palsy Eduardo A Zancolli (II) 275
19
Surgical technique Jose L Borrero 189
28
Palliative surgery: forearm and hand deformities David C-C Chuang 293
20
Indications and strategy Alain Gilbert 205
29
Treatment of co-contraction Robert Hierner and Alfred C Berger
21
Results of repair to the obstetrical plexus Alain Gilbert 211
22
Results of surgery after breech delivery Gerhard Blaauw, Albert (Bart) CJ Slooff, and Robert S Muhlig 217
23
24
Palliative surgery: shoulder paralysis Piero L Raimondi, Alexandre Muset i Lara, and Elisabetta Saporiti 225 Palliative surgery: tendon transfers to the shoulder in children Aydın Yücetürk 239
IV
SPECIAL LESIONS
30
Traumatic brachial plexus injuries in children Alain Gilbert and Christian Dumontier
31
War Injuries Jamal Gousheh Index
326
321
303
315
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LIST OF CONTRIBUTORS
Jean Y Alnot Service de Chirurgie Orthopédique et Traumatologique Département de Chirurgie de la Main et des Nerfs Périphériques Centre Urgences Mains Hôpital Bichat-Claude Bernard 46, rue Henri Huchard Paris 75877 Cedex 18 France Dimitri J Anastakis Minimally Invasive Surgery Program Surgical Services Toronto Western Hospital 399 Bathurst Street Fell Pavillion 4-140 Toronto, ON M5T 2S8 Canada Atakan Aydın Division of Hand Surgery Plastic and Reconstructive Department Istanbul Medical Faculty Istanbul University Istanbul Turkey Alfred C Berger International Institute for Neuroscience Alexis-Carrel-Strasse 4 Hannover 30625 Germany Rolfe Birch Royal National Orthopaedic Hospital PNI Unit Brockley Hill Stanmore, Middlesex UK
Gerhard Blaauw Department of Neurosurgery University Hospital Maastricht PO Box 5800 6202 AZ Maastricht The Netherlands Chantal Bonnard Service Universitaire de Chirurgie Plastique et Reconstructive Permanence de Longeraie Avenue de la Gare 9 CH-1003 Lausanne Switzerland Jose L Borrero Florida Hand Center 610 Jasmine Road Altamonte Springs, FL 32701 USA Giorgio A Brunelli Via Galvani 26 25123 Brescia Italy David C-C Chuang Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital 199 Tung Hwa North Road Taipei, Taiwan 105 Howard M Clarke Division of Plastic Surgery Department of Surgery University of Toronto The Hospital for Sick Children 555 University Avenue, Suite 1524 Toronto, ON M5G 1X8 Canada
vi
LIST OF CONTRIBUTORS
Christine G Curtis Department of Rehabilitation Medicine University of Toronto The Hospital for Sick Children 555 University Avenue, Suite 1524 Toronto, ON M5G 1X8 Canada
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Kazuteru Doi Department of Orthopaedic Surgery Ogori Daaichi General Hospital Ogori Yamaguchi-ken 754-0002 Japan Carlos Dolz Servicio de Cirugia Ortopedica y Traumatologia Hospital de Viladecans Barcelona Spain Christian Dumontier Institut de la Main Clinique Jouvenet 6, Place Jouvenet Paris 75016 France Alain Gilbert Institut de la Main Clinique Jouvenet 6, Place Jouvenet Paris 75016 France Jamal Gousheh Department of Reconstructive and Microsurgery Shahid Behesti University of Medical Sciences 38 Keshavarz Boulevard Tehran 14167 Iran Vincent R Hentz 900 Welch Road Suite 15 Palo Alto, CA 94304 USA
Robert Hierner Clinic for Plastic, Hand and Reconstructive Surgery Burn Center Hannover Medical University School of Medicine Podbielskistrasse 380 30569 Hannover Germany Lutz Kleinschmidt Clinic for Plastic, Hand and Reconstructive Surgery Burn Center Hannover Medical University School of Medicine Podbielskistrasse 380 30569 Hannover Germany Jan W Kortleve Plastic Surgery Department Atrium Medical Center 6401 CX Heerlen The Netherlands Aymeric Lim Hand and Reconstructive Microsurgery National University Hospital 5 Lower Kent Ridge Road Main Building, Level 3 Singapore 119074 Michel Merle Institut Européen de la Main 13, rue Blaise Pascal F-54320 Maxéville-Nancy France Hanno Millesi University of Vienna Medical School Ludwig-Boltzmann Institute of Experimental Plastic Surgery Lange Gasse 48 A-1090 Vienna Austria Robert S Muhlig Department of Rehabilitation Atrium Medical Center 6401 CX Heerlen The Netherlands
LIST OF CONTRIBUTORS
Alexandre Muset i Lara Orthopaedic Surgery Department Viladecans Hospital 08840 Barcelona
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Türker Özkan Division of Hand Surgery Plastic and Reconstructive Department Istanbul Medical Faculty Istanbul University Istanbul Turkey Piero L Raimondi Plastic and Hand Surgery Department Legnano Hospital 20025 Legnano Milan Italy Alfonso Rodríguez-Baeza Unidad de Anatomia y Embriologia Departamento de Ciencias Morfologicas Facultad de Medicina Universidad Autonoma de Barcelona Barcelona Spain Elisabetta Saporiti Plastic and Hand Surgery Department Legnano Hospital 20025 Legnano Milan Italy Albert (Bart) CJ Slooff Department of Neurosurgery University Hospital Maastricht PO Box 5800 6202 AZ Maastricht, Department of Neurosurgery Free University PO Box 7057 1007 MB Amsterdam The Netherlands, (contact address:) Rozenlaan 20 3620 Lanaken Belgium
Panupan Songcharoen Hand and Microsurgery Unit Department of Orthopaedic Surgery Faculty of Medicine Siriraj Hospital Mahidol University Bangkok 10700 Thailand Alfons J Tonino Orthopaedic Surgery Department Atrium Medical Center 6401 CX Heerlen The Netherlands JM Hans Ubachs Pijnsweg 33 6419 CJ Heerlen The Netherlands Willem JR van Ouwerkerk Department of Neurosurgery Free University Amsterdam The Netherlands Corneleus (Cees) WM Versteege Department of Radiology Atrium Medical Center 6401 CX Heerlen The Netherlands Jan W Vredeveld Department of Clinical Neurophysiology Atrium Medical Center Postbox 4446 6401 CX Heerlen The Netherlands Aydın Yücetürk Clinic Plexus Tahran Cad. 3/3 Kavaklıdere 06700 Ankara Turkey Eduardo A Zancolli (II) Avenida Alvear 1535 1014 Buenos Aires Argentina
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