Original article <br>
Neurolysis of the conducting neuroma-in-continuity  in perinatal brachial plexus palsy – evaluation of the results  of surgical treatment

Jerzy Gosk; Roman Rutowski; Maciej Urban; Roman Wiącek; Piotr Mazurek; Witold Wnukiewicz

eISSN: 1509-572x
ISSN: 1641-4640

Folia Neuropathologica

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3/2011
vol. 49

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abstract:

Original article
Neurolysis of the conducting neuroma-in-continuity in perinatal brachial plexus palsy – evaluation of the results of surgical treatment

Jerzy Gosk

,

Roman Rutowski

,

Maciej Urban

,

Roman Wiącek

,

Piotr Mazurek

,

Witold Wnukiewicz

Folia Neuropathol 2011; 49 (3): 197-203

Online publish date: 2011/09/30

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The aim of the study was to evaluate the surgical treatment results of cases of perinatal brachial plexus palsy with presence of neuroma-in-continuity. Clinical material included 21 children, aged from 3.5 to 36 months, treated surgically between 1996 and 2005. The control examination included 19 children. The shortest postoperative observation period was 4 years. After surgical treatment during clinical evaluation of function dependent on localization of neuroma-in-continuity we observed the following: in upper injury in 1 child good shoulder and elbow function; in upper-middle injuries with neuroma-in-continuity in upper trunk good elbow function in 66.6%, good shoulder function in 83.3% of cases; in upper-middle injuries with neuroma-in-continuity in upper and middle trunk in 1 examined child good function of elbow, shoulder, and wrist; in total injuries with neuroma-in-continuity in upper trunk good elbow function in 75%, and good shoulder function in 50% of cases; in total injuries with neuroma-in-continuity in upper and middle trunk good elbow function in 66.6%, good shoulder function in 33.3%, good wrist function in 66.6% of cases; in total injuries with neuroma-in-continuity in lower trunk grade 2 of motor hand function and return of sensibility to a level of S3+. Conclusions: The choice of microsurgical technique during surgical treatment of perinatal brachial plexus palsies with neuroma-in-continuity should be based on the whole clinical and intraoperative view. The best results after neurolysis should be expected when neuroma-in-continuity is localized in the upper trunk, the injury corresponds to third degree on Sunderland’s scale, and during electric stimulation a normal motor response can be obtained.

keywords:

Original article Neurolysis of the conducting neuroma-in-continuity in perinatal brachial plexus palsy – evaluation of the results of surgical treatment

Jerzy Gosk , Roman Rutowski , Maciej Urban , Roman Wiącek , Piotr Mazurek , Witold Wnukiewicz

neuroma-in-continuity, neurolysis, traction, obstetrical brachial plexus injuries

Original article
Neurolysis of the conducting neuroma-in-continuity in perinatal brachial plexus palsy – evaluation of the results of surgical treatment

Jerzy Gosk

,

Roman Rutowski

,

Maciej Urban

,

Roman Wiącek

,

Piotr Mazurek

,

Witold Wnukiewicz