Scarring of the C8-T1 roots with partial avulsion in situ in total obstetric brachial plexus palsy.
作者信息
Al-Qattan Mohammad M, El-Sayed Amel A F
机构信息
Department of Surgery, King Saud University, P.O. Box 18097, Riyadh, 11415 Saudi Arabia.
Department of Obstetrics and Gynecology, King Saud University, Riyadh, Saudi Arabia.
出版信息
Eur J Plast Surg. 2017;40(5):465-470. doi: 10.1007/s00238-017-1281-3. Epub 2017 Feb 17.
BACKGROUND
Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach.
METHODS
A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots). Management of the injured upper roots was done by neurotization. Recovery was assessed as per our motor grading system.
RESULTS
After a minimum follow-up of 4 years, hand functional recovery was considered good in 7 patients and excellent in the remaining 7 patients.
CONCLUSIONS
We highlight the scarring of lower roots with evidence of partial avulsion-in situ in obstetric palsy. We also document that neurolysis is an acceptable approach to such lesions. Level of Evidence: Level IV, therapeutic study.
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