Functional outcome of spinal accessory nerve transfer to the suprascapular nerve to restore shoulder function: Results in upper and complete traumatic brachial plexus palsy in adults.
Brachial plexus palsy
brachial plexus surgery
nerve transfers
Journal
Neurology India
ISSN: 0028-3886
Titre abrégé: Neurol India
Pays: India
ID NLM: 0042005
Informations de publication
Date de publication:
Historique:
entrez:
29
1
2019
pubmed:
29
1
2019
medline:
18
12
2019
Statut:
ppublish
Résumé
Shoulder stability, abduction and external rotation are vital for the performance of usual daily tasks. To compare the functional outcomes in the shoulder following spinal accessory to suprascapular nerve transfer (SASNT). Comparison of the outcome of adult patients with upper traumatic brachial plexus palsy undergoing SASNT with patients with complete palsy submitted to the same procedure. Ranges of motion were compared via the Mann-Whitney U test. The percentages of patients with a favorable outcome were compared by the chi-square test. All tests were two-tailed and P values <0.05 were considered statistically significant. SASNT was performed in 76 patients: 23 cases (30.2%) of upper-plexus injuries and 53 cases (69.7%) of complete brachial plexus palsy. Good shoulder abduction was achieved in 15 patients (65.2%) with upper plexus palsy and a good external rotation in 5 (21.7%). In those patients with a good recovery, the average range of motion (ROM) was 53° for shoulder abduction and 71.2° for external rotation. Thirty-six patients (67.9%) with complete palsy had a good shoulder abduction recovery with 30.7° of average ROM, but only 3 patients (5.6%) recovered a good shoulder external rotation with 68.3° of average ROM. There was no statistical difference for the abduction outcome, but the external rotation outcome was superior in the upper plexus palsy group. SASNT is a consistent procedure to achieve functional recovery of shoulder abduction after a partial or complete plexus injury, but the outcomes of external rotation were quite disappointing in both the groups.
Sections du résumé
BACKGROUND
BACKGROUND
Shoulder stability, abduction and external rotation are vital for the performance of usual daily tasks.
AIMS
OBJECTIVE
To compare the functional outcomes in the shoulder following spinal accessory to suprascapular nerve transfer (SASNT).
PATIENTS AND METHODS
METHODS
Comparison of the outcome of adult patients with upper traumatic brachial plexus palsy undergoing SASNT with patients with complete palsy submitted to the same procedure.
STATISTICAL ANALYSIS
METHODS
Ranges of motion were compared via the Mann-Whitney U test. The percentages of patients with a favorable outcome were compared by the chi-square test. All tests were two-tailed and P values <0.05 were considered statistically significant.
RESULTS
RESULTS
SASNT was performed in 76 patients: 23 cases (30.2%) of upper-plexus injuries and 53 cases (69.7%) of complete brachial plexus palsy. Good shoulder abduction was achieved in 15 patients (65.2%) with upper plexus palsy and a good external rotation in 5 (21.7%). In those patients with a good recovery, the average range of motion (ROM) was 53° for shoulder abduction and 71.2° for external rotation. Thirty-six patients (67.9%) with complete palsy had a good shoulder abduction recovery with 30.7° of average ROM, but only 3 patients (5.6%) recovered a good shoulder external rotation with 68.3° of average ROM. There was no statistical difference for the abduction outcome, but the external rotation outcome was superior in the upper plexus palsy group.
CONCLUSION
CONCLUSIONS
SASNT is a consistent procedure to achieve functional recovery of shoulder abduction after a partial or complete plexus injury, but the outcomes of external rotation were quite disappointing in both the groups.
Identifiants
pubmed: 30688238
pii: ni_2019_67_7_77_250708
doi: 10.4103/0028-3886.250708
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S77-S81Déclaration de conflit d'intérêts
None