Abstract
Traumatic brachial plexus injury (BPI) in patients with complete spinal cord injury (SCI) such as paraplegia or tetraplegia is a very rare and debilitating combined injury that can occur in high-energy traumas. Management of a BPI should be aimed at regaining strength for self-transfers and activities of daily living to restore independence. However, brachial plexus reconstruction (BPR) in this unique patient population requires considerable planning due to the combined elements of upper and lower motor neuron injuries. We present 2 cases of traumatic complete SCI with concomitant BPI with mean follow-up of 42 months after BPR. The first patient had a left C5-7 BPI with a T2 complete SCI. The second patient sustained a left C5-8 BPI with complete SCI at C8. The first patient underwent BPR including free functioning muscle, intra- and extraplexal nerve transfers, and tendon transfers resulting in active elbow flexion and active elbow, finger, and thumb extension, but no recovery of shoulder function. While the second patient underwent extra-plexal nerve transfer to restore elbow flexion yet did not recover any function in the left upper extreimty. Because extensive upper and lower motor neuron injuries are present in these combi...Continue Reading
References
Mar 1, 1986·Experimental Neurology·R L LieberE R Feringa
Jul 1, 1983·Injury·D J Grundy, J R Silver
Jan 1, 1982·The Journal of Bone and Joint Surgery. British Volume·L Sedel
Jul 1, 1995·Plastic and Reconstructive Surgery·D C ChuangF C Wei
Mar 1, 1994·The Journal of Hand Surgery·C OberlinJ J Sarcy
Jun 1, 1993·Journal of the Neurological Sciences·J M RoundD A Jones
Mar 1, 1993·The Journal of Hand Surgery·D C ChuangF C Wei
May 1, 1993·The Journal of Bone and Joint Surgery. British Volume·R Birch
May 1, 1997·The Journal of Trauma·P M Richardson
Jan 26, 2005·Hand Clinics·Allen T Bishop
Apr 29, 2006·The Journal of Bone and Joint Surgery. British Volume·S AkitaH Kawai
Sep 16, 2011·Surgical Neurology International·Justin M Brown
May 17, 2012·Journal of Neurosurgery·Susan E MackinnonWilson Z Ray
Sep 30, 2017·The Surgical Clinics of North America·Matthew J Eckert, Matthew J Martin