Is it possible to follow the risk of rupture after end-to-end nerve repairs in brachial plexus surgery? Technical note.

IF 1.1 4区 医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2023-05-01 DOI:10.5152/j.aott.2023.22157
Servet Aydın Yücetürk
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Abstract

Objective: In traumatic and obstetric brachial plexus injuries, removal of the damaged nerve, repair with the nerve grafts, and nerve transfers are mostly preferred techniques. Success is directly proportional to surgical technique as it is known that end-to-end repair of the peripheral nerves gives better results. The greatest risk in end-to-end repair is the nerve rupture at the brachial plexus repair region and this cannot be detected by conventional radiological techniques.

Methods: Brachial plexus injuries of obstetrical and traumatic patients were operated. If possible and at least one nerve was repaired end to end, follow-up of nerve continuity was done by titanium hemopclip insertion to both sides of the nerve repair area. A new technique nerve repair site marking was developed and end-to-end nerve repair continuity was followed simply by x-ray.

Results: This technique was used for end-to-end nerve coaptions of 38 obstetric and 40 traumatic brachial plexus injuries. Follow-up was done for 6 weeks. Every week patients sent the x-ray of the repair site. Only 3 patients had nerve repair site rupture, and revision surgery was done immediately.

Conclusion: Nerve repair site marking technique and follow-up with only x-ray is a simple reliable, safe, and cheap method that can be applied to any end-to-end nerve repair. This technique has no morbidity or side effects. The aim of the study is to summarize or explain the nerve repair site marking technique used in the brachial plexus region.

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臂丛神经手术中端到端神经修复后是否有可能追踪破裂风险?技术说明。
目的:在创伤性和产科臂丛神经损伤中,切除受损神经、神经移植物修复和神经转移是首选的技术。成功与手术技术成正比,因为众所周知,外周神经的端到端修复效果更好。端到端修复的最大风险是臂丛神经修复区的神经断裂,而传统的放射学技术无法检测到这一点。方法:对产科及创伤患者的臂丛损伤进行手术治疗。如果可能,并且至少有一条神经被端到端修复,则通过在神经修复区域两侧插入钛血夹来进行神经连续性的随访。结果:该技术用于38例产科和40例创伤性臂丛神经损伤的端到端神经联合手术。随访6周。患者每周都会发送修复部位的x光片。只有3名患者出现神经修复部位断裂,并立即进行了翻修手术。结论:神经修复部位标记技术和仅x线随访是一种简单、可靠、安全、廉价的方法,可用于任何端到端的神经修复。该技术没有发病率或副作用。本研究的目的是总结或解释臂丛神经修复部位标记技术。
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来源期刊
CiteScore
2.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.
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