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Rattavuth Raksakulkiat - One of the best experts on this subject based on the ideXlab platform.
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Restoration of winged scapula in upper arm type brachial plexus injury: anatomic feasibility.
Journal of the Medical Association of Thailand Chotmaihet thangphaet, 2009Co-Authors: Rattavuth Raksakulkiat, Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishrope, Sukumal ChongthammakunAbstract:Background: The patients who have C5-C6 root avulsion in brachial plexus injury, suffered from loss of elbow flexion, shoulder abduction and winged scapula. The purpose of study is to provide anatomic feasibility of Thoracodorsal Nerve (medial and lateral branches) and long thoracic Nerve for restoration of the shoulder function caused by winged scapula. Material and Method: To study the length of Thoracodorsal Nerve and long thoracic Nerve from the apex of the posterior axillary line to the insertion of the latissimus dorsi muscle and the serratus anterior muscle respectively, 10 fresh cadavers were dissected. The distance between the Thoracodorsal Nerve and long thoracic Nerve, and the numbers of fascicles and axon were measured by histomorphometry. We transferred the lateral branch of the Thoracodorsal Nerve to the long thoracic Nerve in order to restore the serratus anterior muscle function. Results: The mean length of the Thoracodorsal Nerve from apex of posterior axillary line to bifurcation before separation to medial and lateral branches was 31.5 mm. The average length of the Thoracodorsal Nerve and long thoracic Nerve from bifurcation to the insertion of the latissimus dorsi muscle and the serratus anterior muscle were 10.3, 82.2, and 99.5 mm, respectively. The distance between the lateral branch of the Thoracodorsal Nerve and long thoracic Nerve was 33.4 mm. The mean number of myelinated Nerve fiber of the Thoracodorsal Nerve medial and lateral branches and long thoracic Nerve were 973.8, 1843.3 and 1135.3 axons, respectively. Conclusion: The anatomic study of the Thoracodorsal Nerve and long thoracic Nerve showed that the lateral branch of the Thoracodorsal Nerve is proper in the length and numbers of axon to transfer to the long thoracic Nerve for restoration of shoulder function caused by the winged scapula. Keywords: Brachial plexus injury, Nerve transfer, Long thoracic Nerve, Thoracodorsal Nerve, winged scapula
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Nerve transfer to serratus anterior muscle using the Thoracodorsal Nerve for winged scapula in c5 and c6 brachial plexus root avulsions
Journal of Hand Surgery (European Volume), 2009Co-Authors: Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishorpe, Rattavuth RaksakulkiatAbstract:Purpose To report the results of Nerve transfer to the serratus anterior muscle using the Thoracodorsal Nerve for winged scapula in C5 and C6 brachial plexus avulsion. Methods Five patients with a mean age of 27 years with loss of shoulder abduction due to upper brachial plexus injuries and with winged scapula had Nerve transfer using 1 branch (1 medial and 4 lateral) of the Thoracodorsal Nerve to the long thoracic Nerve. The spinal accessory Nerve and the Nerve to the long head of the triceps were used simultaneously for Nerve transfer to the suprascapular Nerve and the axillary Nerve, respectively. The follow-up period ranged from 24 to 33 months (mean, 28 months). Results All patients recovered serratus anterior muscle function. Two patients had no winged scapula, whereas 3 patients had mild winged scapula after the surgery at the last follow-up evaluation. The result was excellent for 2 patients, good for 2 patients, and fair for 1 patient. The mean arcs of motion of shoulder abduction and external rotation were 134° and 124°, respectively. No notable weakness of shoulder adduction was observed. Conclusions Use of the branch of the Thoracodorsal Nerve ensured adequate return function of the serratus anterior muscle by decreasing or correcting winged scapula in upper brachial plexus injury. We recommend Nerve transfer for winged scapula for achieving optimum shoulder function. Type of study/level of evidence Therapeutic IV.
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Restoration of winged scapula in upper arm type brachial plexus injury: anatomic feasibility.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009Co-Authors: Rattavuth Raksakulkiat, Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishrope, Sukumal ChongthammakunAbstract:The patients who have C5-C6 root avulsion in brachial plexus injury, suffered from loss of elbow flexion, shoulder abduction and winged scapula. The purpose of study is to provide anatomic feasibility of Thoracodorsal Nerve (medial and lateral branches) and long thoracic Nerve for restoration of the shoulder function caused by winged scapula. To study the length of Thoracodorsal Nerve and long thoracic Nerve from the apex of the posterior axillary line to the insertion of the latissimus dorsi muscle and the serratus anterior muscle respectively, 10 fresh cadavers were dissected. The distance between the Thoracodorsal Nerve and long thoracic Nerve, and the numbers of fascicles and axon were measured by histomorphometry. We transferred the lateral branch of the Thoracodorsal Nerve to the long thoracic Nerve in order to restore the serratus anterior muscle function. The mean length of the Thoracodorsal Nerve from apex of posterior axillary line to bifurcation before separation to medial and lateral branches was 31.5 mm. The average length of the Thoracodorsal Nerve and long thoracic Nerve from bifurcation to the insertion of the latissimus dorsi muscle and the serratus anterior muscle were 10.3, 82.2, and 99.5 mm, respectively. The distance between the lateral branch of the Thoracodorsal Nerve and long thoracic Nerve was 33.4 mm. The mean number of myelinated Nerve fiber of the Thoracodorsal Nerve medial and lateral branches and long thoracic Nerve were 973.8, 1843.3 and 1135.3 axons, respectively. The anatomic study of the Thoracodorsal Nerve and long thoracic Nerve showed that the lateral branch of the Thoracodorsal Nerve is proper in the length and numbers of axon to transfer to the long thoracic Nerve for restoration of shoulder function caused by the winged scapula.
Jayme Augusto Bertelli - One of the best experts on this subject based on the ideXlab platform.
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Thoracodorsal Nerve transfer for triceps reinnervation in partial brachial plexus injuries.
Microsurgery, 2015Co-Authors: Francisco Soldado, Marcos Flávio Ghizoni, Jayme Augusto BertelliAbstract:Purpose: To report the clinical outcomes of Thoracodorsal Nerve (TDN) transfers to the triceps motor branches for elbow extension resto-ration in patients with partial brachial plexus injuries (BPI). Methods: Eight male patients of mean age 23 years and suffering from a par-tial BPI underwent direct coaptation of the TDN to the Nerve of the upper medial and long heads of the triceps, an average 6 monthsafter their accident. Results: Seven patients achieved M4 elbow extension strength and one patient M3, according to the BMRC scale,after a mean follow-up of 21 months. Discussion: Direct TDN transfer might be a valid surgical procedure for the restoration of elbowextension in patients with partial BPI.
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Thoracodorsal Nerve transfer for elbow flexion reconstruction in infraclavicular brachial plexus injuries.
Journal of Hand Surgery (European Volume), 2014Co-Authors: Francisco Soldado, Marcos Flávio Ghizoni, Jayme Augusto BertelliAbstract:Purpose To report the clinical results of Thoracodorsal Nerve (TDN) transfer to the biceps Nerve for elbow flexion restoration in infraclavicular brachial plexus injuries. Methods Five male patients, mean age 33 years and affected with infraclavicular brachial plexus injuries, underwent a direct coaptation of the TDN to the Nerve to the biceps an average of 8 months after injury. The procedure included the transfer of a branch of the TDN to the musculocutaneous Nerve in 2 patients. Results All patients achieved M4 elbow flexion strength according to the British Medical Research Council scale at a mean follow-up of 22 months. Conclusions Direct TDN transfer seems to be a useful surgical procedure for restoring elbow flexion in patients with infraclavicular brachial plexus injuries. Type of study/level of evidence Therapeutic IV.
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transfer of axillary Nerve branches to reconstruct elbow extension in tetraplegics a laboratory investigation of surgical feasibility
Microsurgery, 2011Co-Authors: Jayme Augusto Bertelli, Marcos Flávio Ghizoni, M Cristiano Paulo D Tacca, Elisa Cristiana Winkelmann Duarte, Hamilton DuarteAbstract:In spinal cord injuries at the C6 level, elbow extension is lost and needs reconstruction. Traditionally, elbow extension has been reconstructed by muscle transfers, which improve function only moderately. We have hypothesized that outcomes could be ameliorated by Nerve transfers rather than muscle transfers. We anatomically investigated Nerve branches to the teres minor and posterior deltoid as donors for transfer to triceps motor branches. In eight formalin-fixed cadavers, the axillary Nerve, the teres minor branch, the posterior deltoid branch, the triceps long and upper medial head motor branches, and the Thoracodorsal Nerve were dissected bilaterally, their diameters measured and their myelinated fibers counted. To simulate surgery, using an axillary approach in two fresh cadavers, we transferred the teres minor or the posterior deltoid branch to the triceps long head and to the Thoracodorsal Nerve. The posterior division of the axillary Nerve gave off the teres minor motor branch and then the branch to the posterior deltoid, terminating as the superior lateral brachial cutaneous Nerve. The diameters of the teres minor motor branch, posterior deltoid, triceps long and upper medial head branches, and the Thoracodorsal Nerve all were 2 mm, with minimal variation. The Nerves varied little in their numbers of myelinated fibers, being consistently about 1,000. Via an axillary approach, either the teres minor or the posterior deltoid branch could be transferred directly to the Thoracodorsal Nerve or to triceps branches without any tension. V V C 2011 Wiley-Liss, Inc. Microsurgery 31:376–381, 2011. Fractures and dislocations of the cervical spine are commonly associated with damage to the spinal cord. Most frequently, injury occurs at the C6 level. This leaves the patient with preserved shoulder motion and elbow flexion. Elbow extension is absent or weak. Despite the preservation of wrist extension, grasping is poor because thumb and finger flexion/extension are paralyzed or extremely weak (group 2 in the International Classification of Muscle Function in Tetraplegia). 1 In the United States, over 100,000 people live with tetraplegia. 2 Tetraplegics struggle to gain independence, so an important goal of rehabilitation is to improve lost upper-limb function. 3 Tendon transfer procedures have been shown to restore basic upper-limb movements, improving abilities to groom, self-feed, self-catheterize, lift objects, write, swim, and drive. 4,5 The first priority in tetraplegic patients is reconstruction of elbow extension, which improves reaching capabilities and stabilizes the elbow, thereby allowing for further reconstruction of grasping. 1,6 An important goal,
Susan E Mackinnon - One of the best experts on this subject based on the ideXlab platform.
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Two-level motor Nerve transfer for the treatment of long thoracic Nerve palsy.
Journal of neurosurgery, 2011Co-Authors: Wilson Z. Ray, Mitchell A. Pet, Michael C. Nicoson, Andrew Yee, Lorna C. Kahn, Susan E MackinnonAbstract:The authors report a case of long thoracic Nerve (LTN) palsy treated with two-level motor Nerve transfers of a pectoral fascicle of the middle trunk, and a branch of the Thoracodorsal Nerve. This procedure resulted in near-total improvement of the winged scapula deformity, and a return of excellent shoulder function. A detailed account of the postoperative physical therapy regimen is included, as this critical component of the favorable result cannot be overlooked. This case establishes the two-level motor Nerve transfer as a new option for treating LTN palsy, and demonstrates that Nerve transfers should be considered in the therapeutic algorithm of an idiopathic mononeuritis.
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Nerve transfer to the triceps after brachial plexus injury: report of four cases.
The Journal of hand surgery, 2011Co-Authors: Mitchell A. Pet, Wilson Z. Ray, Andrew Yee, Susan E MackinnonAbstract:These case reports review the clinical outcomes of 4 patients who underwent Nerve transfer to a triceps motor branch of the radial Nerve. Mean follow-up was 26 ± 15 months. Two patients had a transfer using an ulnar Nerve fascicle to the flexor carpi ulnaris muscle, yielding a motor recovery of grade M5 elbow extension strength in one case and M4+ in the other. In 1 patient, a Thoracodorsal Nerve branch was used as the donor; this patient recovered M4 strength. One patient had a transfer using a radial Nerve fascicle to the extensor carpi radialis longus muscle and recovered M5 strength. These outcomes indicate that expendable fascicles of the ulnar, Thoracodorsal, and radial Nerves are viable donors in the surgical reconstruction of elbow extension.
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patient outcome following a Thoracodorsal to musculocutaneous Nerve transfer for reconstruction of elbow flexion
British Journal of Plastic Surgery, 2002Co-Authors: Christine B Novak, Susan E Mackinnon, Thomas H TungAbstract:This study reports patient outcome following a Thoracodorsal to musculocutaneous Nerve transfer. We retrospectively reviewed the charts of six patients who had undergone transfer of the Thoracodorsal Nerve to the musculocutaneous Nerve for reconstruction of elbow flexion. The mean age was 47 years (standard deviation: 24 years; range: 17-72 years). The mean time from injury to surgery was 3 months (standard deviation: 2 months; range: 1-5 months). In all cases, the biceps muscle was successfully reinnervated; in one case the Medical Research Council (MRC) muscle grade was grade 5, in four cases it was grade 4, and in one case it was grade 2. No patients complained of functional weakness with shoulder adduction and/or internal rotation. In the majority of cases, transfer of the Thoracodorsal Nerve to the musculocutaneous Nerve provides excellent recovery of elbow flexion.
Chairoj Uerpairojkit - One of the best experts on this subject based on the ideXlab platform.
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Restoration of winged scapula in upper arm type brachial plexus injury: anatomic feasibility.
Journal of the Medical Association of Thailand Chotmaihet thangphaet, 2009Co-Authors: Rattavuth Raksakulkiat, Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishrope, Sukumal ChongthammakunAbstract:Background: The patients who have C5-C6 root avulsion in brachial plexus injury, suffered from loss of elbow flexion, shoulder abduction and winged scapula. The purpose of study is to provide anatomic feasibility of Thoracodorsal Nerve (medial and lateral branches) and long thoracic Nerve for restoration of the shoulder function caused by winged scapula. Material and Method: To study the length of Thoracodorsal Nerve and long thoracic Nerve from the apex of the posterior axillary line to the insertion of the latissimus dorsi muscle and the serratus anterior muscle respectively, 10 fresh cadavers were dissected. The distance between the Thoracodorsal Nerve and long thoracic Nerve, and the numbers of fascicles and axon were measured by histomorphometry. We transferred the lateral branch of the Thoracodorsal Nerve to the long thoracic Nerve in order to restore the serratus anterior muscle function. Results: The mean length of the Thoracodorsal Nerve from apex of posterior axillary line to bifurcation before separation to medial and lateral branches was 31.5 mm. The average length of the Thoracodorsal Nerve and long thoracic Nerve from bifurcation to the insertion of the latissimus dorsi muscle and the serratus anterior muscle were 10.3, 82.2, and 99.5 mm, respectively. The distance between the lateral branch of the Thoracodorsal Nerve and long thoracic Nerve was 33.4 mm. The mean number of myelinated Nerve fiber of the Thoracodorsal Nerve medial and lateral branches and long thoracic Nerve were 973.8, 1843.3 and 1135.3 axons, respectively. Conclusion: The anatomic study of the Thoracodorsal Nerve and long thoracic Nerve showed that the lateral branch of the Thoracodorsal Nerve is proper in the length and numbers of axon to transfer to the long thoracic Nerve for restoration of shoulder function caused by the winged scapula. Keywords: Brachial plexus injury, Nerve transfer, Long thoracic Nerve, Thoracodorsal Nerve, winged scapula
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Nerve transfer to serratus anterior muscle using the Thoracodorsal Nerve for winged scapula in c5 and c6 brachial plexus root avulsions
Journal of Hand Surgery (European Volume), 2009Co-Authors: Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishorpe, Rattavuth RaksakulkiatAbstract:Purpose To report the results of Nerve transfer to the serratus anterior muscle using the Thoracodorsal Nerve for winged scapula in C5 and C6 brachial plexus avulsion. Methods Five patients with a mean age of 27 years with loss of shoulder abduction due to upper brachial plexus injuries and with winged scapula had Nerve transfer using 1 branch (1 medial and 4 lateral) of the Thoracodorsal Nerve to the long thoracic Nerve. The spinal accessory Nerve and the Nerve to the long head of the triceps were used simultaneously for Nerve transfer to the suprascapular Nerve and the axillary Nerve, respectively. The follow-up period ranged from 24 to 33 months (mean, 28 months). Results All patients recovered serratus anterior muscle function. Two patients had no winged scapula, whereas 3 patients had mild winged scapula after the surgery at the last follow-up evaluation. The result was excellent for 2 patients, good for 2 patients, and fair for 1 patient. The mean arcs of motion of shoulder abduction and external rotation were 134° and 124°, respectively. No notable weakness of shoulder adduction was observed. Conclusions Use of the branch of the Thoracodorsal Nerve ensured adequate return function of the serratus anterior muscle by decreasing or correcting winged scapula in upper brachial plexus injury. We recommend Nerve transfer for winged scapula for achieving optimum shoulder function. Type of study/level of evidence Therapeutic IV.
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Restoration of winged scapula in upper arm type brachial plexus injury: anatomic feasibility.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009Co-Authors: Rattavuth Raksakulkiat, Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishrope, Sukumal ChongthammakunAbstract:The patients who have C5-C6 root avulsion in brachial plexus injury, suffered from loss of elbow flexion, shoulder abduction and winged scapula. The purpose of study is to provide anatomic feasibility of Thoracodorsal Nerve (medial and lateral branches) and long thoracic Nerve for restoration of the shoulder function caused by winged scapula. To study the length of Thoracodorsal Nerve and long thoracic Nerve from the apex of the posterior axillary line to the insertion of the latissimus dorsi muscle and the serratus anterior muscle respectively, 10 fresh cadavers were dissected. The distance between the Thoracodorsal Nerve and long thoracic Nerve, and the numbers of fascicles and axon were measured by histomorphometry. We transferred the lateral branch of the Thoracodorsal Nerve to the long thoracic Nerve in order to restore the serratus anterior muscle function. The mean length of the Thoracodorsal Nerve from apex of posterior axillary line to bifurcation before separation to medial and lateral branches was 31.5 mm. The average length of the Thoracodorsal Nerve and long thoracic Nerve from bifurcation to the insertion of the latissimus dorsi muscle and the serratus anterior muscle were 10.3, 82.2, and 99.5 mm, respectively. The distance between the lateral branch of the Thoracodorsal Nerve and long thoracic Nerve was 33.4 mm. The mean number of myelinated Nerve fiber of the Thoracodorsal Nerve medial and lateral branches and long thoracic Nerve were 973.8, 1843.3 and 1135.3 axons, respectively. The anatomic study of the Thoracodorsal Nerve and long thoracic Nerve showed that the lateral branch of the Thoracodorsal Nerve is proper in the length and numbers of axon to transfer to the long thoracic Nerve for restoration of shoulder function caused by the winged scapula.
Somsak Leechavengvongs - One of the best experts on this subject based on the ideXlab platform.
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Restoration of winged scapula in upper arm type brachial plexus injury: anatomic feasibility.
Journal of the Medical Association of Thailand Chotmaihet thangphaet, 2009Co-Authors: Rattavuth Raksakulkiat, Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishrope, Sukumal ChongthammakunAbstract:Background: The patients who have C5-C6 root avulsion in brachial plexus injury, suffered from loss of elbow flexion, shoulder abduction and winged scapula. The purpose of study is to provide anatomic feasibility of Thoracodorsal Nerve (medial and lateral branches) and long thoracic Nerve for restoration of the shoulder function caused by winged scapula. Material and Method: To study the length of Thoracodorsal Nerve and long thoracic Nerve from the apex of the posterior axillary line to the insertion of the latissimus dorsi muscle and the serratus anterior muscle respectively, 10 fresh cadavers were dissected. The distance between the Thoracodorsal Nerve and long thoracic Nerve, and the numbers of fascicles and axon were measured by histomorphometry. We transferred the lateral branch of the Thoracodorsal Nerve to the long thoracic Nerve in order to restore the serratus anterior muscle function. Results: The mean length of the Thoracodorsal Nerve from apex of posterior axillary line to bifurcation before separation to medial and lateral branches was 31.5 mm. The average length of the Thoracodorsal Nerve and long thoracic Nerve from bifurcation to the insertion of the latissimus dorsi muscle and the serratus anterior muscle were 10.3, 82.2, and 99.5 mm, respectively. The distance between the lateral branch of the Thoracodorsal Nerve and long thoracic Nerve was 33.4 mm. The mean number of myelinated Nerve fiber of the Thoracodorsal Nerve medial and lateral branches and long thoracic Nerve were 973.8, 1843.3 and 1135.3 axons, respectively. Conclusion: The anatomic study of the Thoracodorsal Nerve and long thoracic Nerve showed that the lateral branch of the Thoracodorsal Nerve is proper in the length and numbers of axon to transfer to the long thoracic Nerve for restoration of shoulder function caused by the winged scapula. Keywords: Brachial plexus injury, Nerve transfer, Long thoracic Nerve, Thoracodorsal Nerve, winged scapula
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Nerve transfer to serratus anterior muscle using the Thoracodorsal Nerve for winged scapula in c5 and c6 brachial plexus root avulsions
Journal of Hand Surgery (European Volume), 2009Co-Authors: Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishorpe, Rattavuth RaksakulkiatAbstract:Purpose To report the results of Nerve transfer to the serratus anterior muscle using the Thoracodorsal Nerve for winged scapula in C5 and C6 brachial plexus avulsion. Methods Five patients with a mean age of 27 years with loss of shoulder abduction due to upper brachial plexus injuries and with winged scapula had Nerve transfer using 1 branch (1 medial and 4 lateral) of the Thoracodorsal Nerve to the long thoracic Nerve. The spinal accessory Nerve and the Nerve to the long head of the triceps were used simultaneously for Nerve transfer to the suprascapular Nerve and the axillary Nerve, respectively. The follow-up period ranged from 24 to 33 months (mean, 28 months). Results All patients recovered serratus anterior muscle function. Two patients had no winged scapula, whereas 3 patients had mild winged scapula after the surgery at the last follow-up evaluation. The result was excellent for 2 patients, good for 2 patients, and fair for 1 patient. The mean arcs of motion of shoulder abduction and external rotation were 134° and 124°, respectively. No notable weakness of shoulder adduction was observed. Conclusions Use of the branch of the Thoracodorsal Nerve ensured adequate return function of the serratus anterior muscle by decreasing or correcting winged scapula in upper brachial plexus injury. We recommend Nerve transfer for winged scapula for achieving optimum shoulder function. Type of study/level of evidence Therapeutic IV.
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Restoration of winged scapula in upper arm type brachial plexus injury: anatomic feasibility.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009Co-Authors: Rattavuth Raksakulkiat, Chairoj Uerpairojkit, Somsak Leechavengvongs, Kiat Witoonchart, Kanchai Malungpaishrope, Sukumal ChongthammakunAbstract:The patients who have C5-C6 root avulsion in brachial plexus injury, suffered from loss of elbow flexion, shoulder abduction and winged scapula. The purpose of study is to provide anatomic feasibility of Thoracodorsal Nerve (medial and lateral branches) and long thoracic Nerve for restoration of the shoulder function caused by winged scapula. To study the length of Thoracodorsal Nerve and long thoracic Nerve from the apex of the posterior axillary line to the insertion of the latissimus dorsi muscle and the serratus anterior muscle respectively, 10 fresh cadavers were dissected. The distance between the Thoracodorsal Nerve and long thoracic Nerve, and the numbers of fascicles and axon were measured by histomorphometry. We transferred the lateral branch of the Thoracodorsal Nerve to the long thoracic Nerve in order to restore the serratus anterior muscle function. The mean length of the Thoracodorsal Nerve from apex of posterior axillary line to bifurcation before separation to medial and lateral branches was 31.5 mm. The average length of the Thoracodorsal Nerve and long thoracic Nerve from bifurcation to the insertion of the latissimus dorsi muscle and the serratus anterior muscle were 10.3, 82.2, and 99.5 mm, respectively. The distance between the lateral branch of the Thoracodorsal Nerve and long thoracic Nerve was 33.4 mm. The mean number of myelinated Nerve fiber of the Thoracodorsal Nerve medial and lateral branches and long thoracic Nerve were 973.8, 1843.3 and 1135.3 axons, respectively. The anatomic study of the Thoracodorsal Nerve and long thoracic Nerve showed that the lateral branch of the Thoracodorsal Nerve is proper in the length and numbers of axon to transfer to the long thoracic Nerve for restoration of shoulder function caused by the winged scapula.