Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is a comprehensive review of our strategies for restoring function to the shoulder and elbow through nerve transfers. In particular, these transfers are discussed in reference to brachial plexus injuries with an […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation describes our approach to management of brachial plexus injuries. This includes a description of the nerve injury classification and the appropriate electrodiagnostic tools used for assessing these challenging cases. Additionally, case examples […]
The axillary nerve has several distal branches that provide shoulder function through the innervation of the anterior, middle, and posterior deltoid and teres minor, as well as sensation to the lateral arm. Injury to the axillary nerve has been traditionally viewed as either a complete non-favorable injury where recovery does not occur or a favorable […]
Injury to the axillary nerve results in the loss of shoulder function, specifically deltoid and teres minor deficits. This injury can either be isolated or more commonly associated with an upper brachial plexus injury that includes the C5,6 roots. The medial triceps is an available donor for nerve transfer into the axillary nerve and is […]
Loss of flexor pollicis longus and radial profundus function results in a deficit of pinch and reduced grip strength in the hand. This palsy can be isolated or commonly included in a lower brachial plexus injury. The brachialis nerve is an available, synergistic, and powerful donor for transfer in these scenarios, especially in C7,8,T1 injuries […]
Reconstructing shoulder function following a nerve injury is a challenge due to its dynamic movement originating from several muscles. The supra/infraspinatus muscles are critical for shoulder function in that they initiate abduction of the arm, external rotation, and stabilization of the shoulder joint. In upper brachial plexus injuries, it is common to find a deficit […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is part of the 2014 Comprehensive Review of Neurosurgery video lectures and the second part of the Brachial Plexus Lesion lecture. Specifically, this presentation discusses nerve transfers for the shoulder and elbow. […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is part of the 2014 Comprehensive Review of Neurosurgery video lectures and the first part of the Brachial Plexus Lesion lecture. Specifically, this presentation discusses the topic of treatment for brachial plexus […]
Compression of the posterior interosseous nerve can exhibit clinical weakness or functional loss of finger / thumb extension and lack of ulnar wrist extension. Provocative tests can confirm whether the radial tunnel in the region of the posterior interosseous nerve is the area of compression. Multiple anatomical structures can be involved in compressing the nerve […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation was given for the 2012 Comprehensive Review of Neurosurgery video lectures. Specifically, this presentation discusses the topic of treatment for brachial plexus injuries, which includes presentation of common injury patterns, management algorithms […]
The pectoral fascicle of the middle trunk is an available donor nerve to transfer to restore spinal accessory nerve function. This procedure involves identifying the brachial plexus and the accessory nerve through a supraclavicular exposure. The pectoral fascicle is identified on the anterior aspect of the middle trunk deep to the identified upper trunk. Typically, […]
Neurological thoracic outlet ‘inlet’ syndrome (TOS) involves compression of the brachial plexus through the thoracic inlet. The neurologic symptoms of TOS can range from mild paresthesias and numbness in the upper extremity to intrinsic hand muscle atrophy. Thoracic outlet decompression entails decompressing the upper, middle, and lower trunks by dividing the anterior and middle scalene […]
The medial triceps branch to axillary nerve transfer is an available option for reconstructing patients with shoulder deficits that include an axillary nerve injury. Not presented in this tutorial, the accessory to suprascapular nerve transfer is additionally performed to stabilize the humerus during its range-of-motion in these patients. The triceps to axillary nerve transfer specifically […]
Patients with long thoracic nerve injuries exhibit scapular winging and sever shoulder deficits that include the inability to forward flex the shoulder past 90 degrees of range of motion. Thoracodorsal to long thoracic nerve transfer utilizes a distal posterior branch of the thoracodorsal nerve to reinnervate the distal half of the long thoracic nerve. This […]
The double fascicular transfer (DFT) includes two nerve transfers: (1) median fascicle to biceps branch and (2) ulnar fascicle to brachialis branch. The median fascicle contains nerve fibers that innervate flexor digitorum superficialis / flexor carpi radialis. The ulnar fascicle contains nerve fibers that innervate flexor carpi ulnaris. The donor fascicles can be used for […]