Restoration of shoulder abduction function by direct muscular neurotization with the phrenic nerve fascicles and nerve grafts
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Restoration of shoulder abduction function by direct muscular neurotization with the phrenic nerve fascicles and nerve grafts : a case report. / Sinis, Nektarios; Boettcher, Michael; Werdin, Frank; Kraus, Armin; Schaller, Hans-Eberhard.
in: MICROSURG, Jahrgang 29, Nr. 7, 01.01.2009, S. 552-5.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Restoration of shoulder abduction function by direct muscular neurotization with the phrenic nerve fascicles and nerve grafts
T2 - a case report
AU - Sinis, Nektarios
AU - Boettcher, Michael
AU - Werdin, Frank
AU - Kraus, Armin
AU - Schaller, Hans-Eberhard
PY - 2009/1/1
Y1 - 2009/1/1
N2 - In this report, we describe the first case of using the partial phrenic nerve transfer and direct muscular implantation into the deltoid muscle for restoration of the shoulder function and stability. A patient suffering from the partial brachial plexus injury with absent axillary nerve underwent reconstructive surgery by an end-to-end nerve coaptation using two fascicles of the phrenic nerve and two autologous nerve grafts, and direct implantation of nerve grafts into the deltoid muscle. Eighteen months after the procedure, we found a functioning biceps with 90 degrees elbow flexion against gravity and 40 degrees shoulder abduction with satisfactory shoulder stability. Electrophysiology revealed reinnervation potentials in the deltoid and biceps muscle. This case demonstrates a satisfactory result after using transfer of the partial ipsilateral phrenic nerve in combination with muscular implantation to restore shoulder abduction and stability. We recommend the described techniques in cases without other reconstructive options. (c) 2009 Wiley-Liss, Inc. Microsurgery, 2009.
AB - In this report, we describe the first case of using the partial phrenic nerve transfer and direct muscular implantation into the deltoid muscle for restoration of the shoulder function and stability. A patient suffering from the partial brachial plexus injury with absent axillary nerve underwent reconstructive surgery by an end-to-end nerve coaptation using two fascicles of the phrenic nerve and two autologous nerve grafts, and direct implantation of nerve grafts into the deltoid muscle. Eighteen months after the procedure, we found a functioning biceps with 90 degrees elbow flexion against gravity and 40 degrees shoulder abduction with satisfactory shoulder stability. Electrophysiology revealed reinnervation potentials in the deltoid and biceps muscle. This case demonstrates a satisfactory result after using transfer of the partial ipsilateral phrenic nerve in combination with muscular implantation to restore shoulder abduction and stability. We recommend the described techniques in cases without other reconstructive options. (c) 2009 Wiley-Liss, Inc. Microsurgery, 2009.
KW - Adult
KW - Axilla
KW - Brachial Plexus
KW - Humans
KW - Male
KW - Muscle, Skeletal
KW - Muscular Atrophy
KW - Nerve Transfer
KW - Phrenic Nerve
KW - Recovery of Function
U2 - 10.1002/micr.20651
DO - 10.1002/micr.20651
M3 - SCORING: Journal article
C2 - 19418470
VL - 29
SP - 552
EP - 555
JO - MICROSURG
JF - MICROSURG
SN - 0738-1085
IS - 7
ER -