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Rekonstruktion isolierter Läsionen des N. axillaris: klinische und elektrophysiologische Langzeitresultate


Hug, U; Vital, D; Guggenheim, M; Jung, F J; Giovanoli, P (2011). Rekonstruktion isolierter Läsionen des N. axillaris: klinische und elektrophysiologische Langzeitresultate. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 43(6):351-355.

Abstract

PURPOSE:

The purpose of this retrospective study was the clinical and electrophysiological assessment of long-term results following surgical treatment of isolated axillary nerve lesions.
PATIENTS AND METHOD:

10 patients, who underwent axillary nerve reconstruction using a nerve graft (80%) or a neurolysis alone (20%), with a follow-up period of 6.7 years (1.6-10.8 years) on average, were included in the study. In addition to the clinical examination, we examined reinnervation by electrophysiological methods and analysed their correlation to clinical results.
RESULTS:

30% of the patients had muscle strength of M5 and full active range of motion of 180°, 40% reached M4 and averaged 170° (80-180°), 30% of the patients M3 and 65° (40-90°). In patients with M5, muscle compound action potential averaged 40% of the contralateral side (21-62%), in patients with M4 36% (29-58%), and in patients with M3 7% (3-11%). Good results were associated with younger patient age, a short delay prior to the operation and neurolysis alone (indicated by intraoperative electroneurography).
CONCLUSION:

The good results confirm our treatment algorithm for isolated axillary nerve lesions by neurolysis alone or reconstruction with autologous nerve transplantation. Measurement of compound muscle action potential is a valuable addition to difficult clinical assessment, as its amplitude enables quantification of axillary nerve recovery.

© Georg Thieme Verlag KG Stuttgart · New York.

Abstract

PURPOSE:

The purpose of this retrospective study was the clinical and electrophysiological assessment of long-term results following surgical treatment of isolated axillary nerve lesions.
PATIENTS AND METHOD:

10 patients, who underwent axillary nerve reconstruction using a nerve graft (80%) or a neurolysis alone (20%), with a follow-up period of 6.7 years (1.6-10.8 years) on average, were included in the study. In addition to the clinical examination, we examined reinnervation by electrophysiological methods and analysed their correlation to clinical results.
RESULTS:

30% of the patients had muscle strength of M5 and full active range of motion of 180°, 40% reached M4 and averaged 170° (80-180°), 30% of the patients M3 and 65° (40-90°). In patients with M5, muscle compound action potential averaged 40% of the contralateral side (21-62%), in patients with M4 36% (29-58%), and in patients with M3 7% (3-11%). Good results were associated with younger patient age, a short delay prior to the operation and neurolysis alone (indicated by intraoperative electroneurography).
CONCLUSION:

The good results confirm our treatment algorithm for isolated axillary nerve lesions by neurolysis alone or reconstruction with autologous nerve transplantation. Measurement of compound muscle action potential is a valuable addition to difficult clinical assessment, as its amplitude enables quantification of axillary nerve recovery.

© Georg Thieme Verlag KG Stuttgart · New York.

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Additional indexing

Other titles:Reconstruction of isolated axillary nerve lesions: clinical and electrophysiological long-term results
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
04 Faculty of Medicine > University Hospital Zurich > Clinic for Reconstructive Surgery
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:2011
Deposited On:28 Feb 2012 16:34
Last Modified:07 Dec 2017 12:54
Publisher:Thieme
ISSN:0722-1819
Publisher DOI:https://doi.org/10.1055/s-0031-1279701
PubMed ID:21674443

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