Restorative surgery with invasive nerve stimulation in brachial plexus injuries

Authors

  • Yuriy Zozulya Restorative Neurosurgery Department, Romodanov Neurosurgery Institute, Kiev, Ukraine https://orcid.org/0000-0002-0573-2740
  • Ihor Tretyak Restorative Neurosurgery Department, Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Yulia Tsymbalyuk Restorative Neurosurgery Department, Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Nikolay Sapon Romodanov Neurosurgery Institute, Kiev, Ukraine https://orcid.org/0000-0001-8775-9033

DOI:

https://doi.org/10.25305/unj.51852

Keywords:

brachial plexus injury, chronic electrical stimulation, surgical treatment

Abstract

Introduction. 6% of all injuries of locomotive apparatus are injuries of peripheral nerves, up to 90% are injuries of upper extremity.

Materials and methods. We present results of surgical treatment of 73 patients with consequences of long branches of brachial plexus injury with invasive chronic electrical stimulation.

Results. The positive effect (full, good and satisfactory recovery of nerve) was achieved in 76.7% of patients who underwent nerve stimulation and 42.9% of patients, which have been subjected only to the standard surgical treatment. A slight improvement or treatment failure observed in 23.3% of patients with nerve stimulation and in 57.1% of patients without long-term neurostimulation.

Conclusions. Invasive chronic electrical stimulation is safe method in complex restorative treatment of long branches of brachial plexus injuries.

Author Biography

Nikolay Sapon, Romodanov Neurosurgery Institute, Kiev

Restorative Neurosurgery Department

References

1. Panov DE. Diagnostika i taktika lecheniya bolnykh s povrezhdeniyem sredinnogo i loktevogo nervov na urovne predplechiya i kisti [Diagnosis and treatment strategy of patients with damage to the median and ulnar nerves at forearm and hand] [dissertation]. Moscow (Russia): NN Priorov Central Research Institute of Traumatology and Orthopedics; 2006. Russian. Available from URL

2. Volkova AM. Khirurgiya kisti [Hand surgery]. Ekaterinburg: Sred-Ural Kn Iz-vo; 1991. 304 p.

3. Cohen MS. Complications of distal biceps tendon repairs. Sports Med Arthrosc. 2008 Sep;16(3):148-53. Review. [PubMed] [CrossRef]

4. Elton SG, Rizzo M. Management of radial nerve injury associated with humeral shaft fractures: an evidence-based approach. J Reconstr Microsurg. 2008 Nov;24(8):569-73. Epub 2008 Oct 16. Review. [PubMed] [CrossRef]

5. Clement H, Pichler W, Tesch NP, Heidari N, Grechenig W. Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus. Surg Radiol Anat. 2010 Mar;32(3):221-4. Epub 2009 Oct 6. [PubMed] [CrossRef]

6. Yildirim AO, Oken OF, Unal VS, Esmer AF, Gülçek M, Uçaner A. Avoiding iatrogenic radial nerve injury during humeral fracture surgery: a modified approach to the distal humerus. Acta Orthop Traumatol Turc. 2012;46(1):8-12. [PubMed] [CrossRef]

7. Naumenko LYu, Khomyakov VN., Domanskiy AN. Nash opyt reabilitatsii bolnykh i invalidov s otdalennymi posledstviyami povrezhdeniy nervov verkhney konechnosti [Our experience in the rehabilitation of patients and disabled persons with long-term consequences of the upper extremity nerve injury]. Travmatologiya i ortopediya. 2008;(2): 51-52. Russian.

8. Gerasimov AA, Dubovik EA. Uskoreniye vosstanovleniya perifericheskikh nervov v eksperimente [Accelerating the recovery of peripheral nerves in the experiment]. In: Proceeding of the Conference "Actual problems of surgery of the upper limb"; 2009 May 14–15; Kurgan, Russia. Kurgan, 2009. p.42-43. Russian.

9. Mokhamad KB. Kompleksnaya diagnostika i optimalnyy podkhod k lecheniyu travmaticheskikh povrezhdeniy luchevogo nerva [Complex diagnostics and optimal approach to the treatment of traumatic lesions of the radial nerve] [dissertation]. Moscow (Russia): NN Priorov Central Research Institute of Traumatology and Orthopedics; 2009. Russian. Available from URL

10. Vasilyev MV. Khirurgicheskoye lecheniye bol'nykh s izolirovannym povrezhdeniyem luchevogo nerva i v sochetanii s perelomom plechevoy kosti [Surgical treatment of patients with isolated radial nerve injury in combination with a fractured humerus] [dissertation]. Kazan (Russia): Kazan State Medical Academy; 2010. Russian. Available from URL

11. Venouziou AI, Dailiana ZH, Varitimidis SE, Hantes ME, Gougoulias NE, Malizos KN. Radial nerve palsy associated with humeral shaft fracture. Is the energy of trauma a prognostic factor? Injury. 2011 Nov;42(11):1289-93. Epub 2011 Feb 24. [PubMed] [CrossRef]

12. Eglseder WA. Distal humeral fractures: impact of lateral approach and fracture-specific plating on radial nerve palsies. Tech Hand Up Extrem Surg. 2012 Sep;16(3):127-31. [PubMed] [CrossRef]

13. Zolotova YuA. Profilaktika yatrogennykh povrezhdeniy luchevogo nerva pri lechenii perelomov plecha [Prevention of iatrogenic damage to the radial nerve in the treatment of fractures of the shoulder] [dissertation]. Yakutsk (Russia): North-Eastern Federal University; 2011. Russian. Available from URL

14. Davlatov AA. Khirurgicheskoye lecheniye posledstviy odnovremennogo povrezhdeniya sredinnogo i loktevogo nervov [The surgical treatment of consequence of combined median and ulnar nerves injuries] [dissertation]. Dushanbe (Tajikistan): Avicenna Tajik State Medical University; 2007. Russian. Available from URL

15. Bruyns CN, Jaquet JB, Schreuders TA, Kalmijn S, Kuypers PD, Hovius SE. Predictors for return to work in patients with median and ulnar nerve injuries. J Hand Surg Am. 2003 Jan;28(1):28-34. [PubMed] [CrossRef]

16. Ilina EN. Lecheniye travmaticheskikh povrezhdeniy plechevogo spleteniya metodom vnutritkanevoy elektrostimulyatsii [Treatment of traumatic injuries of the brachial plexus by interstitial electrostimulation] [dissertation]. Kurgan (Russia): Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics; 2004. Russian. Available from URL

17. Shulyaka GK. Osnovy elektrostimulyatsii [Fundamentals of electrical stimulation]. Kiev: Varta, 2006. 212 p. Russian.

18. Samosyuk IZ, Chuhraev NV, Samosyuk NI, Chuhraeva EN. Elektroterapiya i elektropunktura v meditsinskoy reabilitatsii, fizioterapii i kurortologii [Electrotherapy and electropuncture in medical rehabilitation, physiotherapy and balneology]. Kiev: publisher unknown; 2012. 291 p. Russian.

19. Tsymbaliuk VI, Sapon MA, Tretiak IB. Vykorystannya dovhotryvaloyi elektrostymulyatsiyi pry ushkodzhennyakh nerviv verkhnoyi kintsivky[Use long electrical stimulation of nerves in the upper limb injuries]. Ukrainian Neurosurgical Journal. 2010;(3):66. Ukrainian.

20. Tretyak IB. [Prolonged electrical stimulation of peripheral nerves and plexus damage]. Ukrainian Neurosurgical Journal. 2007;(2):58-61. Ukrainian. [eLIBRARY.ru]

21. Sapon NA. The efficiency of neuropathic pain removing using different methods of neurostimulation. In: Materials of EANS Annual Meeting 2012; 2012 October 24-27; Bratislava, Slovakia. Available from URL

22. Tsimbalyuk VI, Yaminskiy YuYa. [Application of epidural electrostimulation method in renewing surgical treatment of patients with consequences of cervical spine traumatic injury]. Ukrainian Neurosurgical Journal. 2011;(1):36-43. Ukrainian. [eLIBRARY.ru]

23. Grigorovich KA. Khirurgicheskoye lecheniye povrezhdeniy nervov [Surgical treatment of nerve injury]. Leningrad: Meditsina; 1981. 302 p. Russian.

Published

2013-06-22

How to Cite

Zozulya, Y., Tretyak, I., Tsymbalyuk, Y., & Sapon, N. (2013). Restorative surgery with invasive nerve stimulation in brachial plexus injuries. Ukrainian Neurosurgical Journal, (2), 19–22. https://doi.org/10.25305/unj.51852

Issue

Section

Original articles