Reliability of Various Predictors for Preoperative Diagnosis of Infraclavicular Brachial Plexus Lesions with Shoulder and/or Elbow Paresis.

Abstract:

BACKGROUND: The distinction between supraclavicular and infraclavicular acute brachial plexus injuries (BPIs) could be challenging in cases of combined shoulder and elbow paresis. The reliability of several preoperative predictors was investigated to avoid unnecessary dissection, prolonged operation time, increased postoperative morbidity, and long scars. METHODS: Between 2004 and 2013, 75 patients, who sustained acute BPI and presented with motor paresis of shoulder and elbow with preservation of hand function, were included and studied retrospectively. Various predictors including muscles function, sensation, fractures, Tinel's sign and nerve conduction velocity (NCV) studies were reviewed. RESULTS: The highest odds ratio (OR) values for infraclavicular BPI were healthy clavicular head of pectoralis major and biceps, presenting with OR = 36.5 and 31.76, respectively, which were identified the most important predictors. CONCLUSION: A combination of functioning pectoralis major or biceps, scapular fracture, an infraclavicular Tinel's sign, and normal NCV in the musculocutaneous nerve was highly predictive of an infraclavicular level.

journal_name

J Reconstr Microsurg

authors

Qiu SS,Chang TN,Lu JC,Chuang DC

doi

10.1055/s-0040-1702177

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

445-449

issue

6

eissn

0743-684X

issn

1098-8947

journal_volume

36

pub_type

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