Oberlin transfer and partial radial to axillary nerve neurotization to repair an explosive traumatic injury to the Brachial Plexus in a child

Case report

Joseph H. Miller, Sarah T. Garber, Don E. McCormick, Ramin Eskandari, Marion L. Walker, Elias Rizk, R. Shane Tubbs, John C. Wellons

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: Explosive injuries to the pediatric brachial plexus are exceedingly rare and as such are poorly characterized in the medical literature. Methods: Herein, we describe an 8-year-old who was struck in the neck by a piece of shrapnel and suffered multiple vascular injuries in addition to a suspected avulsion of the cervical 5 and 6 ventral rami. The patient had a complete upper brachial plexus palsy and failed to demonstrate any clinical improvement at 6-months follow-up. He was taken to the operating from for a partial ulnar to musculocutaneous nerve neurotization as well as a partial radial to axillary nerve neurotization. Results: The patient's motor exam improved from a Medical Research Council scale 1 to 4+ for biceps brachii and 0 to 4 deltoid function with greater than 90 of shoulder abduction. Conclusions: This outcome supports complex neurotization techniques as viable treatment options for persistent motor deficits following an upper brachial plexus injury in older, non-infant age, children.

Original languageEnglish (US)
Pages (from-to)2105-2109
Number of pages5
JournalChild's Nervous System
Volume29
Issue number11
DOIs
StatePublished - Nov 1 2013

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Nerve Transfer
Brachial Plexus
Arm Injuries
Wounds and Injuries
Arm
Musculocutaneous Nerve
Multiple Trauma
Vascular System Injuries
Paralysis
Biomedical Research
Neck
Pediatrics
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Miller, Joseph H. ; Garber, Sarah T. ; McCormick, Don E. ; Eskandari, Ramin ; Walker, Marion L. ; Rizk, Elias ; Tubbs, R. Shane ; Wellons, John C. / Oberlin transfer and partial radial to axillary nerve neurotization to repair an explosive traumatic injury to the Brachial Plexus in a child : Case report. In: Child's Nervous System. 2013 ; Vol. 29, No. 11. pp. 2105-2109.
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abstract = "Purpose: Explosive injuries to the pediatric brachial plexus are exceedingly rare and as such are poorly characterized in the medical literature. Methods: Herein, we describe an 8-year-old who was struck in the neck by a piece of shrapnel and suffered multiple vascular injuries in addition to a suspected avulsion of the cervical 5 and 6 ventral rami. The patient had a complete upper brachial plexus palsy and failed to demonstrate any clinical improvement at 6-months follow-up. He was taken to the operating from for a partial ulnar to musculocutaneous nerve neurotization as well as a partial radial to axillary nerve neurotization. Results: The patient's motor exam improved from a Medical Research Council scale 1 to 4+ for biceps brachii and 0 to 4 deltoid function with greater than 90 of shoulder abduction. Conclusions: This outcome supports complex neurotization techniques as viable treatment options for persistent motor deficits following an upper brachial plexus injury in older, non-infant age, children.",
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Oberlin transfer and partial radial to axillary nerve neurotization to repair an explosive traumatic injury to the Brachial Plexus in a child : Case report. / Miller, Joseph H.; Garber, Sarah T.; McCormick, Don E.; Eskandari, Ramin; Walker, Marion L.; Rizk, Elias; Tubbs, R. Shane; Wellons, John C.

In: Child's Nervous System, Vol. 29, No. 11, 01.11.2013, p. 2105-2109.

Research output: Contribution to journalArticle

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T2 - Case report

AU - Miller, Joseph H.

AU - Garber, Sarah T.

AU - McCormick, Don E.

AU - Eskandari, Ramin

AU - Walker, Marion L.

AU - Rizk, Elias

AU - Tubbs, R. Shane

AU - Wellons, John C.

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Purpose: Explosive injuries to the pediatric brachial plexus are exceedingly rare and as such are poorly characterized in the medical literature. Methods: Herein, we describe an 8-year-old who was struck in the neck by a piece of shrapnel and suffered multiple vascular injuries in addition to a suspected avulsion of the cervical 5 and 6 ventral rami. The patient had a complete upper brachial plexus palsy and failed to demonstrate any clinical improvement at 6-months follow-up. He was taken to the operating from for a partial ulnar to musculocutaneous nerve neurotization as well as a partial radial to axillary nerve neurotization. Results: The patient's motor exam improved from a Medical Research Council scale 1 to 4+ for biceps brachii and 0 to 4 deltoid function with greater than 90 of shoulder abduction. Conclusions: This outcome supports complex neurotization techniques as viable treatment options for persistent motor deficits following an upper brachial plexus injury in older, non-infant age, children.

AB - Purpose: Explosive injuries to the pediatric brachial plexus are exceedingly rare and as such are poorly characterized in the medical literature. Methods: Herein, we describe an 8-year-old who was struck in the neck by a piece of shrapnel and suffered multiple vascular injuries in addition to a suspected avulsion of the cervical 5 and 6 ventral rami. The patient had a complete upper brachial plexus palsy and failed to demonstrate any clinical improvement at 6-months follow-up. He was taken to the operating from for a partial ulnar to musculocutaneous nerve neurotization as well as a partial radial to axillary nerve neurotization. Results: The patient's motor exam improved from a Medical Research Council scale 1 to 4+ for biceps brachii and 0 to 4 deltoid function with greater than 90 of shoulder abduction. Conclusions: This outcome supports complex neurotization techniques as viable treatment options for persistent motor deficits following an upper brachial plexus injury in older, non-infant age, children.

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