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Traumatic pseudoaneurysm of the axillary artery combined with brachial plexus injury is extremely rare. The factors that influence the symptoms and functional recovery related to this condition are unclear. Nine patients who had sustained this trauma were surgically treated at our unit between June 1999 and November 2010. The cause of trauma, symptoms, signs and examinations of neurological and vascular deficits, and the surgical findings of the involved nerves and vessels were recorded in detail. The functional recovery of vessels and nerves, as well as the extent of pain, were evaluated, respectively. The average length of patient follow-up was 4.5 years (range, 24 months to 11.3 years). After vessel repair, whether by endovascular or operative treatment, the distending, constant, and pulsating pain was relieved in all patients. Furthermore, examination of the radial artery pulse on the repaired side appeared normal at last follow-up. All patients showed satisfactory sensory recovery, with motor recovery rated as good in five patients and fair in four patients. The symptom characteristics varied with the location of the damage to the axillary artery. Ultrasound examination and computed tomography angiography are useful to evaluate vascular injury and provide valuable information for operative planning. Surgical exploration is an effective therapy with results related to the nerve injury condition of the brachial plexus. [ABSTRACT FROM AUTHOR]

Two-phase TC21 titanium alloy samples were solution-treated at 990 °C (β phase zone) and cooled by furnace cooling (FC), air cooling (AC), and water quenching (WQ), respectively. The second solution stage treatment was carried out at 900 °C (α + β phase zone), then aging treatment was performed at 590 °C. The influence of the size and quantity of the α phase on the properties of the sample were studied. The experimental results showed as the cooling rate increased after the first solution stage treatment, wherein the thickness of primary layer α gradually decreased, and the tensile strength and yield strength gradually increased. After the second solution stage treatment, the tensile properties of samples increased due to the quantity of layers α increased. The aging treatment promoted the precipitation of the dispersed α phase and further improved the tensile strength. After the third solution stage treatments, the FC samples with more β-phase had the best comprehensive mechanical properties. [ABSTRACT FROM AUTHOR]

Background: Thoracic outlet syndrome (TOS) is largely overlooked in children and adolescents because the condition is not widely viewed as a pediatric disorder. This study aimed to clarify the causes, best treatment approaches, and prognosis for young patients with TOS., Methods: A retrospective study was conducted on 13 patients, from 4 to 13 years of age, with TOS. Ten children underwent surgical treatment, and three were treated conservatively. All patients received local nerve blocks on two occasions and were followed-up for more than 2 years., Results: Among the 10 children who underwent surgery, six school-aged children returned to school 10 to 14 days after surgery. Parents of the three children treated conservatively reported that activity within the affected limb and overall muscle strength had increased in their children and none of the three children had complained about discomfort in the affected limb., Conclusion: A diagnosis of TOS should be considered when a child or adolescent has neck and shoulder discomfort, hand numbness, and upper limb weakness. As with adults with TOS, detailed physical examination is the key to diagnosing pediatric TOS. Conservative treatment is effective for young TOS patients who have mild changes in the length and thickness of the affected limb and is an option when parents refuse surgical treatment.

Object: Contralateral C-7 transfer is often used in patients with brachial plexus avulsion injury. Traditionally, the contralateral C-7 root has only been transferred to a single nerve, such as the median or radial nerve. In this study, the authors aimed to evaluate the efficacy of contralateral C-7 transfer to 2 different recipient nerves in patients with brachial plexus avulsion injuries., Methods: Between 2004 and 2008, 10 patients with brachial plexus root avulsions underwent nerve reconstruction using a modified C-7 neurotization technique. In this procedure, the contralateral C-7 root was transferred via vascularized ulnar nerve grafts to both the musculocutaneous nerve and the median nerve on the affected side., Results: The strength of the biceps muscles increased to M3 or M4 in 6 patients and to M2 in 2 patients. The median nerve transfers led to regained motor function and strength of the wrist and finger flexors with improvement to M3 in 5 patients. Seven patients showed notable gains of sensory function (≥ S3)., Conclusions: Contralateral C-7 transfer to 2 different recipient nerves is a feasible and efficient approach in patients with brachial plexus avulsion injuries when the donor nerve is limited.