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Differences in strength fatigue when using different donors in traumatic brachial plexus injuries.
- Source :
-
Acta neurochirurgica [Acta Neurochir (Wien)] 2020 Aug; Vol. 162 (8), pp. 1913-1919. Date of Electronic Publication: 2020 Jun 18. - Publication Year :
- 2020
-
Abstract
- Background: The purpose of this study was to assess the results of elbow flexion strength fatigue, rather than the maximal power of strength, after brachial plexus re-innervation with phrenic and spinal accessory nerves. We designed a simple but specific test to study whether statistical differences were observed among those two donor nerves.<br />Method: We retrospectively reviewed patients with severe brachial plexus palsy for which either phrenic nerve (PN) or spinal accessory nerve (SAN) to musculocutaneous nerve (MCN) transfer was performed. A dynamometer was used to determine the maximal contraction strength. One and two kilograms circular weights were utilized to measure isometrically the duration of submaximal and near-maximal contraction time. Statistical analysis was performed between the two groups.<br />Results: Twenty-eight patients were included: 21 with a PN transfer while 7 with a SAN transfer for elbow flexion. The mean time from trauma to surgery was 7.1 months for spinal accessory nerve versus 5.2 for phrenic nerve, and the mean follow-up was 57.7 and 38.6 months, respectively. Statistical analysis showed a quicker fatigue for the PN, such that patients with the SAN transfer could hold weights of 1 kg and 2 kg for a mean of 91.0 and 61.6 s, respectively, while patients with transfer of the phrenic nerve could hold 1 kg and 2 kg weights for just a mean of 41.7 and 19.6 s, respectively. Both differences were statistically significant (at p = 0.006 and 0.011, respectively). Upon correlation analysis, endurances at 1 kg and 2 kg were strongly correlated, with r = 0.85 (p < 0.001).<br />Conclusions: Our results suggest that phrenic to musculocutaneous nerve transfer showed an increased muscular fatigue when compared with spinal accessory nerve to musculocutaneous transfer. Further studies designed to analyze this relation should be performed to increase our knowledge about strength endurance/fatigue and muscle re-innervation.
- Subjects :
- Accessory Nerve surgery
Adult
Brachial Plexus injuries
Female
Humans
Male
Middle Aged
Muscle Strength
Musculocutaneous Nerve surgery
Nerve Transfer adverse effects
Paralysis surgery
Phrenic Nerve surgery
Postoperative Complications epidemiology
Range of Motion, Articular
Brachial Plexus Neuropathies surgery
Muscle Fatigue
Nerve Transfer methods
Postoperative Complications physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0942-0940
- Volume :
- 162
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Acta neurochirurgica
- Publication Type :
- Academic Journal
- Accession number :
- 32556814
- Full Text :
- https://doi.org/10.1007/s00701-020-04454-y