title: Method for surgical access to the brachial plexus.
abstract: Problem of brachial plexus injuries is deemed one of the most topical in contemporary surgery. Irrespective of the newest achievements in medical science and technique, outcomes of treatment of brachial plexus injuries are yet incapable to be estimated as satisfactory. Quality of technical performance in many respects depends on convenience of access to the structures to be operated. The deficiency of the offered methods is that they are incapable to ensure sufficiently wide access to indicated structures, thus making operation more complicated and long and depressing functional and esthetical outcomes of the surgical treatment. The method, offered by us, is deemed to be solution of the above-mentioned problems. The core of the method is making of additional incision along lateral side of the horizontal wound, cutting out collarbone segment along the sides of wound and peeling up the formed rectangular clout, ensuring the wide access to the appropriate structures. We have examined and operated 59 patients with pathologies of brachial plexus and nearby structures. In 22 cases, where we applied the methodology offered by us, the above-mentioned complications did not arise: wide access facilitated technical aspect of the operation, reducing the duration of corresponding operation by in average 13-20%. Healing of wounds in both cases -- singularity-free. Controlling X-ray have shown successful coalescence of cut-off segments of collarbone without any deformation along axis. Method for ensuring access to brachial plexus, offered by us, provides more extensive and easier mobilization of plexus elements and nearby structures, facilitates technical side of the operation, shortens duration of surgical operation, and, finally, improves outcomes of treatment.
authors.affiliation: National Center of Surgery, Vascular and Plastic-Reconstructive Surgery Clinic, Tbilisi, Georgia.
authors.forename: I
authors.initials: I
authors.lastname: Pheradze
authors.forename: T
authors.initials: T
authors.lastname: Pheradze
authors.forename: M
authors.initials: M
authors.lastname: Baratashvili
mesh_terms: D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D016896:Treatment Outcome