title: Neurolysis of the conducting neuroma-in-continuity in perinatal brachial plexus palsy - evaluation of the results of surgical treatment.
abstract: The aim of the study was to evaluate the surgical treatment results of cases of perinatal brachial plexus palsy with presence of neuroma-in-continuity. Clinical material included 21 children, aged from 3.5 to 36 months, treated surgically between 1996 and 2005. The control examination included 19 children. The shortest postoperative observation period was 4 years. After surgical treatment during clinical evaluation of function dependent on localization of neuroma-in-continuity we observed the following: in upper injury in 1 child good shoulder and elbow function; in upper-middle injuries with neuroma-in-continuity in upper trunk good elbow function in 66.6%, good shoulder function in 83.3% of cases; in upper-middle injuries with neuroma-in-continuity in upper and middle trunk in 1 examined child good function of elbow, shoulder, and wrist; in total injuries with neuroma-in-continuity in upper trunk good elbow function in 75%, and good shoulder function in 50% of cases; in total injuries with neuroma-in-continuity in upper and middle trunk good elbow function in 66.6%, good shoulder function in 33.3%, good wrist function in 66.6% of cases; in total injuries with neuroma-in-continuity in lower trunk grade 2 of motor hand function and return of sensibility to a level of S3+.
  
  
  CONCLUSIONS
  The choice of microsurgical technique during surgical treatment of perinatal brachial plexus palsies with neuroma-in-continuity should be based on the whole clinical and intraoperative view. The best results after neurolysis should be expected when neuroma-in-continuity is localized in the upper trunk, the injury corresponds to third degree on Sunderland's scale, and during electric stimulation a normal motor response can be obtained.
authors.affiliation: Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, Poland. chiruraz@churaz.am.wroc.pl
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gosk
authors.forename: Roman
authors.initials: R
authors.lastname: Rutowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Urban
authors.forename: Roman
authors.initials: R
authors.lastname: Wiącek
authors.forename: Piotr
authors.initials: P
authors.lastname: Mazurek
authors.forename: Witold
authors.initials: W
authors.lastname: Wnukiewicz
mesh_terms: D001720:Birth Injuries / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009463:Neuroma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D010243:Paralysis / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function