title: The effect of humerus diaphyseal shortening on brachial plexus tension: a cadaver study.
abstract: OBJECTIVE
  To assess the extent to which diaphyseal shortening of the humerus can allow direct suture in case of rupture or transection injuries of the brachial plexus.
  
  
  METHODS
  The use of 3 fresh cadaver specimens allowed for the study of 6 brachial plexuses. Distance measurements were made between reference points placed on the clavicle and on different parts of the plexus. Those measurements were repeated after shortening the humerus by 2, 4, and 6 cm.
  
  
  RESULTS
  None of the dissected plexuses had classic anatomy. A humeral shortening of 6 cm allowed for a statistically significant reduction of length between the supraclavicular part of the plexus and the terminal branches, which did not exceed 17 mm on average. The difference of length was much greater for the specimen in which the musculocutaneous nerve did not pierce the coracobrachialis muscle proximally.
  
  
  CONCLUSIONS
  In clinical situations, nerve defects are usually larger than the gain observed when doing a 6-cm humeral shortening. Moreover, this procedure implies a large dissection, a functional loss of certain muscles, and a risk of humeral nonunion.
  
  
  CONCLUSIONS
  In the absence of extensive nerve dissection, the observed change of length is insufficient in the most brachial plexus disruptions to allow for a direct suture instead of long nerve grafts.
authors.affiliation: Department of Orthopaedics and Traumatology, Université Libre de Bruxelles, Campus Hospitalo-Facultaire Erasme, Brussels, Belgium. Electronic address: aurelie.andrzejewski@ulb.ac.be.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Andrzejewski
authors.affiliation: Department of Orthopaedics and Traumatology, Université Libre de Bruxelles, Campus Hospitalo-Facultaire Erasme, Brussels, Belgium.
authors.forename: Fabian
authors.initials: F
authors.lastname: Moungondo
authors.affiliation: Department of Orthopaedics and Traumatology, Université Libre de Bruxelles, Campus Hospitalo-Facultaire Erasme, Brussels, Belgium.
authors.forename: Véronique
authors.initials: V
authors.lastname: Feipel
authors.affiliation: Department of Orthopaedics and Traumatology, Université Libre de Bruxelles, Campus Hospitalo-Facultaire Erasme, Brussels, Belgium.
authors.forename: Marcel
authors.initials: M
authors.lastname: Rooze
authors.affiliation: Department of Orthopaedics and Traumatology, Université Libre de Bruxelles, Campus Hospitalo-Facultaire Erasme, Brussels, Belgium.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Schuind
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology*; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology*; D018483:Diaphyses / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000601:surgery*; D066298:In Vitro Techniques; D008866:Microsurgery / Q000379:methods*; D016067:Nerve Transfer / Q000379:methods*; D010525:Peripheral Nerves / Q000637:transplantation*; D013536:Suture Techniques
keywords: Anatomical study; brachial plexus; humeral shortening