Nerve Transfer for Elbow Flexion in Radiation-Induced Brachial Plexopathy: A Case Report
Identifieur interne : 001D31 ( Pmc/Curation ); précédent : 001D30; suivant : 001D32Nerve Transfer for Elbow Flexion in Radiation-Induced Brachial Plexopathy: A Case Report
Auteurs : Thomas H. Tung [États-Unis] ; Daniel Z. Liu [États-Unis] ; Susan E. Mackinnon [États-Unis]Source :
- Hand (New York, N.Y.) [ 1558-9447 ] ; 2008.
Abstract
Radiation-induced brachial plexopathy is an uncommon but devastating late complication seen in patients receiving radiation therapy to the chest wall and axilla. Treatment options are unfortunately limited. We report a case of a 59-year-old woman treated with radiation therapy for breast cancer 12 years earlier, who presented with loss of elbow flexion and marked shoulder weakness. Electromyogram and intraoperative stimulation of the musculocutaneous nerve branches were consistent with a proximal motor nerve conduction block. Microsurgical transfer of median and ulnar nerve fascicles to the biceps and brachialis branches of the musculocutaneous nerve, respectively, were performed. The patient recovered MRC grade 4/5 elbow flexion after surgery. The characteristics of this disorder and surgical treatment options are reviewed.
Url:
DOI: 10.1007/s11552-008-9136-9
PubMed: 18843522
PubMed Central: 2686782
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<front><div type="abstract" xml:lang="en"><p>Radiation-induced brachial plexopathy is an uncommon but devastating late complication seen in patients receiving radiation therapy to the chest wall and axilla. Treatment options are unfortunately limited. We report a case of a 59-year-old woman treated with radiation therapy for breast cancer 12 years earlier, who presented with loss of elbow flexion and marked shoulder weakness. Electromyogram and intraoperative stimulation of the musculocutaneous nerve branches were consistent with a proximal motor nerve conduction block. Microsurgical transfer of median and ulnar nerve fascicles to the biceps and brachialis branches of the musculocutaneous nerve, respectively, were performed. The patient recovered MRC grade 4/5 elbow flexion after surgery. The characteristics of this disorder and surgical treatment options are reviewed.</p>
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<journal-title>Hand (New York, N.Y.)</journal-title>
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<title-group><article-title>Nerve Transfer for Elbow Flexion in Radiation-Induced Brachial Plexopathy: A Case Report</article-title>
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<contrib-group><contrib contrib-type="author" corresp="yes"><name name-style="western"><surname>Tung</surname>
<given-names>Thomas H.</given-names>
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<address><phone>+1-314-3624586</phone>
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<email>tungt@wustl.edu</email>
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<contrib contrib-type="author"><name name-style="western"><surname>Liu</surname>
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<contrib contrib-type="author"><name name-style="western"><surname>Mackinnon</surname>
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<pub-date pub-type="epub"><day>9</day>
<month>10</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2009</year>
</pub-date>
<volume>4</volume>
<issue>2</issue>
<fpage>123</fpage>
<lpage>128</lpage>
<history><date date-type="received"><day>26</day>
<month>6</month>
<year>2008</year>
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<date date-type="accepted"><day>12</day>
<month>9</month>
<year>2008</year>
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<permissions><copyright-statement>© American Association for Hand Surgery 2008</copyright-statement>
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<abstract xml:lang="EN"><p>Radiation-induced brachial plexopathy is an uncommon but devastating late complication seen in patients receiving radiation therapy to the chest wall and axilla. Treatment options are unfortunately limited. We report a case of a 59-year-old woman treated with radiation therapy for breast cancer 12 years earlier, who presented with loss of elbow flexion and marked shoulder weakness. Electromyogram and intraoperative stimulation of the musculocutaneous nerve branches were consistent with a proximal motor nerve conduction block. Microsurgical transfer of median and ulnar nerve fascicles to the biceps and brachialis branches of the musculocutaneous nerve, respectively, were performed. The patient recovered MRC grade 4/5 elbow flexion after surgery. The characteristics of this disorder and surgical treatment options are reviewed.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Nerve transfer</kwd>
<kwd>Radiation brachial plexopathy</kwd>
<kwd>Fascicular transfer</kwd>
</kwd-group>
<custom-meta-wrap><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© American Association for Hand Surgery 2009</meta-value>
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