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Brachial plexus injury after median sternotomy
Journal of Neurology, Neurosurgery, and Psychiatry
|July 1, 1981
Summary
Cardiac surgery patients can develop brachial plexus injuries, particularly affecting the lower plexus roots. These injuries often cause prominent pain and motor deficits, with traction suspected as the primary cause.
Area of Science:
- Neurology
- Cardiothoracic Surgery
- Orthopedic Surgery
Background:
- Median sternotomy is a common surgical approach for cardiac procedures.
- Brachial plexus injuries are a potential, though infrequent, complication of sternotomy.
Observation:
- This study details five cases of brachial plexus injury following median sternotomy.
- The lower roots of the brachial plexus (medial cord) were predominantly affected, with some bilateral lesions observed.
Findings:
- Patients presented with significant pain, motor symptoms more pronounced than sensory deficits.
- Recovery from these injuries was prolonged and often incomplete.
- Traction, potentially combined with compression, is implicated as the primary mechanism of injury, with traction being more probable.
Implications:
- Awareness of these injuries is crucial for cardiac surgeons and neurologists.
- Understanding the mechanism can inform preventative strategies during sternotomy.
- Further research into minimizing traction-related brachial plexus injuries during cardiac surgery is warranted.