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Neuroma-in-continuity resection: early outcome in obstetrical brachial plexus palsy
L Capek1, H M Clarke, C G Curtis
1Division of Plastic Surgery at The Hospital for Sick Children, University of Toronto, Canada.
Plastic and Reconstructive Surgery
|October 17, 1998
Summary
Resecting neuromas in obstetrical brachial plexus palsy (OBPP) did not significantly impair limb function. Post-surgery scores showed initial decreases but recovered by 12 months, similar to neurolysis alone.
Area of Science:
- Pediatric Surgery
- Neurology
- Orthopedic Surgery
Background:
- Obstetrical brachial plexus palsy (OBPP) can result in neuromas-in-continuity, potentially affecting limb function.
- The role of these neuromas in functional outcomes remains a subject of investigation.
Purpose of the Study:
- To evaluate the short-term impact of neuroma-in-continuity resection in OBPP.
- To test the hypothesis that neuromas do not contribute to useful limb function.
Main Methods:
- Retrospective study comparing 26 patients with OBPP undergoing neuroma resection and nerve grafting with 17 patients undergoing neurolysis only.
- Preoperative and postoperative active movement scores (eight-point scale for 15 joint motions) were analyzed.
Main Results:
- Limb motion scores significantly decreased at 6 weeks post-resection, were not significantly different at 3 months, and significantly improved by 12 months.
- No significant difference in limb motion scores was observed between the neuroma resection and neurolysis groups at 3, 6, and 12 months postoperatively.
- Findings suggest recovery is due to nerve regeneration in non-grafted segments, not axonal regeneration across grafts.
Conclusions:
- Resection of neuromas-in-continuity in OBPP does not significantly diminish motor activity.
- The surgical approach does not negatively impact functional recovery compared to neurolysis alone.