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Inicio Revista Española de Cirugía Ortopédica y Traumatología Cronología en la cirugía de las lesiones del plexo braquial
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Vol. 47. Núm. 1.
Páginas 73-82 (enero 2003)
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Vol. 47. Núm. 1.
Páginas 73-82 (enero 2003)
Acceso a texto completo
Cronología en la cirugía de las lesiones del plexo braquial
Timing of surgery in brachial plexus injuries
Visitas
8075
A. García López*, L. López-Durán Stern
Servicio de Traumatología y Cirugía Ortopédica. Hospital Clínico San Carlos. Madrid
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Información del artículo

Las lesiones del plexo braquial son frecuentes en nuestro medio y son el origen de graves invalideces en el niño y en el adulto. Si esta patología se trata de forma precoz se pueden obtener buenos resultados, pero si se deja evolucionar las posibilidades se quedan limitadas a la cirugía paliativa o el paciente puede perder toda oportunidad de mejoría. Se analizan las indicaciones quirúrgicas y el momento de realizarla según el mecanismo de producción, las lesiones asociadas, la fase evolutiva tanto en el adulto como en el niño. Se establecen las prioridades terapéuticas, y se analizan las indicaciones de cirugía paliativa, de la cirugía de parálisis actínica y de la cirugía para eliminar el dolor.

Palabras clave:
plexo braquial
adultos
niños
parálisis
miembro superior

Injuries of the brachial plexus are common and cause severe impairment in children and adults. If these injuries are treated promptly, good results can be obtained. However, if left untreated the possibilities are limited to palliative surgery or there may be no possibility for improvement. An analysis is made of the surgical indications and timing of surgery depending on the mechanism of production, associated injuries, and phase of evolution in adults and children. Therapeutic priorities are established and the indications for palliative surgery, surgery for paralysis after radiotherapy of breast carcinoma, and surgery for pain relief are analyzed.

Key words:
brachial plexus
adults
children
palsy
upper extremity
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Bibliografía
[1.]
C. León.
Análisis de las lesiones sufridas por motociclistas [tesis doctoral].
Universidad Complutense de Madrid, (1990),
[2.]
R. Midha.
Epidemiology of brachial plexus injuries in a multitrauma population.
Neurosurg, 40 (1997), pp. 1182-1189
[3.]
A.O. Narakas.
The treatment of brachial plexus injuries.
Int Orthop, 9 (1985), pp. 29-36
[4.]
M. Camus, G. Lefebvre, P. Veron.
Traumatisme obstétrique du nouveau né.
J Gynecol Obstet, 14 (1995), pp. 1033-1044
[5.]
J.L. Ecker, J.A. Greenberg, E.R. Norwitz, A.S. Nadel, J.T. Repke.
Birth weight as a predictor of brachial plexus injury.
Obstet Gynecol, 89 (1977), pp. 643-647
[6.]
Sloof ACJ.
Obstetric brachial plexus lesions.
The brachial plexus, pp. 89-106
[7.]
A.E. Hardy.
Birth injuries of brachial plexus: incidence and prognosis.
J Bone Joint Surg Br, 63B (1981), pp. 98-101
[8.]
C. Bonnard, A.C.J. Slooff.
Brachial plexus lesions. Drawings of explorations and reconstructions by Algimantas Otonas Narakas.
[9.]
A. García-López.
Diagnóstico de las parálisis traumáticas del plexo braquial.
Jano Traumatol, 2 (2000), pp. 11-14
[10.]
R.D. Leffert.
Clinical diagnosis, testing, and electromyographic study in brachial plexus tractions injuries.
Clin Orthop, 237 (1988), pp. 24-31
[11.]
S. Palazzi, J. Marti.
Plexo braquial. Recuerdo anatómico, clínica y diagnóstico.
Rev Ortop Traumatol, 16 (1972), pp. 837-854
[12.]
P. Burge.
Diagnostic investigations.
The brachial plexus, pp. 19-29
[13.]
G.A. Carvalho, G. Nikkhah, C. Matthies, G. Penkert, M. Samii.
Diagnosis of root avulsions in traumatic brachial plexus injuries: value of computerized tomography myelography and magnetic resonance imaging.
J Neurosurg, 86 (1977), pp. 69-76
[14.]
B. Roger, V. Travers, M. Laval-Jeantet.
Imaging of postraumatic brachial plexus injury.
Clin Orthop, 237 (1988), pp. 57-61
[15.]
P.C. Francel, M. Koby, T.S. Park, B.C. Lee, M.J. Noetzel, S.E. McKinnon, et al.
Fast spin-echo magnetic resonance imaging for radiological assessment of neonatal brachial plexus injury.
J Neurosurg, 83 (1995), pp. 461-466
[16.]
R. Gasparotti, S. Ferraresi, L. Pinelli, M. Crispino, M. Pavia, M. Bonetti, et al.
Three-dimensional MR myelography of traumatic injuries of brachial plexus.
Am J Neuroradiol, 18 (1997), pp. 1733-1742
[17.]
T.E.J. Hems, R. Birch, T. Carlsted.
The role of magnetic resonance imaging in the management of traction injuries to the adult brachial plexus.
J Hand Surg Br, 24B (1999), pp. 550-555
[18.]
T. Nakamura, Y. Yabe, Y. Horiuchi, S. Takayama.
Magnetic resonance myelography in brachial plexus injuries.
J Bone Joint Surg Br, 79B (1997), pp. 764-769
[19.]
A.O. Randsford, S.P.F. Hughes.
Complete brachial plexus lesions.
J Bone Joint Surg Br, 59B (1977), pp. 417-420
[20.]
C.H. Rorabeck.
The management of the flail upper extremity in brachial plexus injuries.
J Trauma, 20 (1980), pp. 491-493
[21.]
P.M. Yeoman.
Brachial plexus injuries: treatment of the flail arm.
J Bone Joint Surg Br, 43B (1961), pp. 493-500
[22.]
G.A. Merrell, K.A. Barrie, D.L. Katz, S.W. Wolfe.
Results of nerve tranfer techniques for restoration of shoulder and elbow function in the context of a meta-analysis of the English Literature.
J Hand Surg Am, 26A (2001), pp. 303-314
[23.]
T. Murase, H. Kawai, T. Masatomi, H. Kawabata, K. Ono.
Evoked spinal cord potencials for diagnosis during brachial plexus surgery.
J Bone Joint Surg Br, 75B (1993), pp. 775-781
[24.]
E. Turkof, H. Millesi, R. Turkof, P. Pfundner, N. Mayr.
Intraoperative electroneurodiagnostics (transcranial electrical motor evoked potentials) to evaluate the functional status of anterior spinal roots and spinal nerves during brachial plexus surgery.
Plastic Reconstruc Surg, 99 (1997), pp. 1632-1641
[25.]
F. Kanaya, A.W. Jevans.
Rapid histochemical identification of motor and sensory fascicles: preparation of solutions.
Plast Reconstr Surg, 90 (1992), pp. 514-515
[26.]
S.E. Gschmeissner, J.H. Pereira, S.A. Cowley.
The rapid assessment of nerve stumps.
J Bone Joint Surg Br, 73B (1991), pp. 688-689
[27.]
J.J. Mosivais, A.O. Narakas, E. Turkof, Y. Sun.
The endoscopic diagnosis and possible treatment of nerve root avulsion in the management of brachial plexus injuries.
J Hand Surg Br, 19B (1994), pp. 547-549
[28.]
R. Birch, G. Bonney, C.B. Wynn-Parry.
Surgical disorders of the peripheral nerves.
[29.]
R.S. Boome.
Penetrating injuries.
The brachial plexus, pp. 107-112
[30.]
M.C. Dunkerton, R.S. Boome.
Stab wounds involving the brachial plexus.
J Bone Joint Surg Br, 70B (1988), pp. 566-570
[31.]
W.C. Breidenbach.
Vascularized nerve grafts. A practical approach.
Orthop Clin North Am, 19 (1988), pp. 81-89
[32.]
H. Kawai, H. Kawabata.
Brachial plexus palsy.
[33.]
G.I. Taylor, F.S. Ham.
The free vascularized nerve graft. A further experimental and clinical application of microvascular techniques.
Plast Reconstr Surg, 133 (1976), pp. 413-426
[34.]
R. Birch.
Infraclavicular lesions.
The brachial plexus, pp. 79-88
[35.]
G. Magalon, J. Bordeaux, R. Legré, J.P. Aubert.
Emergency versus delayed repair of severe brachial plexus injuries.
Clin Orthop, 237 (1988), pp. 32-35
[36.]
W.W. Brien, H. Gellman, V. Becker, D.E. Garland, R.L. Waters, D. Wiss.
Management of fractures of the humerus in patients who have an injury of the ipsilateral brachial plexus.
J Bone Joint Surg Am, 72A (1990), pp. 1208-1210
[37.]
T. Carlstedt, R.G. Hallin, I. Nilsson-Remahl, K.G. Hedström.
Funcional recovery in primates with brachial plexus injury after spinal cord implantation of avulsed ventral roots.
J Neurol Neurosurg Psychiatry, 56 (1993), pp. 649-654
[38.]
T. Carstedt, P. Grane, R.G. Hallin, G. Norén.
Return of function after spinal cord implantation of avulsed spinal nerve roots.
Lancet, 346 (1995), pp. 1323-1325
[39.]
A.O. Narakas, G. Herzberg.
Neuro-neural intraplexal transfers in traumatic radicular avulsions of the brachial plexus.
Ann Chir Main, 4 (1985), pp. 211-218
[40.]
A.O. Narakas, V.R. Hentz.
Neurotization in brachial plexus injuries. Indication and results.
Clin Orthop, 237 (1988), pp. 43-56
[41.]
H. Kawai, H. Kawabata, K. Masada, K. Ono, K. Yamamoto, Y. Tsuyaguchi, K. Tada.
Nerve repairs for traumatic brachial plexus palsy with root avulsion.
Clin Orthop, 237 (1988), pp. 75-86
[42.]
A.O. Narakas.
Neurotization or nerve transfer for brachial plexus lesions.
Ann Chir Main, 1 (1982), pp. 101-108
[43.]
C. Oberlin, D. Beal, S. Leechavenguongs, A. Salon, M.C. Dauge, J.J. Sarcy.
Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsions of the brachial plexus: Anatomical study and report of four cases.
J Hand Surg Am, 19A (1994), pp. 232-237
[44.]
S. Palazzi, J.P. Cáceres, J.L. Palazzi.
Nuestra experiencia en la neurotización cúbito-bicipital (operación de Oberlin).
Rev Iber Cir Mano, 58 (2000), pp. 29-36
[45.]
Y. Allieu, P. Cenac.
Neurotization via spinal accessory nerve in complete paralisis due to multiple avulsion injuries of the brachial plexus.
Clin Orthop, 237 (1988), pp. 67-74
[46.]
Y. Hattori, D. Kazuteru, S. Toh, A.S. Baliarsing.
Surgical approach to the spinal accesory nerve for brachial plexus reconstruction.
J Hand Surg Am, 26A (2001), pp. 1073-1076
[47.]
Chuang DCC.
Nerve transfer.
The Brachial Plexus, pp. 51-62
[48.]
Y.D. Gu, M.M. Wu, Y.L. Zheng, J.A. Zhao, G.M. Zhang, D.S. Chen, et al.
Phrenic nerve transfer for brachial plexus motor neurotization.
Microsurgery, 10 (1989), pp. 287-289
[49.]
D.C.C. Chuang, F.C. Wei, M.S. Noodhoff.
Cross-chest C7 nerve grafting followed by free muscle transplantation for the treatment of total avulsed brachial plexus injuries.
Plast Reconstr Surg, 92 (1993), pp. 717-725
[50.]
Y.D. Gu, D.S. Chen, G.M. Zhang, X.M. Cheng, J.G. Xu, L.Y. Zhang, et al.
Long-term functional results of contralateral C7 transfer.
J Reconstr Microsurg, 14 (1998), pp. 57-59
[51.]
P. Songcharoen, S. Wongtrakul, B. Mahaisavariya, R.J. Spinner.
Hemi-contralateral C7 transfer to median nerve in the treatment of root avulsion brachial plexus injury.
J Hand Surg Am, 26A (2001), pp. 1058-1064
[52.]
A. Gilbert.
Neurotization by contralateral pectoral nerve. Presented at the 10th Symposium of the brachial plexus.
Lausanne, Switzerland, (January 1992),
[53.]
A.O. Narakas.
Lésions anatomo-pathologiques dans les paralysies traumatiques du plexus brachial.
Les paralysies du plexus brachial,
[54.]
R.S. Boome, J.C. Kaye.
Obstetric traction injuries of the brachial plexus. Natural History, indications for surgical repair and results.
J Bone Joint Surg Br, 70B (1988), pp. 571-576
[55.]
H.M. Clarke, C.G. Curtis.
An approach to obstetrical brachial plexus injuries.
Hand Clinics, 11 (1995), pp. 563-580
[56.]
M.L. Pearl, B.W. Edgerton.
Glenoid deformity secondary to brachial birth palsy.
J Bone Joint Surg Am, 80A (1998), pp. 659-667
[57.]
P.M. Waters, G.R. Smith, D. Jaramillo.
Glenohumeral deformity secondary to brachial plexus birth palsy.
J Bone Joint Surg Am, 80A (1998), pp. 668-677
[58.]
P.M. Waters.
Comparison of the natural history, the outcome of microsurgical repair, and the outcome of the operative reconstruction in brachial plexus birth palsy.
J Bone Joint Surg Am, 81A (1999), pp. 649-659
[59.]
V. Bentolilla, R. Nizard, P. Bizot, L. Sedel.
Complete traumatic brachial plexus palsy.
J Bone Joint Surg Am, 81A (1999), pp. 20-28
[60.]
A. Gilbert, I. Whitaker.
Obstetrical brachial plexus lesions.
J Hand Surg Br, 16B (1991), pp. 489-491
[61.]
A. Gilbert, R. Brockman, H. Carlioz.
Surgical treatment of brachial plexus birth palsy.
Clin Orthop, 264 (1991), pp. 39-47
[62.]
A. Gilbert.
Indications et resultatas de la chirurgie du plexus brachial dans la paralysie obstetricale.
Les paralysies du plexus brachial,
[63.]
R.W. Marshall, D.H. Williams, R. Birch, G. Bonney.
Operations to restore elbow flexion after brachial plexus injuries.
J Bone Joint Surg Br, 70B (1988), pp. 577-582
[64.]
K. Doi, K. Sakai, N. Kuwata, K. Ihara, S. Kucai.
. Reconstruction of finger and elbow function after complete avulsion of the brachial plexus.
J Hand Surg Am, 16A (1991), pp. 796-803
[65.]
M.M. Hoffer, G.J. Phipps.
Closed reduction and tendon transfer for treatment of dislocation of the glenohumeral joint secondary to brachial plexus birth palsy.
J Bone Joint Surg Am, 80A (1998), pp. 997-1001
[66.]
J.M. Kirkos, I.A. Papadopoulos.
Late treatment of brachial plexus palsy secondary to birth injuries: Rotation osteotomy of the proximal part of the humerus.
J Bone Joint Surg Am, 80A (1998), pp. 1477-1483
[67.]
G.A. Brunelli, G.R. Brunelli.
Miscellaneous conditions. Radiation injuries.
The brachial plexus, pp. 135-138
[68.]
C.B. Wynn Parry.
Management of deafferentation pain.
The brachial plexus, pp. 165-168
[69.]
A.O. Narakas.
Problems and challenges.
J Hand Surg Am, 10A (1985), pp. 992-993
[70.]
B.S. Nashold, R.H. Ostdahl.
Dorsal root entry zone lesion for pain relief.
J Neurosurg, 51 (1979), pp. 59-69
[71.]
J. Bruxelle, V. Travers, J.B. Thiebaut.
Occurrence and treatment of pain after brachial plexus injury.
Clin Orthop, 237 (1988), pp. 87-95
Copyright © 2003. Sociedad Española de Cirugia Ortopédica y Traumatología (SECOT)
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