[Surgical treatment of injuries to the distal sections and terminal branches of the brachial plexus in traumatic shoulder dislocations]

A M Tomnikov, V P Dashin, O I Kalashnikova, V R Abramenko, E G Petrova
Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko 1988, (3): 34-8
Twenty-one patients with injury to the brachial plexus suffered as the result of traumatic dislocation of the shoulder were examined and operated on with the use of microsurgical techniques. Traumatic changes of the nerve trunks, the development of a cicatricial-adhesive process around and within them lead to stable disorders of conduction which do not yield to nonoperative treatment. Stable traumatic changes revealed in the nerve trunks on EMG in the first 4-6 weeks after the trauma as well as the absence of an effect of nonoperative treatment within this period of time were indications for surgery. Despite the coarse macroscopic external changes found in the nerves of the brachial plexus they should not be resected without preliminary intratruncal inspection of the fasciculi with intraoperative electrodiagnosis.

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