Dissertation > Excellent graduate degree dissertation topics show

C3、4 Transfer for Reconstruction of Erb’s Brachial Plexus

Author: CaoXueCheng
Tutor: CaiJinFang
School: Second Military Medical University
Course: Orthopedics
Keywords: Indexable therapy Brachial plexus Avulsion Radicular Deltoid muscle Biceps Anatomical Observation Nerve root Electrophysiological examination Significant difference
CLC: R651.3
Type: PhD thesis
Year: 2002
Downloads: 61
Quote: 0
Read: Download Dissertation

Abstract


Branch neurotization to restore specific function of the arm is the common practice for avulsion injury of brachial plexus. We proposed the concept of "root or trunk reconstruction". As a method of "root reconstruction", we adopted C3, 4 transferring for reconstruction of C5,6 root avulsion. Anatomic, experimental studies and clinical application were conducted.In experimental Study, eighteen New Zealand rabbits were randomly divided into three groups. In group A, C3, 4 nerve roots were transferred to C5, 6 roots after avulsion with nerve graft. In group B, C5, 6 nerve roots were directly sutured after dissection. Group C was made as a negative group in which C5,6 roots were unrepaired after avulsion. All the three groups were positively controlled by contra lateral sides. Functional, anatomical, electrophysiological and histological studies were conducted postoperatively. The results showed that active motion of experimental limbs was not fond in all the three groups. Electrophysiological examination four months after operation showed that the neutrotization level of C3,4 transfer was weaker than that of direct suture. Histological study confirmed the existance of motor fibers in group A and B but C. These findings indicate that extraplexal nerve transfer indeed could re-neurotize the avulsed nerve roots down to the target organ and "root or trunk repair" for avulsion injury of brachial plexus is possible provided the donor nerve has enough fibers and nerve regeneration ability is increased by modern techniques.Based on the experimental studies, 6 patients with avulsion injuries of brachial plexus were treated by C3,4 transferring. The operating time was less than 6 months. 5 patients were followed up less than 6 months and partial sensation was restored while the motor function is in the process of recovering. One patient was followed-up for 14 months. The patients could abduct and flex his shoulder and sensation restoration was satisfactory.To facilitate the operation, we conducted anatomical study on cervical plexus. Ten fresh corpses were used in the study. We found that there were extensive communications and loops among the cervical plexus. Both motor and sensory fibers were contained in the roots. C3,4 nerve root were comparable with C5,6 in terms of diameter.

Related Dissertations

  1. Study on the Influence of Weaning Stress on Blood and Biochemical Profiles in Pigs,S828
  2. Application of 3.0T Magnetic Resonance Neurography in Diagnosing Spinal Nerves Diseases,R745
  3. Application of De-rotation Osteotomy of Ulnar and Radial Bone in the Treatment of Obstetric Brachial Plexus Palsy,R726.8
  4. Overuse Could Induce Rat Long Head of Biceps Tendon Injury and Apoptosis of Tenocyte,R686
  5. Clinical Outcome of Contralateral C7 Nerve Root Transfer and Application of Intraoperative Electrophysiological Test,R651.3
  6. Clinical Application in Diagnosis of Brachial Plexus Avulsion by MRI,R651.3
  7. Yasunari Kawabata view of women,I313
  8. Effects of Radicular Dentin Treatments and Luting Materials on the Bond of Quartz Fiber Posts in Vitro,R783
  9. Expression of bFGF and PDGF-A in Choroidal Tear Trauma,R779.1
  10. Knife Therapy and Plasma Cutter Knife Treatment of Nerve Root Type Cervical Spondylosis Clinical Research,R246
  11. The Comparision of Trunk Repair and Branch Repair of Brachial Plexus with Root Avulsion Injury,R651.3
  12. Clinical Study on Treatment of Cervical Spondylosis of Nerve-Root Type by Electroacupuncture at Jiaji Point,R246
  13. Analysis on Clinical Efficacy of the Traction with Cervical Spine Tuina on the Treatment for Nerve Root Type Cervical Spondylosis,R274.9
  14. Clinical Observation on Electro-Acupuncture and Massage Treatment of Cervical Spondylosis of Nerve-Root Type,R246
  15. Experimental Study of Jiaja EA for Cervical Spondylotic Radiculopathy Rats Analgesia Mechanism,R245
  16. Clinical Research on the Treatment of Cervical Spondylotic Radiculopathy by Tuina Manipulation of Give Priority to Massage Jiaji Acupoint,R274.9
  17. Research on the Reliability and Validity of the Disease and Syndrome Combined Scale on Nerve-root Cervical Spondylosis,R274.9
  18. The Clinical Research of Nine-needle Around the Injury Layer Therapy with Ultrared Radiation for Cervical Spondylotic Radiuopathy,R246
  19. The Minimum Local Anesthetic Concentration of Ropivacaine in Patient Receiving Infraclavicular Brachial Plexus Block,R614
  20. Clinical Investigation and Preventional Measures Study on Neurological Complications of Regional Anesthesia,R614
  21. A Model of Skin Flap Crush Injuries in Rats Using Intravital Microscopy and Vasonatrin Peptide (VNP) Protects the Skin Flap Against Crush-avulsion Injury,R641

CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Peripheral nerve
© 2012 www.DissertationTopic.Net  Mobile