Differences in strength fatigue when using different donors in traumatic brachial plexus injuries View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-06-18

AUTHORS

Mariano Socolovsky, Gonzalo Bonilla, Ana Carolina Lovaglio, Gilda di Masi

ABSTRACT

BackgroundThe purpose of this study was to assess the results of elbow flexion strength fatigue, rather than the maximal power of strength, after brachial plexus re-innervation with phrenic and spinal accessory nerves. We designed a simple but specific test to study whether statistical differences were observed among those two donor nerves.MethodWe retrospectively reviewed patients with severe brachial plexus palsy for which either phrenic nerve (PN) or spinal accessory nerve (SAN) to musculocutaneous nerve (MCN) transfer was performed. A dynamometer was used to determine the maximal contraction strength. One and two kilograms circular weights were utilized to measure isometrically the duration of submaximal and near-maximal contraction time. Statistical analysis was performed between the two groups.ResultsTwenty-eight patients were included: 21 with a PN transfer while 7 with a SAN transfer for elbow flexion. The mean time from trauma to surgery was 7.1 months for spinal accessory nerve versus 5.2 for phrenic nerve, and the mean follow-up was 57.7 and 38.6 months, respectively. Statistical analysis showed a quicker fatigue for the PN, such that patients with the SAN transfer could hold weights of 1 kg and 2 kg for a mean of 91.0 and 61.6 s, respectively, while patients with transfer of the phrenic nerve could hold 1 kg and 2 kg weights for just a mean of 41.7 and 19.6 s, respectively. Both differences were statistically significant (at p = 0.006 and 0.011, respectively). Upon correlation analysis, endurances at 1 kg and 2 kg were strongly correlated, with r = 0.85 (p < 0.001).ConclusionsOur results suggest that phrenic to musculocutaneous nerve transfer showed an increased muscular fatigue when compared with spinal accessory nerve to musculocutaneous transfer. Further studies designed to analyze this relation should be performed to increase our knowledge about strength endurance/fatigue and muscle re-innervation. More... »

PAGES

1913-1919

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00701-020-04454-y

DOI

http://dx.doi.org/10.1007/s00701-020-04454-y

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https://app.dimensions.ai/details/publication/pub.1128581081

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32556814


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