Assuntos
Fratura-Luxação/complicações , Fixação Interna de Fraturas/métodos , Fraturas do Úmero/complicações , Neuropatia Radial/etiologia , Neuropatia Radial/cirurgia , Criança , Articulação do Cotovelo/cirurgia , Feminino , Seguimentos , Fratura-Luxação/diagnóstico por imagem , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Escala de Gravidade do Ferimento , Neuropatia Radial/diagnóstico por imagem , Recuperação de Função Fisiológica/fisiologia , Medição de Risco , Resultado do Tratamento , Lesões no CotoveloRESUMO
Brachial plexus injuries (BPI) can be complicated by diaphragmatic paralysis (DP). This study determined the influence of DP on biceps brachii (BB) recovery after intercostal nerve transfer (ICNT) for BPI and investigated the respiratory complications of ICNT. The study included 100 patients, 84 showing no DP in preoperative and early postoperative chest radiographic images (non-DP group) and 16 with DP that persisted for over one year after surgery (DP group). The postoperative reinnervation time did not differ between groups. BB strength one year after surgery was lower in the DP group than non-DP group (p = 0.0007). No differences were observed 2-3 years after surgery. In the DP group, four patients had respiratory symptoms that affected daily activities and their outcomes deteriorated (p = 0.04). Phrenic nerve transfer should not be combined with ICNT in patients with poor respiratory function because of the high incidence of respiratory complications.
