L’épaule est totalement paralysée, le trapezius est normal ainsi que le pectoralis major ( grand pectoral qui permet de rapprocher le membre supérieur du tronc) et le serratus antérieur ( grand
dentelé qui stabilise l’omoplate).
La flexion du coude est nulle (paralysie du biceps, du brachial antérieur et du brachioradialis). Les Fléchisseurs du coude sont au nombre de trois. Ils dépendent des racines supérieures du plexus
brachial. Le biceps brachial et le brachial antérieur sont les muscles fléchisseurs du bras. Le Brachioradialis où Long supinateur est un muscle de l’avant bras.
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
(tableau en cas d’atteinte de la racine C7 en plus des racines C5 et C6). Le plan d’extension du coude (muscle Triceps), du poignet (muscles Radiaux et Cubital Postérieur) et des chaînes digitales
(muscles extenseurs des doigts et du pouce) est alors paralytique.
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
(tableau en cas d’atteinte de la racine C7 en plus des racines C5 et C6). Le plan d’extension du coude (muscle Triceps), du poignet (muscles Radiaux et Cubital Postérieur) et des chaînes digitales
(muscles extenseurs des doigts et du pouce) est alors paralytique
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
La flexion des doigts longs et du pouce est impossible. Il existe aussi une paralysie des muscles interosseux (rapprochement et écartement des doigts, flexion des articulations
métacarpo-phalangiennes des doigts). Parfois l’extension des articulations métacarpophalangiennes peut être conservée (évoquant un passage par C7 et non C8, des fibres nerveuses à destinée du nerf
radial). L’extension du poignet est le plus souvent normale(muscles radiaux). La main est alors plate et atrophique. Il existe aussi une perte de sensibilité du bord ulnaire de la main, source de
lésions directes (brûlures, ulcérations…).
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
Goubier JN,
Teboul
F,
Papadogeorgou E : Nerve transfers in children with traumatic partial brachial plexus injuries,
publié dans Microsurgery (USA). 2008;28(2):117-20.
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years
old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve transfers have
been performed. Shoulder abduction was restored by an accessory-to-suprascapular nerve transfer in one patient, while the triceps long head motor branch was transferred to the axillary nerve in both
patients. Fascicles of the ulnar and median nerve were transferred respectively to the biceps muscle nerve and the brachialis motor branch. At 11 months follow-up, the elbow flexion scored M4 and the
shoulder abduction recovered in both patients. No complications were observed. Nerve transfers currently used in adult patients may be applied in children with traumatic partial brachial plexus
palsies. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008.
Lire
- Séquelles de Paralysie Obstétricale du Plexus Brachial (récupération mosaïque). Les tableaux cliniques sont très variés. Les motifs habituels de consultation sont les séquelles à la main, les
cocontractions biceps triceps, le défaut de rotation latérale de l’épaule, la supination fixée de l’avant-bras…
- Atteinte des branches terminales : paralysie combinée du nerf supra-scapulaire, du nerf axillaire et musculo-cutané
- Séquelles après luxation d’épaule
- Atteinte plexique traumatique chez les enfants
- Atteinte bilatérale
Partager
Version imprimable 