Obstetric brachial plexus lesions : a framework for therapy

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Obstetric brachial plexus lesions : a framework for therapy

Title: Obstetric brachial plexus lesions : a framework for therapy
Author: Pondaag, Willem
Publisher: Department of Neurosurgery, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2012-02-15
Keywords: Obstetric brachial plexus lesion
Peripheral nerve surgery
Brachial Plexus/surgery [MESH]
Brachial Plexus Neuropathies/surgery [MESH]
Brachial Plexus Neuropathies/physiopathology [MESH]
Paralysis, Obstetric/physiopathology [MESH]
Birth Injuries/physiopathology [MESH]
Electromyography [MESH]
Erb’s palsy
Abstract: An obstetric brachial plexus lesion (OBPL) is a traction injury of a peripheral nerve network resulting in function loss of the upper limb – which may be permanent. The aim of this thesis is to provide a conceptual framework for treatment of infants with an OBPL. The research is largely based on our own patient cohort of the LUMC Department of Neurosurgery, which serves as a tertiary referral center in the Netherlands. Each year, 25-35 infants are treated with nerve surgery. Part 1 consists of a general introduction, a historical overview, and a critical analysis of selection criteria for surgery advocated by different surgeons. Part 2 describes obstetric factors related to the severity of OBPL in our own patient cohort. In addition, a systematic literature review of the natural history is presented. Part 3 evaluates the use of electrodiagnostic studies (EMG, NAP, CMAP) in the preoperative and intra-operative assessment of lesion severity. Part 4 consists of four outcome studies of nerve surgery. Three chapters describe results of the LUMC patient cohort, and one chapter presents the results of an innovative technique performed by Prof Gilbert, one of the OBPL pioneers. Part 5 consists of a summary and discussion of all chapters.
Description: Promotor: M.J.A. Malessy
With Summary in Dutch
Faculty: LUMC
Citation: Pondaag, W., 2012, Doctoral Thesis, Leiden University
ISBN: 9789461911513
Sponsor: Dept of Neurosurgery LUMC, Braun, Biomet, Implantcast, Nycomed, Zeiss
Handle: http://hdl.handle.net/1887/18486
 

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