Plexus brachialis strain and compression deformation in the costo-axillary-brachial region: A cadaveric study

Edgars Vasilevskis, Sandra Skuja, Irina Evansa, Eva Šteina, Anna Sondore Pilipa, Grigorijs Vabels, Uldis Teibe, Haralds Jansons, Valerija Groma, Indulis Vanags

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
7 Downloads (Pure)

Abstract

Objective: The aim of this study was to clarify the role of different mechanisms in nerve injury during arm abduction positions. The tasks were to determine the strain deformation of the plexus brachialis during arm abduction, to measure the pressures in the neurovascular bundle in the cervico-costoclavicular-axillary area, and evaluate the histological changes of nerve after the stretch test. Material and Methods: During the cadaveric study on 7 specimens 7-20 h after death, strain deformation of plexus brachialis as well as compression deformation caused by the surrounding structures of the neurovascular bundle were investigated in the arm abduction position of 0°, 90°, 12°, 150°, and 180°. One nerve sample was studied histologically after 15% stretch on the bench. Results: The relative strain deformation of 3%-23% was documented during 0° to 180° abduction tests. The strain deformation from 0° to 90° was significant (P<0.001). The mean pressure change in the bundle was 13.6 mm Hg at 90°, 53.7 mm Hg at 120°, 73.4 mm Hg at 150°, and 89.0 mm Hg at 180° arm abduction. An increase in pressure was significant in the intervals: 0°-90° (P<0.001), 91°-120° (P<0.001), 121°-150° (P<0.001) and 151°-180° (P<0.05). Conclusions: Nerve traction and tissue compression arising during the arm abduction above 90° were found to be sufficient to induce lesions in neural bundles of the plexus brachialis.

Original languageEnglish
Pages (from-to)566-572
Number of pages7
JournalMedicina
Volume47
Issue number10
DOIs
Publication statusPublished - 2011

Keywords*

  • Compression deformation
  • Plexus brachialis
  • Postoperative neuropathy
  • Strain deformation

Field of Science*

  • 3.1 Basic medicine
  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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