Autoneuroplasty method in treatment of brachial plexus posttraumatic defects
Objectives. The study of the effectiveness of autoneuroplasty operations of the brachial plexus (BP) structures with the use of advanced techniques depending on the level of the brachial plexus damage, the length of diastasis and timing of the injury. Methods. Autoneuroplasty was carried out in 13 patients with the outcomes of the brachial plexus damage; according to a standard technique in 8 (61,5%) patients, according to an advanced technique in 5 (38,5%) patients. Following differentiated approach to the implementation of the method depending on the length of diastasis at certain levels of BP, on the localization of fasciculi of the separate nerves in the BP trunks, prevention of dehiscence at the level of anastomosis were the main differences of the advanced technique. Results. Use of the advanced technique permitted to increase the results of autoneuroplasty from 22,8% up to100%. Autoneuroplasty efficacy was higher at diastasis from 2,3 to 7,0cm and didn,t depend on the level of the operative intervention. Autoneuroplasty surgeries are to be carried out more appropriately in terms up to 6 months after traumas. Conclusions. Advanced autoneuroplasty of BP structures is an effective method of surgical treatment of outcomes of its traumatic injury with the disturbance of its integrity on the extension.