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Effect of Ropivacaine in Combined Costoclavicular Brachial Plexus - Cervical Plexus Blocks on Hemidiaphragmatic Paralysis for Humeral Fracture Surgery: A Prospective Single - Centre Cohort Study.
Drug Des Devel Ther
December 2024
Department of Orthopedics, Ningbo No.6 hospital, Ningbo University School of Medicine, Ningbo, Zhejiang, People's Republic of China.
Background: The brachial plexus block is conducive to providing postoperative analgesia for patients with humeral fractures. The commonly used brachial plexus block techniques have a high incidence rate of hemidiaphragmatic paralysis (HDP), which may lead to respiratory problems. The combined costoclavicular brachial plexus - cervical plexus blocks (CCB-CPBs) had demonstrated favorable analgesic effects and had reduced the incidence of HDP in shoulder surgeries.
View Article and Find Full Text PDFSymptomatic Nonunion of the Coracoid Process Following Osteosynthesis Using a Suture Button for Coracoid Process and Distal Clavicle Fracture: A Case Report.
Am J Case Rep
March 2024
Department of Orthopaedics, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan.
BACKGROUND Coracoid process fractures are uncommon and are often complicated by many types of shoulder girdle injuries. Previous reports have shown that osteosynthesis for isolated coracoid process fractures results in favorable outcomes and high bone union rates. However, owing to the rarity of coracoid process fractures combined with distal clavicle fractures, there are limited data to guide treatment strategies.
View Article and Find Full Text PDFCombined Infraclavicular-Suprascapular Nerve Blocks Compared With Interscalene Block for Arthroscopic Rotator Cuff Repair: A Prospective, Randomized, Double-blind, and Comparative Clinical Trial.
Pain Physician
November 2023
Pain and Intensive Care Medicine, Fayoum University, Fayoum, Egypt.
Background: The gold standard postoperative analgesia protocol for arthroscopic rotator cuff repair procedures is the interscalene block (ISB), which prevents the significant consequences of phrenic nerve block associated with hemidiaphragmatic paralysis (HDP). The infraclavicular brachial plexus block (BPB) combined with the suprascapular nerve block (SSNB) had the same analgesic efficacy as the infraclavicular BPB alone, with no effect on respiration.
Objectives: Therefore, the study aimed to assess the HDP and analgesic efficacy of both approaches in controlling pain following arthroscopic rotator cuff repair surgeries.
Modern Treatment of Neurogenic Thoracic Outlet Syndrome: Pathoanatomy, Diagnosis, and Arthroscopic Surgical Technique.
J Hand Surg Glob Online
July 2023
Department of Orthopaedic Surgery, Hand & Upper Extremity Surgery, Emory University School of Medicine, Atlanta, GA.
Article Synopsis
- Thoracic outlet syndrome (TOS) is primarily a neurogenic condition caused by compression in the supraclavicular and infraclavicular fossae, linked to issues like repetitive overhead activities and scapular dyskinesia.
- This condition involves muscle contractures that narrow key anatomical spaces, leading to brachial plexus compression and specific syndromes like pectoralis minor syndrome when symptoms are localized to the infraclavicular area.
- Diagnosis requires a thorough history, physical examination, and imaging; most patients respond well to nonsurgical treatments, but surgery is an option for those who don’t improve, with techniques evolving towards less invasive endoscopic procedures.
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