Case: Traditional surgical intervention for brachial plexus birth injury (BPBI) has involved proximal nerve grafting. At the age of 6 months, an infant with Klumpke birth palsy had not recovered finger flexion and extension. He underwent extensor carpi radialis brevis to anterior interosseous nerve and supinator-to-posterior interosseous nerve transfers. Three months postoperatively, he was noted to have recovery of finger flexion and extension which continued to improve to 18 months postoperative follow-up.
Conclusion: This case shows effectiveness of early surgical intervention using distal nerve transfers, as opposed to traditional proximal nerve grafting, for reanimating the hand in BPBI.
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http://dx.doi.org/10.2106/JBJS.CC.24.00368 | DOI Listing |
Acc Mater Res
December 2024
The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332, United States.
As a ubiquitous feature of the biological world, gradation, in either composition or structure, is essential to many functions and processes. Taking protein gradation as an example, it plays a pivotal role in the development and evolution of human bodies, including stimulation and direction of the outgrowth of peripheral nerves in a developing fetus. It is also critically involved in wound healing by attracting and guiding immune cells to the site of injury or infection.
View Article and Find Full Text PDFFront Aging Neurosci
December 2024
Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Nat Commun
December 2024
Nanobiology Institute, Yale University, West Haven, CT, USA.
Neurotransmitters are released from synaptic vesicles with remarkable precision in response to presynaptic calcium influx but exhibit significant heterogeneity in exocytosis timing and efficacy based on the recent history of activity. This heterogeneity is critical for information transfer in the brain, yet its molecular basis remains poorly understood. Here, we employ a biochemically-defined fusion assay under physiologically relevant conditions to delineate the minimal protein machinery sufficient to account for various modes of calcium-triggered vesicle fusion dynamics.
View Article and Find Full Text PDFPlast Reconstr Surg
December 2024
Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Background: Nerve wraps composed of various autologous and bioengineered materials have been used to bolster nerve repair sites. In this study, we describe the novel use of autologous fascia nerve wraps (AFNW) as an adjunct to epineurial repair and evaluate their effect on inflammatory cytokine expression, intraneural collagen deposition and end-organ reinnervation in rats and use of AFNW in a patient case series.
Methods: Lewis rats received sciatic transection with repair either with or without AFNW, sciatic-to-common peroneal nerve transfer with or without AFNW, or sham surgery (n=14/group).
Plast Reconstr Surg
December 2024
The Peripheral Nerve Injury Service, University Hospitals Birmingham NHS Foundation Trust, UK.
Background: Transfer of the supinator motor branches to the posterior interosseous nerve (SPIN) was first described as a reliable method of restoration of digit extension in cases of paralysis when there is retained function in the 5th and 6th cervical nerve roots with loss of function in the 8th cervical nerve root.
Methods: We performed a retrospective review of all the SPIN transfers that were performed in our unit which included 16 limbs in 14 patients over a 6-year period. The median age was 49 years (range 22-74).
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