PubMed · 613709
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D R Miranda. 1977. Continuous brachial plexus block.. https://pubmed.ncbi.nlm.nih.gov/613709/
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Ulnar neuropathies following surgery are common. However, they often go undetected during the early postoperative period, because the patient may be unaware of symptoms related to the neuropathy. Nerve conduction studies are useful in localizing the lesion, but are usually employed only in cases developing signs and symptoms. We undertook this study to determine the incidence, time of onset, and outcome of clinical and subclinical ulnar neuropathies. Electrophysiological studies were carried out preoperatively, immediately following surgery, and 4 to 6 weeks postoperatively in 20 coronary artery bypass patients. Conduction velocity across the elbow was reduced in 3 limbs (8%) postoperatively, all of which were detected immediately following surgery. One patient developed conduction block and weakness in ulnar supplied intrinsic hand muscles. Denervation was seen in 2 cases and, in 1 case (5%), a right brachial plexus injury was clinically evident 5 days following surgery. All newly developing ulnar neuropathies were asymptomatic, with most recovering to their preoperative electrophysiological status at follow-up.
The aim of this study was to establish the incidence and the pattern of referral of injuries to the brachial plexus for a single calendar year: 1987. A questionnaire was sent to every orthopaedic consultant and referral centre in the United Kingdom. Replies were received from 402 surgeons. It is estimated that in 1987 there were at least 336 patients with traumatic injuries and 137 patients with other problems related to the plexus. Only 145 patients were seen at a referral centre. The anatomical nature, mode of injury and methods of treatment were analysed for both the referred and unreferred patients. We found that injuries to the brachial plexus are far more common than is generally appreciated, but only a minority of patients are referred for specialist evaluation and treatment.
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