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Anatomical possibilities of the suprascapular nerve reconstruction by dorsal approach
Krajcová, Aneta ; Kaiser, Radek (advisor) ; Kachlík, David (referee) ; Měšťák, Ondřej (referee)
The presented dissertation primarily investigates new possibilities of targeted reconstruction of the lower branch of the suprascapular nerve for the infraspinatus muscle in patients with palsy of external rotation of the arm. It arises either on the basis of the brachial plexus palsy or during fractures of the scapula. The aim of the first part of the thesis was to use a systematic review of the literature and a subsequent meta-analysis to define data on the epidemiology and etiopathogenesis of severe injuries to the brachial plexus, which are indicated for surgical treatment. The second part describes two experimental studies on the reconstruction of the lower branch of the suprascapular nerve using the spinal accessory and lower subscapular nerves. Determining the values of the frequency of different types of brachial plexus lesions and their dependence on gender and causal mechanisms can be used as a basic reference when informing patients and the professional public about these types of injuries. In the experiment, it was proven that both methods of the suprascapular nerve reconstruction can be used in the vast majority of cadavers. They are thus potentially usable in clinical practice depending on the type of injury.
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The determination of the end-to-side anastomosis within the neurotization techni ques in thebrachial plexus reconstruction and the influence of the locally appli ed VEGF on the peripheral nerve regeneration
Kaiser, Radek ; Haninec, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Ehler, Edvard (referee)
There is rising importance of the brachial plexus injury firstly due to its increasing incidence as a result of higher survival rate of the patients after polytrauma and due to the higher success rate of the surgical treatment. Recently, the obstetric brachial plexus palsy is the area of interest of many articles. The indication criterion is one of the most important problems to be solved as well as increasing awareness about the possibility of the surgical treatment. Many of injured elements of the brachial plexus are reconstructed by a donor nerve transfered onto the recipient nerve, i.e. by neurotization. This method can have better outcome than the suturing of the proximal parts of the plexus especially due to its main advantage - suturing as close to the muscle as possible. It is still not clear which donor nerve is better to use for neurotization of specific recipients due to the lack of large randomized clinical trials. End-to-side anatomosis (ETS) was re-discovered at the beginning of 90's at the same time when the Oberlin method (OT) was firstly described in the literaure. These techniques are applicable only in the Erb's palsy with functional lower part of the plexus. The basis of the effect of ETS anastomosis is the collateral sprouting of the axons which is one of the most important...
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The determination of the end-to-side anastomosis within the neurotization techni ques in thebrachial plexus reconstruction and the influence of the locally appli ed VEGF on the peripheral nerve regeneration
Kaiser, Radek ; Haninec, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Ehler, Edvard (referee)
There is rising importance of the brachial plexus injury firstly due to its increasing incidence as a result of higher survival rate of the patients after polytrauma and due to the higher success rate of the surgical treatment. Recently, the obstetric brachial plexus palsy is the area of interest of many articles. The indication criterion is one of the most important problems to be solved as well as increasing awareness about the possibility of the surgical treatment. Many of injured elements of the brachial plexus are reconstructed by a donor nerve transfered onto the recipient nerve, i.e. by neurotization. This method can have better outcome than the suturing of the proximal parts of the plexus especially due to its main advantage - suturing as close to the muscle as possible. It is still not clear which donor nerve is better to use for neurotization of specific recipients due to the lack of large randomized clinical trials. End-to-side anatomosis (ETS) was re-discovered at the beginning of 90's at the same time when the Oberlin method (OT) was firstly described in the literaure. These techniques are applicable only in the Erb's palsy with functional lower part of the plexus. The basis of the effect of ETS anastomosis is the collateral sprouting of the axons which is one of the most important...
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