Index A forearm, superficial radial and lateral cutaneous Abdomen and pelvis, 270–271 nerves of, 8, 18 sympathetic system, 36 hand, median and ulnar nerves in, 17 Ablation, central nervous system, 557–558 median nerve, 16 Acromegaly, 488 musculocutaneous nerve, 14 Action potential, ion channels, 56, 57 phrenic nerve, course of, 9 Adult radial nerve, 14 cutaneous sensation, recovery of, 130 right axilla and arm, 12 traumatic brachial plexopathy, 214 suprascapular and circumflex nerves, 13 Afferent autonomic pathways, 37 suprascapular nerves, 13 Ageing, peripheral nerve fibres changes, 59–61 trunks and cords, 7 Alcohol, iatrogenous injuries, 487 ulnar nerve, 16 Allodynia, 529 Anterior tarsal tunnel syndrome, 220 Allografts, large gaps repair, 125–126 Arterial thoracic outlet syndrome, 277–279 Amputation Articaine, 503 limbs, 629 Atrophy, of foot, 110 reconstruction, 601–602 Autonomic nerve fibres, sweat glands, 65 revascularisation Autonomic nervous system axillary artery, rupture, 337, 338 afferent autonomic pathways, 37 brachial plexus, 333–334 efferent and afferent paths, 33 closed infraclavicular lesion, 334–339 parasympathetic nervous system, 36 incomplete avulsion injury, 336 sympathetic system median and ulnar nerves, 338 abdomen and pelvis, 36 patterns, 335 cervico thoracic (stellate) ganglion, 34 suprascapular and circumflex nerves, 339 in chest and abdomen, 35 Anatomy Avulsed ventral root autonomic nervous system, 2 (see also Autonomic reinnervation, 399 nervous system) repair, 410–411 cervical nerves, from spinal cord, 1 Avulsion lesion, spinal nerves repair cranial and spinal nerves (see also Cranial nerves; Spinal nerves) abdomen and pelvis, 270–271 brainstem and cervical cord, laminectomy, 4 anterolateral transvertebral approach, 262 division of, 2 brachial plexus, infraclavicular part of, 265 hemilaminectomy, 3 circumflex nerve, 266 origin of roots, 2 endoscopic transforaminal approach, 262 spine and spinal cord, 3 lateral approach, 262–264 musculo skeletal injury, nerves risk, 37–40 median nerves in, 266–269 Ankle plantar nerves and tibial nerve, 273, 275 equino-varus deformity of, 573 posterior interosseous nerve, 267, 269 eversion, 182 radial nerve, 266–267 foot orthosis, 596 sciatic nerve, 271–272 and heel, lumbar and sacral anterior primary rami, 30 spinal accessory nerve, 264–265 schwannoma, 539 suprascapular nerve, 265 Anterior horn cell disorders, 224 tibial and common peroneal nerves, 272–274 Anterior interosseous nerve syndrome, 208 ulnar nerves in, 266, 269–270 Anterior primary rami, of spinal nerves Axilla brachial plexus, 7, 10, 11 medial cord rupture, 153 cervical plexus, 8, 9 reversed vein grafting in, 242 circumflex (axillary) nerve, 13 Axillary (circumflex) nerve, upper limb neuropathies, 213 dermatomes distribution, upper limb, 12 Axon, 118, 119 elbow, 15 Axonal transport, peripheral nerve fibres, 57 R. Birch, Surgical Disorders of the Peripheral Nerves, DOI: 10.1007/978-1-84882-108-8, © Springer-Verlag London Limited 2011 631 632 Index Axonotmesis neurophysiological investigations (NPI) and neurotmesis outcome, electrodiagnostic grade, 449 focal mechanical nerve injury, classification of, 82 pre-operative NPI investigations, 450–452 hour glass constriction of, 82 operation peripheral nerve injuries, 204 incomplete lesion, 454 Axoplasm, 43 indications for, 453–454 intra operative conduction studies, 455 B paralysis, evolution of, 454 Bilateral lesion post-operative care, 456–457 penetrating missile injuries, 332 repair, methods of, 456 repair, preganglionic injury, 407–409 ruptured C5 repair, with avulsion, 457 Biopsy, 243–244 recovery, in complete lesion Birth lesions of brachial plexus (BLBP), 217–218, 611–612 elbow and hand, 445 deformities evolution of, 446 biceps pseudotumor, 463 group 4 lesion, 446 C7 and C8, poor recovery for, 467 outcome, 447 clavicle and scapula shortening, 464 spinal nerve in elbow and forearm, 478–479 central affect, 431–432 flexor origin, proximal advancement of, 467 types of, 430, 431 injuries inflicted during, 463 study methods limb, denervation of, 464 C5, C6 and C7, 432 persisting muscular imbalance, 464–465 elbow, flexion and extension of, 434 shoulder dislocation, closed manipulation of, 466 green chart, 438–440 supination, 478–479 group 4 lesion, 434 electrodiagnostic findings, clinical interpretation of, 449 hand function, analysis of, 434 epidemiology inferior scapulo humeral angles, cocontraction bilateral lesion, from breech delivery, 440 and contracture, 436 causation, 437 Klumpke’s lesion, 434 incidence, 436–437 limb growth, 434–435 Mallet score, 444 Mallet chart, 435 natural history, 441 Narakas classification, 432–433 outcome of, 441 records, 432 ranges of active movement in, 445 risk factor chart, 432, 433 risk factors, 437–438, 440–444 scoring system for, 437 shoulder and of forearm rotation, ranges of movement, 443 serratus anterior paralysis, breech delivery, 436 untreated complex subluxation in, pain, 442, 444 shoulder, function of, 433–434, 436 gleno-humeral joint, posterior subluxation and wrist and hand, 434 dislocation (PS/PD) treatment, 447–448 active range of movement, 473 Bleeding, control, 233–234 AP and axial radiographs, after glenoplasty, 476 Blood supply, peripheral nerve fibres course to recovery, after relocation, 474–475 neck, resin cast of, 59 diagnosis and classification, 469–470 segmental medullary (radicular) arteries and anterior incidence of, 472 spinal artery, 60 inferior scapulo-humeral angle, fixed contracture of, 478 spinal cord and cauda equina, dorsal vessels, 58 lateral rotation osteotomy, shoulder dislocation, 471 Bone and muscle transfer, reconstruction, 601 medial rotation contracture, 470–471 Brachial plexus radiological and operative findings in, 476 amputation revascularisation, 333–334 reduction, anterior approach, 472 anterior primary rami, 7, 10, 11 secondary deformities, onset and progression of, 467–469 blood supply, 379–380 shoulder function, 477 BLPP, 611–612 group 4 lesion, spontaneous recovery in, 429 complete lesion, 621 imaging, 453 cranial nerves nerve operations, 453 cervical and, 9 afferent function, method of repair, 459 excision of clavicles, 10 breech delivery, 461 and great vessels, 11 C5 and 6 rupture, C7, C8 and T1 avulsion, 462 left, 11 case report, 459 distal stump, 86–87 C5, C6 and C7, repair of, 461 document used for, 186 cocontraction, 463 infraclavicular part of, 265 C5 rupture, C6, C7, C8 and T1 avulsion, 462 lesions in, pain control, 540–541 findings, 460 lesions, upper limb neuropathies grading of results of, 460 adult traumatic brachial plexopathy, 214 late reinnervation, 462 birth lesion of, 217–218 results of repair, 461 electrodiagnostic findings, in pre and post-ganglionic spinal nerves, 460, 461 lesions, 214 ulnar nerve, 459 elements, 215 Index 633 neuralgic amyotrophy, 216–217 Complex subluxation (CS), 470 stinger injury, 215–216 Compound muscle action potential (CMAP), 193, 194, 210 true neurogenic thoracic outlet syndrome, 216 Compound nerve injury orthosis, 620 amputation revascularisation penetrating missile injuries, 326–327 brachial plexus, 333–334 preganglionic injury of, 533–534 closed infraclavicular lesion, 334–339 Brachio radialis, elbow, 179 contraindications, 303 Brain derived nerve factor (BDNF), 44–45 lower limb Brainstem and cervical cord, laminectomy, 4 femoral nerve, 360–361 British Association of Otorhinolaryngologists (2002), 485 hip, 363–365 British Society for Clinical Neurophysiology, 206, 207 lumbo sacral plexus, 361–363 Buccal technique, third molar surgery, 509–510 peroneal and tibial nerves, 365–367 Royal National Orthopaedic Hospital, 367–369 C nerves and bone and joint injuries Carcinoma and lympho-proliferative disease, 489 clavicle, 344–345 Carpal tunnel syndrome, 99, 282 elbow, 356–359 Cauda equina, dorsal vessels, 58 forearm, 359–360 Causalgia gleno-humeral joint dislocation, 345–351 case report, 542, 544, 545 iatrogenous injuries, 359 definition of, 542 incidence, 351–355 incidence and, 543–544 musculocutaneous nerve, 355–356 nerve lesion in, 543 nerve to serratus anterior, 344 response to direct treatment, 547–548 pattern of fracture, 341–343 response to sympathetic block/sympathectomy, 546 radial nerve and fractures of humerus, 351 Cell body and proximal stump, reactions to injury spinal accessory nerve, 343–344 chromatolysis, 83 penetrating missile injuries contralateral effects, 85 ballistic peripheral nerve injuries, 331 delay, 84 bilateral lesions, 332 injection injury, 85 brachial plexus, 326–327 perineurium, wounds of, 84–85 delayed primary suture, 323 TRPV1, 83 grafts, 324–326 Central motor conduction time (CMCT), 194–196 high energy transfer (HET), tissue damage, 327 Central nervous system incidence, cause and distribution, 330 definition, 1 low energy transfer (LET), tissue damage, 327 pain massive energy transfer (MET), tissue damage, 327 ablation, 557–558 military rifle bullet wound, 323 case report, 556 MRCR evidence, 323–324 stimulation, 556–557 nerve lesion, 330 Cerebral palsy, reconstruction nerves, 331–332 hip, dislocation of, 565 pain, 328, 330–331 severe pain from dysplasia, 565 peripheral nerves, 328–330 Cervical cord, laminectomy, 4 recovery, 331 Cervical nerves, from spinal cord, 1 sacular aneurysm, 330 Cervical plexus, anterior primary rami, 8, 9 shot gun blast, 322 Cervico thoracic (stellate) ganglion, 34 sciatic nerve, suture, 303 Chest and abdomen, sympathetic system, 35 skin, 320–321 Circumflex nerve vascular lesion avulsion lesion, 266 arterio-venous fistula, axilla, 316 reinnervation of, 252 catastrophic bleeding,