Adult Brachial Plexus Injuries. Part 1: Anatomy, Exam and Evaluation

Autores/as

DOI:

https://doi.org/10.25214/28056272.1177

Palabras clave:

Plexo braquial, Plexopatia braquial, Lesión del nervio periferico

Resumen

Introducción. El plexo braquial es una red intrincada de nervios que proveen la inervación sensitiva y motora de la cintura escapular y la extremidad superior. Diferentes mecanismos pueden lesionar estos nervios en diferentes grados y localizaciones, y en los casos más severos las raíces se avulsionan de la médula espinal resultando en una pérdida global de la función y la sensibilidad de la extremidad superior.

Objetivos. Revisar la anatomía del plexo braquial y los mecanismos y patrones de lesión; proveer guías para una evaluación estructurada, y revisar el rol de los estudios diagnósticos.

Resultados. El conocimiento sobre la anatomía del plexo braquial es útil para identificar el sitio de la lesión y elegir el tratamiento más adecuado. La tracción cerrada es el mecanismo más común de lesión en esta red de nervios y la mayoría de lesiones son completas en el momento de la presentación. El examen físico es fundamental para descartar situaciones que ponen en riesgo la vida, interpretar los estudios diagnósticos y tomar decisiones durante el tratamiento. El mielotac es el estándar de oro de las imágenes diagnósticas y el electrodiagnóstico es la manera más confiable de identificar la lesión nerviosa y documentar los signos más tempranos de reinervación. Aunque existe una gran variedad de opciones para restaurar la función, la elección depende de los nervios lesionados y de los hallazgos al examen físico.

Conclusión. El pronóstico de las lesiones del plexo braquial depende de un diagnóstico correcto y oportuno. Los procesos diagnósticos multifactoriales buscan delimitar las opciones para ayudar al cirujano a decidir el mejor curso de tratamiento y evitar pérdidas de tiempo.

Biografía del autor/a

María Cristina Rodríguez Ricardo, Javeriana Pontifical University

Javeriana Pontifical University, Department of Orthopaedic Surgery, Bogotá D.C., Colombia. El Bosque University, Hand Surgeon and Microsurgeon, Bogotá D.C., Colombia.

Luis Alejandro García González, Javeriana Pontifical University

Javeriana Pontifical University, Department of Orthopaedic Surgery, Bogotá D.C., Colombia.

Alexander Y. Shin, Mayo Clinic

Mayo Clinic, Department of Orthopaedic Surgery, Division of Hand and Microvascular Surgery, Rochester, Minnesota.

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Publicado

2021-09-11

Cómo citar

Rodríguez Ricardo, M. C., García González, L. A., & Shin, A. Y. (2021). Adult Brachial Plexus Injuries. Part 1: Anatomy, Exam and Evaluation. Cirugía De Mano Y Microcirugía, 1(1), 15–23. https://doi.org/10.25214/28056272.1177

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