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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Plexus brachialis Strain and Compression Deformation in the Costo-Axillary-Brachial Region: A Cadaveric Study

1
Department of Anesthesiology, Riga Stradins University, Latvia
2
Department of Histology, Riga Stradins University, Latvia
3
State Forensic Medicine Center, Riga, Latvia
4
Department of Physics, Riga Stradins University, Latvia
5
Riga Stradins University, Latvia
*
Authors to whom correspondence should be addressed.
Medicina 2011, 47(10), 81; https://doi.org/10.3390/medicina47100081
Received: 6 September 2010 / Accepted: 31 October 2011 / Published: 5 November 2011
Objective. The aim of this study was to clarify the role of different mechanisms in nerve injury during arm abduction positions. The tasks were to determine the strain deformation of the plexus brachialis during arm abduction, to measure the pressures in the neurovascular bundle in the cervico-costoclavicular-axillary area, and evaluate the histological changes of nerve after the stretch test.
Material and Methods.
During the cadaveric study on 7 specimens 7–20 h after death, strain deformation of plexus brachialis as well as compression deformation caused by the surrounding structures of the neurovascular bundle were investigated in the arm abduction position of 0°, 90°, 12°, 150°, and 180°. One nerve sample was studied histologically after 15% stretch on the bench.
Results
. The relative strain deformation of 3%–23% was documented during 0° to 180° abduction tests. The strain deformation from 0° to 90° was significant (P<0.001). The mean pressure change in the bundle was 13.6 mm Hg at 90°, 53.7 mm Hg at 120°, 73.4 mm Hg at 150°, and 89.0 mm Hg at 180° arm abduction. An increase in pressure was significant in the intervals: 0°–90° (P<0.001), 91°–120° (P<0.001), 121°–150° (P<0.001) and 151°–180° (P<0.05).
Conclusions.
Nerve traction and tissue compression arising during the arm abduction above 90° were found to be sufficient to induce lesions in neural bundles of the plexus brachialis.
Keywords: postoperative neuropathy; plexus brachialis; strain deformation; compression deformation postoperative neuropathy; plexus brachialis; strain deformation; compression deformation
MDPI and ACS Style

Vasilevskis, E.; Skuja, S.; Evansa, I.; Šteina, E.; Pīlipa, A.S.; Vābels, G.; Teibe, U.; Jansons, H.; Groma, V.; Vanags, I. Plexus brachialis Strain and Compression Deformation in the Costo-Axillary-Brachial Region: A Cadaveric Study. Medicina 2011, 47, 81.

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