Dr. Ali Al-Bayati

Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.tv

The patient came to the clinic 07-March-2006 with flail right upper limb. The patient is an Iraqi citizen got RTA 02-August-2004 with avulsion injury to the right upper limb and fracture of the right humerus mid-third. The patient underwent several operations for the fracture and neurolysis.

On examination, the deltoid , supra-infraspinatus , biceps brachii muscles are completely paralyzed. The median and ulnar nerves are completely not functioning. The triceps is weak 4/5 and the brachioradialis muscle is 2/5.

MRI performed 07-March-2006 showing avulsion of right C7 root and ECS confirmed extensive injury of the right brachial plexus with absent response from right C6-7 and T1 roots.

The patient underwent exploration of the brachial plexus through the most ugly incision undertaken before. The pectoralis major was bisected for 3 cm to have more superior access to the brachial plexus. The median nerve was identified from the most distal part and followed up to end with vigorous scan without neural elements.

The brachial artery and vein were dissected and preserved, trying during that to preserve the integrity of the lymphatic nodes and channels.

The ulnar nerve was identified distally and followed proximally. It was penetrating the bone with useless neural elements at the lower third of the arm. 

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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved