{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:59:33Z","timestamp":1790420373869,"version":"4.1.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The majority of brachial plexus injuries (BPIs) are caused by trauma; most commonly due to two-wheeler road accidents. It is important to determine whether the lesion in question is pre-ganglionic or post-ganglionic for purposes of surgical planning and prognosis. Diagnostic testing helps the surgeon to not only decide whether surgical intervention is required, but also in planning the procedure, thereby maximizing the patient's chances of early return to function. The aim of the study was to determine the diagnostic efficacy of electrodiagnostic studies (Edx) and magnetic resonance imaging (MRI) individually, and in unison, in detecting the type and site of BPI by comparison with intraoperative findings (which were used as the reference standard) in patients with posttraumatic BPI.<\/jats:p><jats:p>\n          Methods\u2003It is an observational cross-sectional prospective randomized study, wherein 48 patients with BPI underwent a detailed clinical and neurological examination of the upper limb, Edx, MRI neurography and were subsequently operated upon. We assessed a total of 240 roots. The diagnosis of all spinal roots was noted on Edx. MRI was performed to look for root avulsion, pseudomeningocoele, and\/or rupture injury. The patients were subsequently operated upon. All roots were traced from infraclavicular level right up to the foramen to ensure continuity of root or note rupture\/ avulsion. The findings were tabulated.<\/jats:p><jats:p>\n          Results\u2003MRI accurately diagnosed 138 of the 147 injured roots and MRI sensitivity for the detection of BPI was 93.88%, whereas Edx correctly identified 146 out of 147 injured roots and thus, had sensitivity of 99.32%; however, both lacked specificity (18.28 and 20.43%, respectively). With Edx and MRI in unison, sensitivity was 100% which meant that if a given patient with a BPI is subjected to both tests, not a single abnormal root will go unnoticed.<\/jats:p><jats:p>\n          Conclusion\u2003Edx and MRI are two highly sensitive investigation modalities whose combined sensitivity is 100% for the detection of a root injury. Therefore, we recommend both tests as they are excellent screening tests.<\/jats:p>","DOI":"10.1055\/s-0042-1760253","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T23:47:35Z","timestamp":1671752855000},"page":"331-338","source":"Crossref","is-referenced-by-count":5,"title":["Correlation of Magnetic Resonance Imaging (Neurography) and Electrodiagnostic Study Findings with Intraoperative Findings in Post Traumatic Brachial Plexus Palsy"],"prefix":"10.1055","volume":"55","author":[{"given":"Neehar R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6190-7082","authenticated-orcid":false,"given":"Anupam B.","family":"Takwale","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.A","family":"Mansukhani","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunila","family":"Jaggi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukund R.","family":"Thatte","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/0022-510X(83)90177-6","article-title":"Somatosensory evoked potentials from musculocutaneous nerve in the diagnosis of brachial plexus injuries","volume":"61","author":"V M Synek","year":"1983","journal-title":"J Neurol Sci"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3171\/jns.1997.86.1.0069","article-title":"Diagnosis of root avulsions in traumatic brachial plexus injuries: value of computerized tomography myelography and magnetic resonance imaging","volume":"86","author":"G A Carvalho","year":"1997","journal-title":"J Neurosurg"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1177\/1753193411422313","article-title":"Imaging and electrodiagnostic work-up of acute adult brachial plexus injuries","volume":"36","author":"K O'Shea","year":"2011","journal-title":"J Hand Surg Eur Vol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.hcl.2004.09.007","article-title":"Planning brachial plexus surgery: treatment options and priorities","volume":"21","author":"R H Brophy","year":"2005","journal-title":"Hand Clin"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1590\/S0004-282X2011000400023","article-title":"Surgical treatment of adult traumatic brachial plexus injuries: an overview","volume":"69","author":"M G Siqueira","year":"2011","journal-title":"Arq Neuropsiquiatr"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.2214\/ajr.167.5.8911196","article-title":"Detection of nerve rootlet avulsion on CT myelography in patients with birth palsy and brachial plexus injury after trauma","volume":"167","author":"A T Walker","year":"1996","journal-title":"AJR Am J Roentgenol"},{"issue":"S 01","key":"ref7","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.1148\/rg.26si065511","article-title":"Brachial plexus injury: clinical manifestations, conventional imaging findings, and the latest imaging techniques","volume":"26","author":"T Yoshikawa","year":"2006","journal-title":"Radiographics"},{"issue":"237","key":"ref8","first-page":"24","article-title":"Clinical diagnosis, testing, and electromyographic study in brachial plexus traction injuries","author":"R D Leffert","year":"1988","journal-title":"Clin Orthop Relat Res"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1002\/mus.20131","article-title":"Brachial plexopathies: classification, causes, and consequences","volume":"30","author":"M A Ferrante","year":"2004","journal-title":"Muscle Nerve"},{"key":"ref10","volume-title":"Nerves and Nerve Injuries","author":"S Sunderland","year":"1978"},{"issue":"S 04","key":"ref11","doi-asserted-by":"crossref","first-page":"A153","DOI":"10.1227\/01.NEU.0000338429.66249.7D","article-title":"Electromyography, nerve action potential, and compound motor action potentials in obstetric brachial plexus lesions: validation in the absence of a \u201cgold standard\u201d","volume":"65","author":"M J Malessy","year":"2009","journal-title":"Neurosurgery"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1136\/jnnp.21.2.109","article-title":"Sensory nerve action potentials in patients with peripheral nerve lesions","volume":"21","author":"R W Gilliatt","year":"1958","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1097\/00006534-200010000-00022","article-title":"The surgical treatment of brachial plexus injuries in adults","volume":"106","author":"J K Terzis","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1055\/s-2005-867112","article-title":"Radiological and electrophysiological detection of nerve roots avulsion in patients with birth-related brachial plexus paralysis","volume":"19","author":"J K Terzis","year":"2005","journal-title":"Semin Plast Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3171\/2011.12.PEDS11416","article-title":"Utility of electrodiagnostic testing and computed tomography myelography in the preoperative evaluation of neonatal brachial plexus palsy","volume":"9","author":"K L VanderHave","year":"2012","journal-title":"J Neurosurg Pediatr"},{"key":"ref16","first-page":"427","article-title":"Management and results of treating obstetrical palsy in the new-born","volume":"55","author":"A Gilbert","year":"2009","journal-title":"Neurochirurgie"},{"issue":"10","key":"ref17","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1016\/j.ejrad.2011.10.007","article-title":"Diagnostic accuracy of MRI in adults with suspect brachial plexus lesions: a multicentre retrospective study with surgical findings and clinical follow-up as reference standard","volume":"81","author":"A Tagliafico","year":"2012","journal-title":"Eur J Radiol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1055\/s-2008-1047271","article-title":"Traktionsverletzungen des Plexus brachialis: radiologischeDiagnostikmitMyelo-CT und MR","volume":"151","author":"U Blum","year":"1989","journal-title":"RoFo Fortschr Geb Rontgenstr Nuklearmed"},{"issue":"S 03","key":"ref19","first-page":"277","article-title":"Cervical nerve root avulsion in brachial plexus injuries: magnetic resonance imaging classification and comparison with myelography and computerized tomography myelography","volume":"96","author":"K Doi","year":"2002","journal-title":"J Neurosurg"}],"container-title":["Indian Journal of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1760253.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:19:31Z","timestamp":1675383571000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1760253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":19,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,1,20]]},"published-print":{"date-parts":[[2022,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1760253","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0970-0358","1998-376X"],"issn-type":[{"value":"0970-0358","type":"print"},{"value":"1998-376X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}