{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:02:38Z","timestamp":1790319758065,"version":"4.1.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Classically, C5\u20137 root injuries of the brachial plexus have been associated with palsies of shoulder abduction\/external rotation, elbow flexion\/extension, and wrist, thumb, and finger extension. However, current myotome maps generally indicate that C-8 participates in the innervation of thumb and finger extensors. Therefore, the authors have hypothesized that, for palsies of the thumb and finger extensors, the injury should affect the C-5 through C-8 roots.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors tested their hypothesis in 30 patients with upper-type palsies of the brachial plexus. They traced a correlation between clinical findings and root injury, as documented by CT myelography, direct visualization during surgery, and electrophysiological studies.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>In C5\u20138 root injuries, shoulder abduction and external rotation were paralyzed, and in all patients, wrist extensors were paralyzed. However, in 22 of the 30 patients, wrist extension was possible, because of contraction of the extensor digitorum communis and extensor pollicis longus. Wrist flexion and pronation also were preserved. The T-1 root contributed significantly to innervation of the thumb and finger flexors, ensuring 34% grasping and 40% pinch strength relative to the normal side. Hand sensation was largely preserved.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Based on the authors' observations, they suspect that the clinical scenario previously attributed to a C5\u20137 root injury is, in fact, a C5\u20138 root injury. The authors propose referring to this partial palsy of the brachial plexus as a \u201cT-1 hand.\u201d<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.7.jns11672","type":"journal-article","created":{"date-parts":[[2011,8,19]],"date-time":"2011-08-19T13:59:20Z","timestamp":1313762360000},"page":"409-413","source":"Crossref","is-referenced-by-count":34,"title":["C5\u20138 brachial plexus root injury: the \u201cT-1 hand\u201d"],"prefix":"10.3171","volume":"116","author":[{"given":"Jayme Augusto","family":"Bertelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Fl\u00e1vio","family":"Ghizoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11672","series-title":"J Bone Joint Surg Br","first-page":"10","article-title":"Traction injuries of the brachial plexus in adults","volume":"31B","author":"Barnes","year":"1949"},{"key":"b2-jns11672","series-title":"J Hand Surg Am","first-page":"387","article-title":"Very distal sensory nerve transfers in high median nerve lesions","volume":"36","author":"Bertelli","year":"2011"},{"key":"b3-jns11672","series-title":"Hand Clin","first-page":"687","article-title":"Brachial plexus dorsal rhizotomy in hemiplegic cerebral palsy","volume":"19","author":"Bertelli","year":"2003"},{"key":"b4-jns11672","series-title":"J Neurosurg","first-page":"105","article-title":"The human cervical myotomes: functional anatomy studied at operation","volume":"28","author":"Brendler","year":"1968"},{"key":"b5-jns11672","series-title":"Microsurgery","first-page":"107","article-title":"Microscopic anatomy of the adult human brachial plexus: an anatomical and histological basis for microsurgery","volume":"5","author":"Bonnel","year":"1984"},{"key":"b6-jns11672","series-title":"J Neurosurg","first-page":"69","article-title":"Diagnosis of root avulsions in traumatic brachial plexus injuries: value of computerized tomography myelography and magnetic resonance imaging","volume":"86","author":"Carvalho","year":"1997"},{"key":"b7-jns11672","series-title":"Muscle Nerve","first-page":"547","article-title":"Brachial plexopathies: classification, causes, and consequences","volume":"30","author":"Ferrante","year":"2004"},{"key":"b8-jns11672","series-title":"Handbook of Neurosurgery","first-page":"521","author":"Greenberg","year":"2001"},{"key":"b9-jns11672","series-title":"Anatomie des Nerfs Craniens et Rachidiens et du Syst\u00e8me Grand Sympathique","first-page":"508","author":"Hovelacque","year":"1927"},{"key":"b10-jns11672","series-title":"J Electromyogr Kinesiol","first-page":"1","article-title":"Can muscle coordination be precisely studied by surface electromyography?","volume":"21","author":"Hug","year":"2011"},{"key":"b11-jns11672","series-title":"Am J Anat","first-page":"285","article-title":"The brachial plexus of nerves in man: the variations in its formation and branches","volume":"23","author":"Kerr","year":"1918"},{"issue":"5","key":"b12-jns11672","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Mechanisms of injury in operative brachial plexus lesions","volume":"16","author":"Kim","year":"2004"},{"key":"b13-jns11672","series-title":"Clin Anat","first-page":"363","article-title":"An evidence-based approach to human dermatomes","volume":"21","author":"Lee","year":"2008"},{"key":"b14-jns11672","series-title":"Brachial Plexus Injuries","author":"Leffert","year":"1985"},{"key":"b15-jns11672","series-title":"Singapore Med J","first-page":"464","article-title":"A review of the T2 segment of the brachial plexus","volume":"51","author":"Loukas","year":"2010"},{"key":"b16-jns11672","series-title":"Les Paralysies du Plexus Brachial","first-page":"52","article-title":"Examen du patient et de la fonction des divers groupes musculaires du membre sup\u00e9rieur","author":"Narakas","year":"1995"},{"key":"b17-jns11672","series-title":"Examination of Peripheral Nerve Injuries: An Anatomical Approach","author":"Russell","year":"2006"},{"key":"b18-jns11672","series-title":"La Main. Anatomie Fonctionnelle et Examen Clinique","author":"Tubiana","year":"1990"},{"key":"b19-jns11672","series-title":"J Electromyogr Kinesiol","first-page":"249","article-title":"Can needle-EMG correctly diagnose combinations of two damaged nerves?","volume":"14","author":"Yaar","year":"2004"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/2\/article-p409.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/2\/article-p409.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/2\/article-p409.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:40:21Z","timestamp":1679877621000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/2\/article-p409.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,2]]},"references-count":19,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2011.7.jns11672","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2]]}}}