{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:36:42Z","timestamp":1787935002503,"version":"build-2784847793"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2014,2]]},"abstract":"\n Object<\/jats:title>\n The debate addressed in this article is that of surgical treatment methods for a neuroma-in-continuity. The authors of this study chose to test the hypothesis that more severe nerve injuries, as distinguished by < 50% conduction across a neuroma-in-continuity, could be treated with neuroma resection and grafting, whereas less severe nerve injuries, with > 50% conduction across the neuroma, could be treated with neurolysis alone.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The goal of this study was to compare preoperative and postoperative Active Movement Scale (AMS) scores in children with upper trunk brachial plexus birth injuries treated with neurolysis alone if the neuroma's conductivity was > 50% on intraoperative nerve testing. Seventeen patients (7 male, 10 female) met the criteria for inclusion in this study. Surgery was done when the patients were an average of 10 months old (range 6\u201319 months). The authors analyzed AMS scores from the preoperative assessment, 1-year postoperative follow-up visit, and subsequent follow-up assessment as close to 3 years after surgery as possible (referred to in this paper as > 2-year postoperative scores).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Comparison of preoperative and 1-year follow-up data showed significant improvement in shoulder abduction, flexion, external rotation, and internal rotation; elbow flexion and supination; and wrist extension. Comparison of preoperative findings and results of assessment at > 2-year follow-up showed significant improvement in shoulder abduction, flexion, external rotation; and elbow flexion and supination. At final follow-up, useful function (AMS score of 6 or 7) was achieved for elbow flexion in 14 of 16 patients, shoulder flexion in 11 of 15 patients, shoulder abduction in 11 of 16 patients, and shoulder external rotation in 5 of 15 patients.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This report indicates that there is a subgroup of patients who can benefit clinically, with functional improvement of shoulder and elbow function, from treatment with neurolysis alone for upper trunk lesions demonstrating more than 50% conduction across the neuroma on intraoperative nerve testing. Patients with less than 50% conduction, indicating more severe disease, are treated with nerve resection and grafting in the authors' treatment algorithm.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2013.10.peds1345","type":"journal-article","created":{"date-parts":[[2013,12,13]],"date-time":"2013-12-13T10:22:34Z","timestamp":1386930154000},"page":"229-237","source":"Crossref","is-referenced-by-count":23,"title":["Neurolysis alone as the treatment for neuroma-in-continuity with more than 50% conduction in infants with upper trunk brachial plexus birth palsy"],"prefix":"10.3171","volume":"13","author":[{"given":"Emily","family":"Andrisevic","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshall","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Gillette Children's Specialty Healthcare, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Partington","sequence":"additional","affiliation":[{"name":"Gillette Children's Specialty Healthcare, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Agel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann E.","family":"Van Heest","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis; and"},{"name":"Gillette Children's Specialty Healthcare, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds1345","series-title":"Z Kinderchir","first-page":"335","article-title":"Early surgical exploration and epineural repair in birth brachial palsy","volume":"41","author":"Alanen","year":"1986"},{"key":"b2-peds1345","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3171\/2008.12.PEDS0885","article-title":"Navigating the gray zone: a guideline for surgical decision making in obstetrical brachial plexus injuries. 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Natural history, indications for surgical repair and results","volume":"70","author":"Boome","year":"1988"},{"key":"b5-peds1345","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1097\/00006534-199810000-00032","article-title":"Neuroma-in-continuity resection: early outcome in obstetrical brachial plexus palsy","volume":"102","author":"Capek","year":"1998"},{"key":"b6-peds1345","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1097\/00006534-199604001-00014","article-title":"Obstetrical brachial plexus palsy: results following neurolysis of conducting neuromas-in-continuity","volume":"97","author":"Clarke","year":"1996"},{"key":"b7-peds1345","series-title":"Hand Clin","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/S0749-0712(21)00264-X","article-title":"An approach to obstetrical brachial plexus injuries","volume":"11","author":"Clarke","year":"1995"},{"key":"b8-peds1345","series-title":"J Hand Surg Am","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1053\/jhsu.2002.32965","article-title":"The active movement scale: an evaluative tool for infants with obstetrical brachial plexus palsy","volume":"27","author":"Curtis","year":"2002"},{"key":"b9-peds1345","series-title":"J Child Neurol","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1177\/08830738040190020101","article-title":"Outcome following nonoperative treatment of brachial plexus birth injuries","volume":"19","author":"DiTaranto","year":"2004"},{"key":"b10-peds1345","series-title":"Hand Clin","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/S0749-0712(21)00266-3","article-title":"Long-term evaluation of brachial plexus surgery in obstetrical palsy","volume":"11","author":"Gilbert","year":"1995"},{"key":"b11-peds1345","series-title":"The Hand","first-page":"575","article-title":"Obstetrical brachial plexus palsy","volume":"4","author":"Gilbert","year":"1993"},{"key":"b12-peds1345","series-title":"J Hand Surg Br","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/J.JHSB.2004.03.008","article-title":"Shoulder function following late neurolysis and bypass grafting for upper brachial plexus birth injuries","volume":"29","author":"Grossman","year":"2004"},{"key":"b13-peds1345","series-title":"J Hand Surg Am","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.jhsa.2009.11.026","article-title":"Current concepts in the management of brachial plexus birth palsy","volume":"35","author":"Hale","year":"2010"},{"issue":"215","key":"b14-peds1345","series-title":"Clin Orthop Relat Res","first-page":"233","article-title":"Early microsurgical reconstruction in birth palsy","author":"Kawabata","year":"1987"},{"key":"b15-peds1345","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"197","DOI":"10.3171\/jns.1993.79.2.0197","article-title":"Neurosurgical correction of upper brachial plexus birth injuries","volume":"79","author":"Laurent","year":"1993"},{"key":"b16-peds1345","series-title":"J Child Neurol","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1177\/088307389400900202","article-title":"Birth-related upper brachial plexus injuries in infants: operative and nonoperative approaches","volume":"9","author":"Laurent","year":"1994"},{"key":"b17-peds1345","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1097\/PRS.0b013e318199f4eb","article-title":"Final results of grafting versus neurolysis in obstetrical brachial plexus palsy","volume":"123","author":"Lin","year":"2009"},{"key":"b18-peds1345","series-title":"The Paralysed Hand","first-page":"116","article-title":"Obstetrical brachial plexus injuries","volume":"2","author":"Narakas","year":"1987"},{"key":"b19-peds1345","series-title":"Neurol Clin","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1016\/S0733-8619(18)30850-8","article-title":"Use of peripheral nerve action potentials for intraoperative monitoring","volume":"6","author":"Nelson","year":"1988"},{"key":"b20-peds1345","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"e214","DOI":"10.1542\/peds.2009-0913","article-title":"New intrauterine growth curves based on United States data","volume":"125","author":"Olsen","year":"2010"},{"key":"b21-peds1345","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1227\/00006123-198804000-00016","article-title":"Preliminary experiences with brachial plexus exploration in children: birth injury and vehicular trauma","volume":"22","author":"Piatt","year":"1988"},{"key":"b22-peds1345","series-title":"Clin Plast Surg","first-page":"77","article-title":"Pediatric microsurgery. 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