METHOD OF CHOOSING A SURGICAL APPROACH FOR CLOSED INJURIES OF THE BRACHIAL PLEXUS WITH A SYNDROME OF COMPLETE CONDUCTION DISTURBANCE ALONG ITS TRUNKS Russian patent published in 2023 - IPC A61N2/08 A61B5/05 

FIELD: medicine; neurosurgery.

SUBSTANCE: invention can be used to select a surgical approach for closed injuries of the brachial plexus with a syndrome of complete conduction disturbance along its trunks. Magnetic stimulation is performed with an assessment of the presence of evoked muscle responses EMR from the muscles innervated by the damaged trunk of the peripheral nerve. The electrodes are placed on the muscles innervated by the long motor branches of the brachial plexus: on one of the heads of the triceps muscle of the shoulder, which abducts the fifth finger of the hand, on the short muscle that abducts the first finger of the hand, on one of the heads of the biceps of the shoulder. Then a stimulus is applied with a coil of a magnetic stimulator to the area of the projection of the branches of the brachial plexus with registration of the EMR below M1 and above M2 of the level of the clavicle. The ratio of M1 to M2 values of each motor nerve of the brachial plexus is determined. When the value of the ratio of M1 to M2 is greater than 1.5 at all registration points, an extra-projective surgical access to the primary branches of the brachial plexus is performed. When M1 to M2 is less than 0.5 at all points of registration, projection access along the deltoid-pectoral sulcus, followed by microsurgical neurolysis of the secondary branches of the brachial plexus is performed. When M1 to M2 is greater than or equal to 0.5 and less than or equal to 1.5 at least at one of the registration points, extended access to the brachial plexus, including revision and neurolysis of both primary and secondary branches of the brachial plexus is performed.

EFFECT: invention allows to reduce the duration of the intervention and the amount of intraoperative blood loss by performing a surgical approach in only one topographic-anatomical region, either supraclavicular or subclavian, reduce the trauma of the manipulations and create prerequisites for faster healing of the postoperative wound by reducing the length of the incision and the tissue dissection area.

1 cl, 5 ex