© 2001 the British Journal of Sports Medicine
Commentary
Consultant Neurosurgeon, Department of Neurosurgery, Austin and Repatriation Medical Centre, Burgundy Street, Heidelberg, Victoria 3084, Australia gadavis@netspace.net.au
see also page 361I congratulate the authors on a functionally good outcome in this case, but a few points on traumatic plexus injury require further comment.
Injuries to the brachial plexus are best categorised as "in continuity" or "not in continuity" (or transections). A nerve can be transected sharply, as in a sharp knife injury, or, more commonly, there is blunt transection (such as a kick from a horse). Blunt transection results in nerve injury not only at the site of transection, but injury extends proximally and distally along the nerve for a variable distance, depending on the degree of associated "stretch" injury and contusion. Macroscopic and electrophysiological delineation of this extra length of injury takes a few weeks to occur. Therefore repair of a blunt transection should not be performed earlier than two weeks after such an injury. When immediate repair of associated injuries occurs, such as repair
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Br. J. Sports Med. 2001 35: 361-362.
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