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A Study on the Mechanism

Jack H. M. Kwaan, MD; Irving Rappaport, MD

AMA Arch Surg. 1970;101(5):612-615.

Abstract
This investigation attempts to define the contributing factor in postoperative brachial plexus palsy by means of a correlative anatomical and clinical study. Tension recording along the brachial plexus was made on nine fresh cadavers by means of a spring guage placed in series with the nerve plexus. Increasing nerve tension or stretch was observed with the arm in progressive abduction. In 39 patients affected by this neurological defect as reported in the literature, hyperabduction of the arm was also noted in the majority of instances. Excessive nerve stretch is believed to be an important causal factor. Observations of brachial plexus tension, with reference to various arm position outlined in this study, may serve as a guide in the prevention of this paralytic disability.

Author Affiliations
Irvine, Calif

From the Department of Surgery, University of California, Irvine, and the Surgical Services of the Orange County Medical Center.

Footnotes
Accepted for publication March 23, 1970.

Read before the sectional meeting of the Southern California Chapter of the American College of Surgeons, Coronado, Calif, Jan 16, 1970.

Reprint requests to Department of Surgery, Orange County Medical Center, Orange, Calif 92668 (Dr. Kwaan).

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