Nerve Transfers in Severe Obstetrical Brachial Plexus Palsy
Bibliographic record
Abstract
Nerve transfers are increasingly utilized for repair of servere brachial plexus injuries and, indeed, are the only option when the proximal spine nerve roots have been avulsed from the spinal cord. The procedure essentially involves the coaption of a proximal foreign nerve to the distal denervated nerve, so that the latter will be reinnervated by the donated axons. The primary goal of surgery in the severe obstetrical brachial plexus palsy case is to return proximal arm function, particularly elbow flexion and a stable, dynamic shoulder that can abduct and externally rotate. Neural input should thus be directed first to the biceps via the musculocutaneous nerve or its branches, and next to reconstructing the suprascapular nerve. Unlike an adult with a complete palsy, where the return of distal hand function is virtually impossible, the infant has better odds of successful reinnervation of the hand. If donor nerve sources are available following repair of the musculocutaneous and suprascapular nerves, grafts can be directed to the radial (for wrist and finger extention) and median (for elbow and finger flexion and critical hand sensibility) nerves. Recovery of intrinsic hand muscle function from plexus reconstruction in the global severe palsy case is not a realistic possibility at present. Cortical plasticity, which is likely more prevelent in the baby than the adult, appears to play an important physiological role in the functional recovery of the reinnervated muscles following nerve transfers. KEYWORDS Brachial plexus injury - nerve repair - neurotization - baby
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".