The Journal of hand surgery
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This report describes a simple technique for identifying the phrenic nerve at the beginning of exploration of the brachial plexus in obstetrical palsy. Both the phrenic and supraclavicular nerves originate from the C4 root; therefore, retrograde dissection of the supraclavicular nerve will end at the C4 root and identify the phrenic nerve. This technique is very useful to less experienced surgeons but may also be helpful when the experienced surgeon encounters excessive scarring of the anterior scalene muscle. Finally, the dissected supraclavicular nerve may be used as a cable graft in brachial plexus reconstruction.
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To determine the clinical outcome of patients with perilunate and lunate dislocations treated with a combined dorsal and volar approach and intraosseous cerclage wire. ⋯ Our results show that a combined dorsal and volar approach with an intraosseous wiring technique can restore effectively normal intercarpal relationships, providing acceptable pain relief, functional motion, and grip strength.