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  1. Article ; Online: Updates in diagnostic tools for diagnosing nerve injury and compressions.

    Bourke, Gráinne / Wade, Ryckie G / van Alfen, Nens

    The Journal of hand surgery, European volume

    2024  , Page(s) 17531934241238736

    Abstract: Predicting prognosis after nerve injury and compression can be challenging, even for the experienced clinician. Although thorough clinical assessment can aid diagnosis, we cannot always be precise about long-term functional recovery of either motor or ... ...

    Abstract Predicting prognosis after nerve injury and compression can be challenging, even for the experienced clinician. Although thorough clinical assessment can aid diagnosis, we cannot always be precise about long-term functional recovery of either motor or sensory nerves. To evaluate the severity of nerve injury, surgical exploration remains the gold standard, particularly after iatrogenic injury and major nerve injury from trauma, such as brachial plexus injury. Recently, advances in imaging techniques (ultrasound, magnetic resonance imaging [MRI] and MR neurography) along with multimodality assessment, including electrodiagnostic testing, have allowed us to have a better preoperative understanding of nerve continuity and prediction of nerve health and possible recovery. This article outlines the current and potential roles for clinical assessment, exploratory surgery, electrodiagnostic testing ultrasound and MRI in entrapment neuropathies, inflammatory neuritis and trauma. Emphasis is placed on those modalities that are improving in diagnostic accuracy of nerve assessment before any surgical intervention.
    Language English
    Publishing date 2024-03-27
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2272801-6
    ISSN 2043-6289 ; 1753-1934
    ISSN (online) 2043-6289
    ISSN 1753-1934
    DOI 10.1177/17531934241238736
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  2. Article: Microsurgical Reconstruction for Reanimation of Foot Dorsiflexion in Children.

    Allen, Luke C E / Bourke, Grainne

    Plastic and reconstructive surgery. Global open

    2022  Volume 10, Issue 3, Page(s) e4041

    Abstract: Foot drop is a debilitating condition, which causes physical disability and psychological challenges associated with difficulties walking. We report the indications, novel technique, and successful outcomes of two children (three limbs) who underwent ... ...

    Abstract Foot drop is a debilitating condition, which causes physical disability and psychological challenges associated with difficulties walking. We report the indications, novel technique, and successful outcomes of two children (three limbs) who underwent free functional gracilis muscle transfers coaptated to the common peroneal nerve to reanimate active foot dorsiflexion and correct foot drop secondary to loss of the anterior compartment.
    Language English
    Publishing date 2022-03-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000004041
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  3. Article: Small Leaves, Big Diversity: Citizen Science and Taxonomic Revision Triples Species Number in the Carnivorous

    Krueger, Thilo / Robinson, Alastair / Bourke, Greg / Fleischmann, Andreas

    Biology

    2023  Volume 12, Issue 1

    Abstract: ... The ... ...

    Abstract The carnivorous
    Language English
    Publishing date 2023-01-16
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2661517-4
    ISSN 2079-7737
    ISSN 2079-7737
    DOI 10.3390/biology12010141
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  4. Article ; Online: Combination of a free vascularised fibula and the Masquelet technique for long bone ulna defect reconstruction: A case report.

    Wright, Edmund Hugh / Bourke, Grainne / Giannoudis, Peter V

    Trauma case reports

    2022  Volume 39, Page(s) 100619

    Abstract: We present a case of spontaneous osteomyelitis of the left ulna in a 25-year-old man. There was no history of trauma or haematogenous source identified. Bone biopsy ... ...

    Abstract We present a case of spontaneous osteomyelitis of the left ulna in a 25-year-old man. There was no history of trauma or haematogenous source identified. Bone biopsy found
    Language English
    Publishing date 2022-02-07
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2835433-3
    ISSN 2352-6440 ; 2352-6440
    ISSN (online) 2352-6440
    ISSN 2352-6440
    DOI 10.1016/j.tcr.2022.100619
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  5. Article: Brachial plexus deficits in patients undergoing shoulder arthroplasty.

    Cochrane, Elliott / Vollans, Sam / Bourke, Gráinne

    Shoulder & elbow

    2022  Volume 15, Issue 1 Suppl, Page(s) 65–70

    Abstract: Background: Nerve deficit following shoulder arthroplasty can cause significant morbidity. We examined the incidence and pattern of nerve injury following shoulder arthroplasty in a University Hospital.: Methods: Retrospective review of all patients ... ...

    Abstract Background: Nerve deficit following shoulder arthroplasty can cause significant morbidity. We examined the incidence and pattern of nerve injury following shoulder arthroplasty in a University Hospital.
    Methods: Retrospective review of all patients undergoing shoulder arthroplasty over a five-year period (September 2014 to August 2019). Patients were identified using clinical codes and relevant data extracted by review of patient records. We excluded patients with preoperative nerve injuries.
    Results: 220 arthroplasties were performed in 210 patients. The overall nerve deficit rate was 2.3% (5/220). Five nerve deficits occurred following reverse total shoulder arthroplasty (rTSA). In two patients, nerve recovery occurred within 12 months. Two patients had persistent deficits at 12 months. One patient had a deficit at seven months, but incomplete follow up. There was no clear documentation of discussions with clinicians specialising in nerve injury.
    Conclusion: Nerve injury rates in our series for rTSA are low and comparable to systematic review data. We purport that for rTSA, adequate soft tissue releases, careful arm positioning and retraction alongside limiting over-lowering the centre of rotation may prevent nerve injuries. A postoperative nerve deficit should warrant an opinion from a specialist in nerve surgery with clear referral pathways to allow efficient access to services.
    Language English
    Publishing date 2022-03-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2503275-6
    ISSN 1758-5732
    ISSN 1758-5732
    DOI 10.1177/17585732221089299
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  6. Article ; Online: Hand surgery training in the United Kingdom: why it is not a separate speciality.

    Ng, Chye Yew / Bourke, Grainne / Hobby, Jonathan

    The Journal of hand surgery, European volume

    2022  Volume 47, Issue 6, Page(s) 672–674

    MeSH term(s) Attitude of Health Personnel ; Hand/surgery ; Humans ; Specialties, Surgical ; United Kingdom
    Language English
    Publishing date 2022-04-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2272801-6
    ISSN 2043-6289 ; 1753-1934
    ISSN (online) 2043-6289
    ISSN 1753-1934
    DOI 10.1177/17531934221095454
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  7. Article ; Online: Prevalence and risk factors for nerve injury following shoulder dislocation.

    Hardie, C M / Jordan, R / Forker, O / Fort-Schaale, A / Wade, R G / Jones, J / Bourke, G

    Musculoskeletal surgery

    2022  Volume 107, Issue 3, Page(s) 345–350

    Abstract: Background: The glenohumeral joint dislocation can be associated with major nerve injury. The reported prevalence and risk factors for major nerve injury are variable and this injury can have a severe and life-long impact on the patient. The objectives ... ...

    Abstract Background: The glenohumeral joint dislocation can be associated with major nerve injury. The reported prevalence and risk factors for major nerve injury are variable and this injury can have a severe and life-long impact on the patient. The objectives of this study were to analyse the prevalence of major nerve injury following shoulder dislocation and examine risk factors. Management and outcomes of nerve injury were explored.
    Methods: A 1 year retrospective cohort study of 243 consecutive adults who presented with a shoulder dislocation was performed. Data were collected on patient demographics, timings of investigations, treatment, follow-up, and nerve injury prevalence and management. The primary outcome measure was prevalence of nerve injury. Risk factors for this were analysed using appropriate tests with Stata SE15.1.
    Results: Of 243 patients with shoulder dislocation, 14 (6%) had neurological deficit. Primary dislocation (p = 0.004) and older age (p = 0.02) were significantly associated with major nerve injury. Sex, time to successful reduction and force of injury were not associated with major nerve injury in this cohort. Patients with nerve injury made functional recovery to varying degrees. Recurrent shoulder dislocation was common accounting for 133/243 (55%) attendances.
    Conclusions: Shoulder dislocation requires careful assessment and timely management in the ED. A 6% rate of nerve injury following shoulder dislocation was at the lower border of reported rates (5-55%), and primary dislocation and older age were identified as risk factors for nerve injury. We emphasise the importance of referring patients with suspected major nerve injury to specialist services.
    MeSH term(s) Adult ; Humans ; Shoulder Dislocation/complications ; Shoulder Dislocation/epidemiology ; Retrospective Studies ; Prevalence ; Risk Factors ; Recovery of Function ; Shoulder
    Language English
    Publishing date 2022-11-29
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2495458-5
    ISSN 2035-5114 ; 2035-5106
    ISSN (online) 2035-5114
    ISSN 2035-5106
    DOI 10.1007/s12306-022-00769-4
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  8. Article ; Online: Diagnostic accuracy of magnetic resonance imaging for nerve injury in obstetric brachial plexus injury: protocol for systematic review and meta-analysis.

    Hardie, Claire / Brooks, James / Wade, Ryckie / Teh, Irvin / Bourke, Grainne

    Systematic reviews

    2022  Volume 11, Issue 1, Page(s) 173

    Abstract: Background: Early and accurate clinical diagnosis of the extent of obstetric brachial plexus injury (OBPI) is challenging. The current gold standard for delineating the nerve injury is surgical exploration, and synchronous reconstruction is performed if ...

    Abstract Background: Early and accurate clinical diagnosis of the extent of obstetric brachial plexus injury (OBPI) is challenging. The current gold standard for delineating the nerve injury is surgical exploration, and synchronous reconstruction is performed if indicated. Magnetic resonance imaging (MRI) is a non-invasive method of assessing the anatomy and severity of nerve injury in OBPI but the diagnostic accuracy is unclear. The primary objective of this review is to determine the diagnostic accuracy of MRI in comparison to surgical brachial plexus exploration for detecting root avulsion in children under 5 with OBPI. The secondary objectives are to determine its' diagnostic accuracy for detecting nerve abnormality and detecting pseudomeningocele(s) in this group.
    Methods: This review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).We will include studies reporting the accuracy of MRI (index test) compared to surgical exploration (reference standard) in detecting any of the three target conditions (root avulsion, any nerve abnormality and pseudomeningocele) in children under five with OBPI. Case reports and studies where the number of true positives, false positives, true negatives and false negatives cannot be derived will be excluded. We plan to search PubMed, Embase and CENTRAL for relevant studies from database inception to 15 June 2022. We will also search grey literature (medRxiv, bioRxiv and Google Scholar) and perform forward and backward citation chasing. Screening and full-text assessment of eligibility will be conducted by two independent reviewers, who will then both extract the relevant data. The QUADAS-2 tool will be used to assess methodological quality and risk of bias of included studies by two reviewers independently. The following test characteristics for the target conditions will be extracted: true positives, false positives, true negatives and false negatives. Estimates of sensitivity and specificity with 95% confidence intervals will be shown in forest plots for each study. If appropriate, summary sensitivities and specificities for target conditions will be obtained via meta-analyses using a bivariate model.
    Discussion: This study will aim to clarify the diagnostic accuracy of MRI for detecting nerve injury in OBPI and define its clinical role.
    Systematic review registration: PROSPERO CRD42021267629.
    MeSH term(s) Brachial Plexus/diagnostic imaging ; Brachial Plexus/injuries ; Child, Preschool ; Humans ; Magnetic Resonance Imaging/methods ; Meta-Analysis as Topic ; Sensitivity and Specificity ; Systematic Reviews as Topic
    Language English
    Publishing date 2022-08-20
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2662257-9
    ISSN 2046-4053 ; 2046-4053
    ISSN (online) 2046-4053
    ISSN 2046-4053
    DOI 10.1186/s13643-022-02037-9
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  9. Article ; Online: An accessory muscle as the possible cause of ulnar nerve compression proximal to the cubital canal: a case report.

    Wright, Hugh / Fahmy, Miriam / Bourke, Grainne

    The Journal of hand surgery, European volume

    2021  Volume 46, Issue 10, Page(s) 1114–1115

    MeSH term(s) Cubital Tunnel Syndrome/etiology ; Cubital Tunnel Syndrome/surgery ; Elbow ; Forearm ; Humans ; Muscles ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes/diagnostic imaging ; Ulnar Nerve Compression Syndromes/etiology ; Ulnar Nerve Compression Syndromes/surgery ; Wrist
    Language English
    Publishing date 2021-06-09
    Publishing country England
    Document type Case Reports ; Letter
    ZDB-ID 2272801-6
    ISSN 2043-6289 ; 1753-1934
    ISSN (online) 2043-6289
    ISSN 1753-1934
    DOI 10.1177/17531934211022162
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  10. Article ; Online: Multidisciplinary reconstructive management of residual recalcitrant empyema cavity: A retrospective observational cohort study.

    Allen, Luke Ce / Milton, Richard / Bourke, Grainne

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2021  Volume 75, Issue 3, Page(s) 1057–1063

    Abstract: Background: Patients with stage III empyema require chest wall fenestration to enable lung re-expansion and continuous drainage of the persisting empyema cavity. This chronic wound negatively affects patients' exercise tolerance, ability to carry out ... ...

    Abstract Background: Patients with stage III empyema require chest wall fenestration to enable lung re-expansion and continuous drainage of the persisting empyema cavity. This chronic wound negatively affects patients' exercise tolerance, ability to carry out activities of daily living, and quality of life.
    Methods: Eight consecutive patients underwent chest wall reconstruction following fenestration and were followed up over a minimum of 12 months. This study included adult patients (over 18 years of age). There were no exclusion criteria. Data were collected retrospectively.
    Results: Eight patients (six male and two female), with a mean age of 56 years (range, 22-76), were included. All of them had comorbidities including history of neoplasia (n = 6), atrial fibrillation (n = 3), and hypertension (n = 2). Aetiology of empyema included lung cancer resection complicated by bronchopleural fistula (n = 4), pneumonia (n = 2), and pleural effusion (n = 2). Five patients had a low metabolic reserve evident by a low BMI (range, 16-22), and a median malnutrition universal screen tool (MUST) score of 2 (range, 1-4). Following intensive infection control and nutritional support, patients underwent reconstruction 11 months (median; range 5-51) after fenestration. Seven patients were followed up and had no recurrence of empyema and bronchopleural fistula. They all reported significant improvements in their quality of life, and their Eastern Cooperative Oncology Group (ECOG) performance status improved from three to one. One patient died 56 days post-reconstruction from cardiorespiratory failure, which required readmission to hospital.
    Conclusion: We demonstrate that free tissue reconstruction including multidisciplinary input and optimisation at all stages of care successfully closes residual recalcitrant empyema cavity without recurrence and leads to significant improvements in the quality of life.
    MeSH term(s) Activities of Daily Living ; Adolescent ; Adult ; Bronchial Fistula/surgery ; Empyema, Pleural/surgery ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies
    Language English
    Publishing date 2021-10-22
    Publishing country Netherlands
    Document type Journal Article ; Observational Study
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2021.09.073
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