Neurotization of elements of the brachial plexus.
Satisfactory therapy for an avulsion injury of the brachial plexus has yet to be described. Dorsal root entry zone lesions will usually mitigate the searing pain which is so disabling in some of these patients. Neurotization procedures are effective in restoring limited function to these patients. The most useful isolated movement of the upper extremity is elbow flexion, which is thus the primary target of neurotization procedures. Intercostal nerves and elements of the cervical plexus are the most commonly used donor nerves for neurotization procedures. From our experience and from a review of the literature, it appears that these procedures will be successful in approximately 50% of cases. It must be stressed that before performing a nerve transfer, the surgeon must be certain that the patient is not a candidate for a simple nerve graft.
Friedman
A H
AH
Duke University Medical Center, Durham, North Carolina.
D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D002648:Child; D006801:Humans; D008866:Microsurgery; D009416:Nerve Regeneration / Q000502:physiology*; D016067:Nerve Transfer / Q000379:methods*; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000503:physiopathology; D013126:Spinal Nerve Roots / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D013524:Surgical Flaps