Transfer of the medial pectoral nerve: myth or reality?
OBJECTIVE
Transfer of the medial pectoral nerve is one of the most controversial procedures used to reinnervate the paralyzed upper arm because of brachial plexus spinal nerve root avulsion or directly irreparable proximal lesions of spinal nerves. The purpose of this study was to determine the value of this type of nerve transfer to the musculocutaneous and axillary nerves.


METHODS
The 25 patients included in the study comprised 14 patients who had nerve transfer to the musculocutaneous nerve and 11 who underwent nerve transfer to the axillary nerve. These patients' functional recovery and the time course of their recovery were analyzed according to the type of transfer of one donor nerve or the donor nerve in combination with other donors.


RESULTS
Useful functional recovery was achieved in 85.7% of patients who had nerve transfer to the musculocutaneous nerve and in 81.8% of patients who underwent nerve transfer to the axillary nerve. There was no significant difference in results with regard to the type of nerve transfer and which recipient nerves were involved. A strong trend toward better results after procedures involving the use of a donor nerve combined with other donors was observed, however.


CONCLUSIONS
Our surgical results suggest that the transfer of the medial pectoral nerve to the musculocutaneous nerve and also to the axillary nerve may be a reliable and effective procedure.
Samardzic
Miroslav
M
Institute of Neurosurgery, Clinical Center of Serbia, Belgrade, Yugoslavia. gruj@infosky.net
Grujicic
Danica
D
Rasulic
Lukas
L
Bacetic
Dragoljub
D
D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000294:innervation; D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000601:surgery*; D002648:Child; D006801:Humans; D008875:Middle Aged; D009138:Musculocutaneous Nerve / Q000601:surgery; D010243:Paralysis / Q000209:etiology / Q000601:surgery*; D020127:Recovery of Function; D013900:Thoracic Nerves / Q000637:transplantation*; D014947:Wounds and Injuries / Q000150:complications