Transfer of pectoral nerves to the musculocutaneous nerve in obstetric upper brachial plexus palsy.
OBJECTIVE
To investigate the results of transfer of pectoral nerves to the musculocutaneous nerve for treatment of obstetric brachial palsy.


METHODS
In 25 cases of obstetric brachial palsy (20 after breech deliveries), branches of the pectoral nerve plexus were transferred directly to the musculocutaneous nerve. For all patients, the nerve transfer was part of an extended brachial plexus reconstruction. Results were tested both clinically and with the Mallet scale, at a mean follow-up time of 70 months (standard deviation, 34.3 mo).


RESULTS
There were two complete failures, which were attributable to disconnection of the transferred nerve endings. The results after transfer were excellent in 17 cases and fair in 5 cases. Steindler flexorplasty improved elbow flexion for three patients.


CONCLUSIONS
Transfer of pectoral nerves to the musculocutaneous nerve for treatment of obstetric upper brachial palsy may be effective, if the specific anatomic features of the pectoral nerve plexus are sufficiently appreciated.
Blaauw
Gerhard
G
Department of Neurosurgery, University Hospital Maastricht, Maastricht, The Netherlands. gerhard.blaauw@planet.nl
Slooff
Albert C J
AC
D000293:Adolescent; D001720:Birth Injuries / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009138:Musculocutaneous Nerve / Q000503:physiopathology / Q000601:surgery*; D009416:Nerve Regeneration / Q000502:physiology*; D016067:Nerve Transfer; D017063:Outcome Assessment, Health Care; D010243:Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function / Q000502:physiology; D013900:Thoracic Nerves / Q000503:physiopathology / Q000637:transplantation*; D013997:Time Factors