[Nerve transfer in traction injuries of the brachial plexus].
BACKGROUND
The aim of this study was to analyze the results of nerve transfer to the musculocutaneous and axillary nerves, using some technical modalities such as intercostal, spinal accessory or intraplexal transfer, and on the basis of the results to try to clarify the most common controversies concerning these operations.


METHODS
The study included 82 patients with brachial plexus traction injuries, who were operated on using various techniques of nerve transfer. The follow-up period was at least two years. The analysis of biceps and deltoid muscles recovery was performed according to the type of the donor nerve.


RESULTS
The corresponding rates of recovery for the musculocutaneous and axillary nerves were 46.7% and 68.1% in intercostal nerve transfer, 71.4% and 75% in accessory nerve transfer, 93.1% and 88.8% in nerve transfer of the brachial plexus collateral branches, and 55.5% and 60% in classical intraplexal nerve transfer, respectively. Comparative statistical analysis demonstrated significantly better final outcome and quality of recovery in regional nerve transfers in comparison to the other methods.


CONCLUSIONS
Our findings suggest that nerve transfer of collateral branches, where possible, (such as in cases with upper or extended upper brachial plexus palsy) might be a method of choice, offering better results and quality of recovery.
Samardzić
Miroslav
M
Klinicki centar Srbije, Institut za neurohirurgiju, Beograd.
Grujicić
Danica
D
Rasulić
Lukas
L
Bacetić
Dragoljub
D
Milicić
Biljana
B
D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer; D016896:Treatment Outcome