Hand prehension recovery after brachial plexus avulsion injury by performing a full-length phrenic nerve transfer via endoscopic thoracic surgery.
OBJECTIVE
The functional recovery of hand prehension after complete brachial plexus avulsion injury (BPAI) remains an unsolved problem. The authors conducted a prospective study to elucidate a new method of resolving this injury.


METHODS
Three patients with BPAI underwent a new procedure during which the full-length phrenic nerve was transferred to the medial root of the median nerve via endoscopic thoracic surgery support. All 3 patients were followed up for a postoperative period of > 3 years.


RESULTS
The power of the palmaris longus, flexor pollicis longus, and the flexor digitorum muscles of all 4 fingers reached Grade 3-4/5, and no symptoms of respiratory insufficiency occurred.


CONCLUSIONS
Neurotization of the phrenic nerve to the medial root of the median nerve via endoscopic thoracic surgery is a feasible means of early hand prehension recovery after complete BPAI.
Department of Hand Surgery, Hua-Shan Hospital, Shanghai Medical College, Shanghai, PR China.
Wen-Dong
WD
Xu
Jiu-Zhou
JZ
Lu
Yan-Qun
YQ
Qiu
Su
S
Jiang
Lei
L
Xu
Jian-Guang
JG
Xu
Yu-Dong
YD
Gu
D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D015331:Cohort Studies; D006225:Hand / Q000294:innervation / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D016067:Nerve Transfer / Q000379:methods*; D010791:Phrenic Nerve / Q000601:surgery*; D020127:Recovery of Function / Q000502:physiology; D013906:Thoracoscopy; D016896:Treatment Outcome