title: End-to-side radial sensory to median nerve transfer to restore sensation and relieve pain in C5 and C6 nerve root avulsion.
abstract: OBJECTIVE
  To report the results of end-to-side nerve transfer of the superficial radial nerve into the median nerve for restoration of sensation and pain relief at the dorsal radial aspect of the hand in C5 and C6 root avulsion.
  
  
  METHODS
  Eight patients with a mean age of 32 years, with paresthesia and pain at the dorsal radial aspect of the hand due to upper brachial plexus injuries, had end-to-side nerve transfer of the superficial radial nerve into the ulnovolar part of the median nerve. Five patients had S0 and 3 patients had S1 sensory evaluation at the dorsal radial aspect of the affected hand. We evaluated patients for pain using a visual analog scale. We assessed sensory recovery with the Semmes-Weinstein monofilament test and British Medical Research Score, respectively. The follow-up period ranged from 24 to 36 months (average, 28 mo).
  
  
  RESULTS
  Six patients had S2 and 2 patients had S3. All patients perceived at least one number lower of the Semmes-Weinstein filament in the dorsal radial aspect of the affected hand compared with the preoperative status. The best result was perception of the 3.61 filament in 2 patients. No downgrading of the donor nerve was observed after surgery. All patients had relief of pain 2 weeks after surgery, and the pain decreased dramatically at the last follow-up.
  
  
  CONCLUSIONS
  This method is a reliable, effective, and simple procedure. We recommend this sensory nerve transfer as an additional procedure to the combined motor nerve transfers to relieve pain and restore sensation in the dorsal radial aspect of the hand in patients who have C5 and C6 root avulsion.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Upper Extremity andReconstructive Microsurgery Unit, Instituteof Orthopedics, Lerdsin General Hospital, Bangkok, Thailand. somsakortho@gmail.com
authors.forename: Somsak
authors.initials: S
authors.lastname: Leechavengvongs
authors.forename: Kittipod
authors.initials: K
authors.lastname: Ngamlamiat
authors.forename: Kanchai
authors.initials: K
authors.lastname: Malungpaishrope
authors.forename: Chairoj
authors.initials: C
authors.lastname: Uerpairotkit
authors.forename: Kiat
authors.initials: K
authors.lastname: Witoonchart
authors.forename: Somchai
authors.initials: S
authors.lastname: Kulkittiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001917:Brachial Plexus / Q000293:injuries*; D002574:Cervical Vertebrae / Q000294:innervation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000601:surgery*; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D010147:Pain Measurement; D011826:Radial Nerve / Q000601:surgery*; D011843:Radiculopathy / Q000175:diagnosis / Q000601:surgery*; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D012678:Sensation Disorders / Q000175:diagnosis*; D016896:Treatment Outcome; D055815:Young Adult